January 2011

When the land forces of the Soviets defeated those of Germany during World War II, their T-34 was one of the best tanks in the world. But it also helped that they had only two basic types of tank, whereas the Germans fought with a hodgepodge. That made it easier for the Soviets to deal with spare parts and maintenance. In looking past the year 2000, the Pentagon is showing a similar concern for the basics of the military art.

In purchasing new aircraft, for instance, the Air Force has in the past had a system under which hordes of blue-uniformed officers would specify design requirements in excruciating detail. As these requirements proliferated and changed, costs would soar to the stratosphere. The Air Force’s latest fighter, the Lockheed F-22, breaks with this arrangement.

In his otherwise extraordinarily comprehensive and insightful article on America’s health-care crisis, John Steele Gordon failed to note the emergence over the last half-century of a form of health-care delivery and insurance that has served as an antidote to some of the ills he identified—the health maintenance organization.

Since HMO care integrates inpatient and outpatient services, the tendency to “maximize the use of hospitals, the most expensive form of medical care,” has been reversed. An additional value accrues to organizations like Kaiser Permanente, in which the physicians are an integral part of the operation: doctors are less likely to “want lots of empty beds to ensure immediate admission and lots of fancy equipment.” In fact, the efficient use of resources is a hallmark of our operation.

Author John Steele Gordon’s historical review of medicine up through about 1970 was excellent, and would have been valuable as society decides where to go from here on this complex and emotional issue had he not wandered on into prescribing remedies in an area for which he had obviously not done enough diagnostic work: Mr. Gordon’s prescribed his remedy based on a twenty-year-old diagnosis!

Examples of Mr. Gordon’s blindness to vital newer factors:

He mentions insurance companies and Blue Cross/Blue Shield continually—apparently ignorant that only 6 percent of U.S. employers today still use fully-insured health plans. He does not mention at all that 65 percent of employers today have self-funded health plans sponsored by employers and employee groups such as unions and associations. (The remaining 29 percent are semi-self-funded programs such as “minimum premium” and “experience rated.”) These self-funded plans are a big step toward the ideal Mr. Gordon and I share of personal responsibility.

As a group health insurance broker, I have never read a clearer, more comprehensive analysis of America’s healthcare crisis as detailed in John Steele Gordon’s essay (“How America’s Health Care Fell 111,” May/June).

His proposed solutions for the current crisis, which are both modest and practical, contrast sharply with the unrealistic ones offered by both Democratic and Republican candidates.

Dozens of fine performances of Dvořák’s chief American works—the Cello Concerto, New World Symphony, and American Quartet—are available on CD and tape. Mstislav Rostropovich alone has recorded the concerto seven times, including a widely admired reading with the Berlin Philharmonic under Karajan on Deutsche Grammophon. The London label offers a first-rate New World Symphony by the Vienna Philharmonic under Kiril Kondrashin with the American Suite—Dvořák’s orchestral version of the Suite for Piano he wrote in New York—filling out the disk. Also on London: the American Quartet and the E-flat Quintet on one disk, played by the Janáček Quartet and members of the Vienna Octet, respectively.

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"I did not come to America to interpret Beethoven or Wagner for the public. That is not my work and I would not waste any time on it. I came to discover what young Americans had in them and to help them express it.”

Antonín Dvořák was very clear about his mission in the New World. He never wanted to be an ambassador representing the music of the Old World, but, rather, a discoverer of what the New had to offer.

It was a woman who had brought this lion of Continental music to America—a woman and fifteen thousand dollars a year. Jeannette M. Thurber, New York society leader and arts patron, had established a National Conservatory of Music of America and had been determined to snare a recognized master to direct it. In 1891, that meant she had to look to Europe. Thurber went straight for the author of the popular Slavonic Dances and the D Minor Symphony, and once she waved her checkbook, Dvořák didn’t require much further persuasion.

Forbes magazine marks its seventy-fifth anniversary this month. It was founded by my grandfather, B. C. Forbes, in 1917 with money he had borrowed from several leading businessmen of the day. Undoubtedly they found appealing his idea for a magazine devoted to what he called “Doers and Doings”—in other words, a magazine about them.