PROMETHEUS

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PROMETHEUS

Provider payment Reform for Outcomes, Margins, Evidence, Transparency, Hassle-reduction, Excellence, Understandability and Sustainability. A bundled payment project sponsored by the Robert Wood Johnson Foundation, which develops "evidence-informed case rates" for various conditions that are adjusted for severity and complexity of a patient's illness, and used to set budgets for episodes of care. If actual quarterly spending by healthcare providers is under budget, the providers receive a bonus; if actual quarterly spending is over budget, payment to the providers is partially withheld.
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The apotheosis of Promethean science was the atomic bomb, which once again stole the gods' fire for mortal use.
Four years ago in this column I criticized the Promethean wing's dominance in the scientific establishment.
These Promethean contrarians offer the promise of profligate energy use and industrial expansion with no negative consequences, but rarely publish in peer-reviewed scientific literature, and sometimes show a cavalier disregard for basic scientific norms.
If audacious defiance is a characteristic of the Promethean attitude, it is surely not sufficient; for intrinsic to Prometheans are the centrality of intellect and reason, necessary to moderate the will and harmonize the world.
Are Prometheans never overcome by depression or despair?
No doubt we need conservative doubters who will seek to restrain at times the inflated sense of arrogance and power of unrestricted Prometheans.
It is the task of Prometheans in our midst to beckon us--not to retreat, not to cower with fear and trembling, not to be overcome by fatigue, nor to give up--but to exceed ourselves by resolve, strength, and fortitude.