Dollar Payments Research Articles

Open Payments Data Analysis of General and Fellowship-trained Surgeons Receiving Industry General Payments from 2016 to 2020: Payment Disparities and COVID-19 Pandemic Impact.

To characterize industry non-research payments made to general and fellowship-trained surgeons between 2016-2020. The Centers for Medicare & Medicaid Services Open Payments Data (OPD) reports industry payments made to physicians related to drugs and medical devices. General payments are those not associated with research. OPD data were queried for general and fellowship-trained surgeons who received general payments from 2016 to 2020. Payments' nature, amount, company, covered product, and location were collected. Surgeons' demographics, subspecialty, and leadership roles in hospitals, societies, and editorial boards were evaluated. From 2016 to 2020, 44,700 general and fellowship-trained surgeons were paid $535,425,543 in 1,440,850 general payments. The median payment was $29.18. The most frequent payments were for food and beverage (76.6%) and travel and lodging (15.6%); however, the highest dollar payments were for consulting fees ($93,128,401; 17.4%), education ($88,404,531; 16.5%), royalty or license ($87,471,238; 16.3%), and travel and lodging ($66,333,149; 12.4%). Five companies made half of all payments ($265,654,522; 49.6%): Intuitive Surgical ($128,517,411; 24%), Boston Scientific ($48,094,570; 9%), Edwards Lifesciences ($41,835,544, 7.8%), Medtronic Vascular ($33,607,136; 6.3%), and W. L. Gore & Associates ($16,626,371; 3.1%). Medical devices comprised 74.7% of payments ($399,897,217), followed by drugs and biologicals ($33,945,300; 6.3%). TX, CA, FL, NY, and PA received the most payments; however, the top dollar payments were in CA ($65,702,579; 12.3%), MI ($52,990,904, 9.9%), TX ($39,362,131; 7.4%), MD ($37,611,959; 7%), and FL ($33,417,093, 6.2%). General surgery received the highest total payments ($245,031,174; 45.8%), followed by thoracic surgery ($167,806,514; 31.3%) and vascular surgery ($60,781,266; 11.4%). A total of 10,361 surgeons were paid >$5,000, of which 1,614 were women (15.6%); in this group, men received higher payments than women (means, $53,446 vs. $22,571; P<0.001) and thoracic surgeons received the highest payments (mean, $76,381; NS, P=0.14). A total of 120 surgeons were paid >$500,000 ($203,011,672; 38%) - 5 non-Hispanic white (NHW) women (4.2%) and 82 NHW (68.3%), 24 Asian (20%), 7 Hispanic (5.8%), and 2 Black (1.7%) men; in this group, men received higher payments than women (means, $1,735,570 vs. $684,224), and NHW men received payments double those of other men (means, $2,049,554 vs. $955,368; NS, P=0.087). Among these 120 highly paid surgeons (>$500,000), 55 held hospital and departmental leadership roles, 30 were leaders in surgical societies, 27 authored clinical guidelines, and 16 served on journal editorial boards. During COVID-19, 2020 experienced half the number of payments than the preceding 3 years. General and fellowship-trained surgeons received substantial industry non-research payments. Highest paid recipients were men. Further work is warranted in assessing how race, gender, and leadership roles influence the nature of industry payments and surgical practice. A significant decline in payments was observed early during the COVID-19 pandemic.

Estimating costs of anesthesia supplies for intraoperative infection control

BackgroundSome costs for anesthesia supplies to reduce intraoperative infections depend on the procedure and duration of the case. For regular anesthesia supplies and medications, costs are linearly related to American Society of Anesthesiologists’ Relative Value Guide units, known for nearly all cases in the United States of America. We hypothesized linear association between costs of infection control items and anesthesia units. MethodsA prospective observational study of 38 surgical cases was performed. Usage of anesthesia infection control supplies was recorded: alcohol hand dispensers, microfiber cloths for machine disinfection, and disinfecting and cleaning caps for syringe tips, Luer connectors, and stopcocks. Cost per case was calculated using 2022 US dollar payments for those items. ResultsUsing least squares linear regression to associate the anesthesia units (base + time) with supply costs, in addition to intercept and linear slope, none of 5 potential extra non-linear terms were significant (all P ≥ .46). Further assessment showed lack of fit to a quadratic model. Pearson linear correlation coefficient between cost and units was 0.88. An example was created showing how to forecast annual infection control supply costs for anesthesia based on the linear model. ConclusionsFor purposes of predicting intraoperative anesthesia supplies to reduce bacterial transmission in the anesthesia workspace, a valid approach is to assume a linear association with the total anesthesia units, a predictor generally known for all anesthetics.

What is money? A lawyer’s perspective on the evolution of the US payment system and dollars in the digital age

This paper analyses the current frictions, and opportunities for evolution, in the US dollar payment system, by viewing money through the lens of network effects, interoperability, and their legal underpinnings. It gives a lawyer’s perspective on the workings of the US payment system and lessons from history, including the free banking era. This paper also discusses current developments, such as various central bank digital currency proposals and private sector stablecoin developments, in this context. The goal is to contribute to the discussion around the future of the US payment system, toward greater efficiency that does not risk introducing instability.

Globalization and sovereignization in the light new theory of money

Recently, both in publicistic speeches and in scientific works, globalization is almost always considered in opposite aspects: either as an extremely positive strategy that allows countries to embark on the path of progressive development, or, on the contrary, prevents it. In fact, globalization itself does not lead to either negative or positive consequences, since it is an objective economic law, i.e. a law that operates independently of the will and consciousness of people. And these people either know how to use its results for the benefit of the country’s development, or not. Hence, the task of understanding the mechanisms and practices of globalization becomes urgent, first of all, by the leaders of the country’s economic bloc. But without relying on the laws of monetary circulation, which are directly related and affect the processes of globalization, it will be impossible to preserve and strengthen the sovereignty of the country, which was the subject of this work. Based on the study, it was shown that Russia and other countries can become truly sovereign states if they abandon payments in dollars and switch to digital national currencies and discrete exchange rates (DCR), and the activities of exchanges will be focused on the national economy in accordance with the laws monetary circulation.

Physician Reimbursement for Endoscopic Submucosal Dissection: A Single Center Analysis

Background and AimsEndoscopic Submucosal Dissection (ESD) has become an established procedure for resection of pre-malignant lesions. Despite its benefits and cost-effectiveness, there are significant challenges to bring ESD to mainstream practice given the unpredictability of reimbursement. ESD is submitted for billing purposes without dedicated Current procedural terminology codes. We analyzed physician component billing and reimbursement data indexed to time, procedure location, and insurance type. MethodsAll physician billing claims and reimbursement data for ESD cases performed between January 2017 and December 2019 in a single tertiary referral center were included. Procedure type was grouped by lesion location: esophageal ESD, gastric and/or duodenal ESD, and colon and/or rectal ESD. To normalize the data, we divided the total dollar payment by the number of hours it took to complete the procedure. ResultsCompleted insurance claims were available for 163 procedures, and 134 met criteria for this study. In our analysis there were 42 government, 92 private insurance payers. The mean charge was $3562.31 for government claims and $3471.33 for private claims. The mean payment was $905.01 (range: $55.64-6140) for government payers, and $1134.24 (range: $44.26-3500) for private payers. The average payment per procedure was $886.43 for esophageal ESD, $732.71 for gastric or duodenal ESD and $1325.35 for colon and/or rectal ESD. The mean $ amount for claims paid for all endoscopic mucosal resection performed in the same time period was $405.50 (range: $106-$1775). ConclusionESD is consistently under-reimbursed across insurance types when compared to surgical alternatives and endoscopist time. With proven efficacy, safety and cost-saving data, appropriate Current procedural terminology codes should be provided for ESD.

A Lawyer's Perspective on U.S. Payment System Evolution and Money in the Digital Age

This article analyzes the current frictions, and opportunities for evolution, in the U.S. dollar payment system, by viewing money through the lens of network effects, interoperability, and their legal underpinnings. It gives a lawyer’s perspective on the workings of the U.S. payment system and lessons from history, including the free banking era. This article also discusses current developments, such as various central bank digital currency (CBDC) proposals and private-sector stablecoin developments, in this context. The goal is to contribute to the discussion around the future of the U.S. payment system, toward greater efficiency that does not come at the cost of introducing instability.

Gender Disparity in 2013-2018 Industry Payments to Plastic Surgeons.

The gender pay gap in medicine has been under intense scrutiny in recent years; female plastic surgeons reportedly earn 11% less than their male peers. "Hidden" pay in the form of industry-based transfers exposes compensation disparity not captured by traditional wage-gap estimations. The aim of this study was to reveal the sex distribution of industry payments to board-certified plastic surgeons across all years covered by the Center for Medicare and Medicaid Services Open Payment Database (CMS OPD). We obtained the National Provider Identifier (NPI) for each surgeon in the American Society of Plastic Surgeons (ASPS) member directory to record gender. Next, "General Payments" data points from annual files for all years present in the CMS OPD, 2013 to 2018, were aggregated and joined to provider details by Physician Profile ID before quantitative analysis was performed. Of 4840 ASPS surgeons, 3864 (79.8%) reporting ≥1 industry payment were included with 3220 male (83.3%) and 644 female (16.7%). Over 2013 to 2018, females received mean [standard deviation] 56.01 [2.51] payments totaling $11,530.67 [$1461.45] each vs 65.70 [1.80] payments totaling $25,469.05 [$5412.60] for males. The yearly ratio of male-to-female payments in dollars was 2.36 in 2013, 2.69 in 2014, 2.53 in 2015, 2.31 in 2016, 1.72 in 2017, and most recently 1.96 in 2018. Individual male plastic surgeons received over twice the payment dollars given to their female counterparts, accepting both more frequent and higher-value transfers from industry partners. Payment inequity slightly declined in recent years, which may indicate shifting industry engagement gender preferences.

The Economics of Soft Dollars: A Review of the Literature and New Evidence from the Implementation of MiFID II

For nearly half a century, the bundling of research services into commissions that paid for the execution of securities trades has been the focus of both policy discussion and academic debate. The practice whereby asset management firms make use of investor funds to cover the costs of research, known as “soft dollar” payments in the United States, resembles a form of kickback or self-dealing. The payments allow asset managers to use investor funds to subsidize the cost of the asset managers’ own research efforts even though those managers charge investors a separate and explicit management fee for advisory services. So why does this form of kickback continue to exist? Over the years, defenders of the practice have argued that soft dollars mitigate principal-agent problems between the investment manager and the broker, improve fund performance, and provide a public good in terms of the increased production of research on public companies. This article evaluates these theoretical arguments through the lens of academic work done in the past as well as an emerging new body of empirical studies exploring the impact of MiFID II, a European Union Directive that severely restricted the use of soft dollar payments in European capital markets as of January 2018. The weight of empirical evidence, including recent evidence coming out of Europe, suggests that the theoretical arguments in favor of soft dollars are not robust. In particular, MiFID II’s unbundling of commissions appears to have, on balance, improved European market efficiency by eliminating redundancy and producing information that is of greater value to investors.

SUN-249 Growth Hormone Utilization By US Youth: Trends as Insurance Pushes Back after FDA-Approved Expansion

In 2003 US FDA approved growth hormone (GH) treatment for idiopathic short stature (ISS), expanding potential eligibility for GH treatment from 1:3500 children with GH deficiency to the shortest 1.2% of the US population, at a potential estimated national cost of $40 billion. In response, over the last decade or so, the insurance industry has been instituting progressive restrictions on coverage for GH treatment, adopting formulary preference coverage strategies as a cost-containing measure, adopting more stringent plan-specific criteria for coverage, and denying any coverage for GH treatment of ISS. Using Optum administrative claims data (Clinformatics DataMart™ 7.0, 2017), which covers an annual 18 million individuals enrolled in commercial health plans, we sought to investigate how utilization of GH drugs by youth has changed in response to FDA approval of GH treatment for ISS, and secular changes in utilization as insurers have imposed greater barriers to GH treatment reimbursements. For our analysis, we included individuals aged 0-18 years who had insurance coverage between 2001 and 2016 for 6 or more months in any given year. Linear time trends in prevalence and financial burden were tested using t-tests with Bonferroni correction. Because of the long time frame covered, we analyzed payments in both nominal dollars and real dollars (1982-84 CPI-deflated). The number of members with GH prescriptions per 10,000 beneficiaries under age 18 rose steadily from 5.1 in 2001 to14.6 in 2016 (total on GH=38,857), without a dramatic change around 2003, the ISS approval date. The proportion of females receiving GH treatment dropped (34% to 28%) as did the proportion of white youth (80% to 77%), while proportions of black (3% to 4%) and Asian (1% to 4%) youth increased. Mean and median ages were 12-13 throughout. Total GH expenditures decreased (by 6% in nominal and 27% in real dollars), as did the estimated insurance-paid amount (by 8% in nominal and 28% in real dollars). However, mean copayments, deductibles and total patient financial burden increased (total up by 234% in nominal and 161% in real dollars). Between 2001 and 2007, beneficiaries switching GH brands at least once in the year ranged from 1.4 to 3.6%. After 2007, the range rose to 5.1-8.8%, with 25.6% switching in 2009 and 13.9% switching in 2015. In conclusion, the FDA ISS approval was not a watershed event in the steady increase in GH utilization by US youth. Progressive restrictions on coverage and formulary preference coverage strategies appear to have succeeded in lowering the total cost and insurer burden of GH treatment. However, those savings were not passed on to patients, who bear higher burdens financially and from brand switches. These patterns are consistent with broader US trends of increased patient cost-sharing and aggressive use of formularies and coverage restrictions to limit insurer exposure to high specialty drug prices.

“ИНТЕГРАЦИЯ ИНТЕГРАЦИЙ” И ПЕРСПЕКТИВЫ БРИКС+

During 2017 BRICS Summit the Chinese government announced the idea to promote the &ldquo;BRICS Plus&rdquo; cooperation approach, encouraging closer partnership among the group of emerging markets and developing countries. The idea was fixed in the final declaration, but the mechanism of its implementation remains uncertain, as well as the list of participants. The paper aims at reflecting Russian approach to the implementation of the &ldquo;BRICS Plus&rdquo; concept and exploring direction of potential cooperation among the countries of the expanded format. The key idea underlying our projections is that all the BRICS countries are leading economies within one of the regional integration arrangements on their continents, so the member countries of these five integration blocks may form the &lsquo;BRICS Plus circle&rsquo; for flexible and multi-dimensional cooperation. The implementation of the &ldquo;BRICS+&rdquo; idea may push interaction within a group of developing countries for strengthening stability and enhancing their role in the world economy. The new expanded format of &ldquo;BRICS Plus&rdquo; can serve as a platform for linking regional integration associations in two ways: (1) expansion of trade cooperation at the trans-regional level, gradual harmonization of foreign trade policies within five integration associations and (2) gradual shift of trans-regional agenda from trade cooperation to a wider range of areas. The author stresses, that in trade cooperation particular attention must be paid to the harmonization of technical regulations, as well as sanitary and phyto-sanitary standards. Besides, the expanded format of &ldquo;BRICS Plus&rdquo; may provide a network of bilateral currency swap agreements aimed at reducing dollar payments and stimulating settlements in national currencies. The system of currency swap agreements can be supplemented by the networks of interbank local currency credit lines agreements and harmonization of banking rules and procedures. The author concludes, that according to contemporary priorities of the developing countries and regional agendas of the five integration blocks the new directions of trans-regional cooperation may include (1) harmonization of e-commerce policies and creation of a common e-commerce information space (trans-regional e-Commerce platform) (2) inter-state cooperation in the interests of small and medium enterprises (3) creation of a consolidated technological platform at &ldquo;BRICS Plus&rdquo; level.

SFS 1-85 (1973-2001) Available

216 SCIENCE FICTION STUDIES, VOLUME 46 (2019) currency. Sometimes publishers had to pay in foreign currency, which was always scarce in the communist economy; but science-fiction rights were not high on a list of commodities to be bought for hard currency. If Dick had insisted on a payment in dollars, Ubik simply would not have appeared in a Polish translation in 1972. But Lem got enough money from other socialist countries—at official exchange rates. If he traveled to Prague and Bratislava (in the 1950s and 1960s it must have been), it was presumably on shopping sprees. In Poland itself, with its economy of dearth, many things simply were not available. Czechosovlakia was a relatively rich country, its cities had not been destroyed by the war, and stores were well stocked, much better than in Poland; so his Czechoslovak income was valuable there, but pretty worthless in Poland, for lack of goods to be bought. Although printings were large in Communist times, books were cheap, and the money not worth much. And in the 1970s, when Lem’s books took off in the German Federal Republic (where he got more royalties than in the rest of the world combined), he earned millions of German marks, which he could dispose of in Poland at blackmarket rates. Then Lem’s income from Communist countries became simply negligible and irrelevant. In Poland, the US dollar was the unofficial currency; its value was excessively high, and for German marks or dollars you could buy in Poland things that were not available otherwise. In this way, Italian marble intended for the renovation of Wawel Castle turned up in the bathrooms of Lem’s luxurious new house, which he had built in the late 1970s. And with his mounting success abroad (while he was neglected at home), his position became in reality unassailable. If Lem often traveled (in the 1970s and early 1980s) to (West)Berlin, it was because the city could be easily reached by car and the East German border-guards, unlike the Polish ones, knew and liked Lem’s books and did not search his car. In addition, because of the special political status of Berlin, Poles could enter the city without needing visas for the German Federal Republic, so there was no red tape to be overcome.—Franz Rottensteiner, Vienna SFS 1-85 (1973-2001) Available. Here is an opportunity for some lucky SFS reader to acquire all the issues from the first, in 1973, up until the end of 2001. All 85 issues are in at least good condition and almost all of them are like new. The SFS website offers the issues from 1980 on. But 20 numbers from 1980 to 2001 are no longer available there, and all issues prior to that date are sold out. Furthermore, the price at that source is $20 each. At $20 each, my holding would come to $1,700. My price, $475, is therefore less than 30% of what you would have to pay if all 85 issues were available from SFS itself. Moreover, my asking price includes shipping (but only to US and Canadian addresses). I also have a number of post-2001 issues available if you can send me a wantlist at .—RMP Call for Essays on “Intersectional Automations: Robotics, AI, Algorithms, and Equity.” This collection will explore a range of situations where robotics, biotechnological enhancement, artificial intelligence (AI), and algorithmic culture collide with intersectional social-justice issues such as race, class, ...

Lem, Philip K. Dick, and Royalties in the Soviet Era

215 NOTES AND CORRESPONDENCE NOTES AND CORRESPONDENCE Lem, Philip K. Dick, and Royalties in the Soviet Era. Marcin Wo³k’s review essay on “Stanis³aw Lem, Holocaust Survivor” (SFS 45.2 [2018]): 33240 ) offers a balanced review of the books by Agnieszka Gajewska and Wojciech Orliñski, including the fact that Lem’s statements about himself are not to be trusted; yet it also contains mistakes and inaccuracies, supposedly because the reviewer takes Orliñski at face value. In note 13, for instance, Wo³k claims that Lem already foresaw in his Dialogi (1957) that “no totalitarian regime could be sustained in the long run because there would be no positive feedback from society” (339); he is obviously referring to the essay “Cybernetyka stosowana: przyk³ad z diedziny socjologii” [Applied cybernetics: an example from the realm of sociology]. But this was added as “Annex I”—“Dialogi po szesnastu latach” [Dialogues after 16 years]—in the second edition of Dialogi in 1972. In 1957 there could hardly have been published in Poland an essay that opens with the statement that “So far there exists no textbook on the pathology of socialist administration.” This piece is, by the way, Lem’s most open political statement in Communist times, and his best political essay. So much for the increased censorship after 1970! Yet in 1972 it is far less impressive a prophecy than it would have been in 1957. Wo³k argues that “Lem’s letters to his most important translators and publishers (Franz Rottensteiner, Michael Kandel, Wolfgang Thadewald, Virgiljus Èepaitis)” (337) also constitute a significant source. Michael Kandel was of course an important Lem translator, and about the only one with whom he conducted an extensive correspondence. But as far as I can find out, Virgilijus Èepaitis, the Lithuanian translator, publisher, and politician, translated only Lem’s “The Chain of Chance” (into Russian) and never was Lem’s publisher. Wolfgang Thadewald was a German science-fiction fan and Lem’s agent for the German language. Unless one counts my sf fanzine, I was never Lem’s publisher, though I was his literary agent up to 1995 in the West (with the exception of Germany) and a free-lance editor for the Insel/ Suhrkamp group responsible for many of Lem’s German appearances. But I never was a “major” Lem translator. I Englished just a few of Lem’s critical writings from German and translated Lem’s “Mein Leben” into English; it had been commissioned by Gale Research for the first volume of their CONTEMPORARY AUTHORS AUTOBIOGRAPHICAL series. When Lem learned that the fee was $1,000, he wrote the piece at once in German, assuming that I would translate it into English. I did and then sold magazine rights for $10,000 to The New Yorker, where it appeared as “Chance and Order” (30 Jan. 1984). The Gale Research publication, which contains photos, is apparently unknown in Poland. The review claims that “in the socialist economic reality, the royalties from foreign film-makers and publishers had to be collected abroad in person and spent there” (337). This does not apply to Lem, for of course there existed a system for the transfer of royalties among socialist countries. The case of Philip K. Dick is quite different, for Dick had signed a contract specifying payment in Polish zloties. And those zloties were not transferable into hard 216 SCIENCE FICTION STUDIES, VOLUME 46 (2019) currency. Sometimes publishers had to pay in foreign currency, which was always scarce in the communist economy; but science-fiction rights were not high on a list of commodities to be bought for hard currency. If Dick had insisted on a payment in dollars, Ubik simply would not have appeared in a Polish translation in 1972. But Lem got enough money from other socialist countries—at official exchange rates. If he traveled to Prague and Bratislava (in the 1950s and 1960s it must have been), it was presumably on shopping sprees. In Poland itself, with its economy of dearth, many things simply were not available. Czechosovlakia was a relatively rich country, its cities had not been destroyed by the war, and stores were well stocked, much better than in...

Lem, Philip K. Dick, and Royalties in the Soviet Era

215 NOTES AND CORRESPONDENCE NOTES AND CORRESPONDENCE Lem, Philip K. Dick, and Royalties in the Soviet Era. Marcin Wo³k’s review essay on “Stanis³aw Lem, Holocaust Survivor” (SFS 45.2 [2018]): 33240 ) offers a balanced review of the books by Agnieszka Gajewska and Wojciech Orliñski, including the fact that Lem’s statements about himself are not to be trusted; yet it also contains mistakes and inaccuracies, supposedly because the reviewer takes Orliñski at face value. In note 13, for instance, Wo³k claims that Lem already foresaw in his Dialogi (1957) that “no totalitarian regime could be sustained in the long run because there would be no positive feedback from society” (339); he is obviously referring to the essay “Cybernetyka stosowana: przyk³ad z diedziny socjologii” [Applied cybernetics: an example from the realm of sociology]. But this was added as “Annex I”—“Dialogi po szesnastu latach” [Dialogues after 16 years]—in the second edition of Dialogi in 1972. In 1957 there could hardly have been published in Poland an essay that opens with the statement that “So far there exists no textbook on the pathology of socialist administration.” This piece is, by the way, Lem’s most open political statement in Communist times, and his best political essay. So much for the increased censorship after 1970! Yet in 1972 it is far less impressive a prophecy than it would have been in 1957. Wo³k argues that “Lem’s letters to his most important translators and publishers (Franz Rottensteiner, Michael Kandel, Wolfgang Thadewald, Virgiljus Èepaitis)” (337) also constitute a significant source. Michael Kandel was of course an important Lem translator, and about the only one with whom he conducted an extensive correspondence. But as far as I can find out, Virgilijus Èepaitis, the Lithuanian translator, publisher, and politician, translated only Lem’s “The Chain of Chance” (into Russian) and never was Lem’s publisher. Wolfgang Thadewald was a German science-fiction fan and Lem’s agent for the German language. Unless one counts my sf fanzine, I was never Lem’s publisher, though I was his literary agent up to 1995 in the West (with the exception of Germany) and a free-lance editor for the Insel/ Suhrkamp group responsible for many of Lem’s German appearances. But I never was a “major” Lem translator. I Englished just a few of Lem’s critical writings from German and translated Lem’s “Mein Leben” into English; it had been commissioned by Gale Research for the first volume of their CONTEMPORARY AUTHORS AUTOBIOGRAPHICAL series. When Lem learned that the fee was $1,000, he wrote the piece at once in German, assuming that I would translate it into English. I did and then sold magazine rights for $10,000 to The New Yorker, where it appeared as “Chance and Order” (30 Jan. 1984). The Gale Research publication, which contains photos, is apparently unknown in Poland. The review claims that “in the socialist economic reality, the royalties from foreign film-makers and publishers had to be collected abroad in person and spent there” (337). This does not apply to Lem, for of course there existed a system for the transfer of royalties among socialist countries. The case of Philip K. Dick is quite different, for Dick had signed a contract specifying payment in Polish zloties. And those zloties were not transferable into hard 216 SCIENCE FICTION STUDIES, VOLUME 46 (2019) currency. Sometimes publishers had to pay in foreign currency, which was always scarce in the communist economy; but science-fiction rights were not high on a list of commodities to be bought for hard currency. If Dick had insisted on a payment in dollars, Ubik simply would not have appeared in a Polish translation in 1972. But Lem got enough money from other socialist countries—at official exchange rates. If he traveled to Prague and Bratislava (in the 1950s and 1960s it must have been), it was presumably on shopping sprees. In Poland itself, with its economy of dearth, many things simply were not available. Czechosovlakia was a relatively rich country, its cities had not been destroyed by the war, and stores were well stocked, much better than in...

&lt;em&gt;SFS&lt;/em&gt; 1-85 (1973-2001) Available

216 SCIENCE FICTION STUDIES, VOLUME 46 (2019) currency. Sometimes publishers had to pay in foreign currency, which was always scarce in the communist economy; but science-fiction rights were not high on a list of commodities to be bought for hard currency. If Dick had insisted on a payment in dollars, Ubik simply would not have appeared in a Polish translation in 1972. But Lem got enough money from other socialist countries—at official exchange rates. If he traveled to Prague and Bratislava (in the 1950s and 1960s it must have been), it was presumably on shopping sprees. In Poland itself, with its economy of dearth, many things simply were not available. Czechosovlakia was a relatively rich country, its cities had not been destroyed by the war, and stores were well stocked, much better than in Poland; so his Czechoslovak income was valuable there, but pretty worthless in Poland, for lack of goods to be bought. Although printings were large in Communist times, books were cheap, and the money not worth much. And in the 1970s, when Lem’s books took off in the German Federal Republic (where he got more royalties than in the rest of the world combined), he earned millions of German marks, which he could dispose of in Poland at blackmarket rates. Then Lem’s income from Communist countries became simply negligible and irrelevant. In Poland, the US dollar was the unofficial currency; its value was excessively high, and for German marks or dollars you could buy in Poland things that were not available otherwise. In this way, Italian marble intended for the renovation of Wawel Castle turned up in the bathrooms of Lem’s luxurious new house, which he had built in the late 1970s. And with his mounting success abroad (while he was neglected at home), his position became in reality unassailable. If Lem often traveled (in the 1970s and early 1980s) to (West)Berlin, it was because the city could be easily reached by car and the East German border-guards, unlike the Polish ones, knew and liked Lem’s books and did not search his car. In addition, because of the special political status of Berlin, Poles could enter the city without needing visas for the German Federal Republic, so there was no red tape to be overcome.—Franz Rottensteiner, Vienna SFS 1-85 (1973-2001) Available. Here is an opportunity for some lucky SFS reader to acquire all the issues from the first, in 1973, up until the end of 2001. All 85 issues are in at least good condition and almost all of them are like new. The SFS website offers the issues from 1980 on. But 20 numbers from 1980 to 2001 are no longer available there, and all issues prior to that date are sold out. Furthermore, the price at that source is $20 each. At $20 each, my holding would come to $1,700. My price, $475, is therefore less than 30% of what you would have to pay if all 85 issues were available from SFS itself. Moreover, my asking price includes shipping (but only to US and Canadian addresses). I also have a number of post-2001 issues available if you can send me a wantlist at .—RMP Call for Essays on “Intersectional Automations: Robotics, AI, Algorithms, and Equity.” This collection will explore a range of situations where robotics, biotechnological enhancement, artificial intelligence (AI), and algorithmic culture collide with intersectional social-justice issues such as race, class, ...

Reports of the dollar's demise greatly exaggerated

▀ Speculation that the dollar could lose its status as the world's main reserve currency “sooner rather than later”i looks, in our view, wide of the mark. Across a range of international uses, the dollar accounts for 40–60% of transactions – a share that has been stable or even increasing in recent years. Potential rivals are far behind, especially the Chinese renminbi, which accounts for just 1–2% of transactions. As a result, the dollar's pre‐eminence looks unlikely to be seriously threatened for many years to come. The US's gains from the dollar's global role may also be more modest than often thought. ▀ The dollar's position is supported by factors including its widespread use as a trading and commodity‐pricing currency, the size and liquidity of US financial markets, and the continued lack of a credible rival. None of these is likely to be significantly eroded in the near term, even with some moves afoot to shift away from dollar payments in oil and other areas. Historical evidence suggests that a world of multiple reserve currencies is possible but also shows it can take decades for reserve currencies to lose their dominant status.

The US dollar and its payments system: architecture and political implications

We aim here to study the frame within which the US dollar circulates, while questioning the role of the main operators which constitute the cross-border dollar payments architecture. The current dollar standard, however, allows the country which issues the currency and centralizes its payment system, through central-bank money emissions, to wield it as a political weapon and as a means to reach political standardization. Envisioning money as a payment system, this paper sheds light on the flaws inherent in the dollar payment system by emphasizing its asymmetrical nature and its reliance on a national payment system rather than on a truly international one.

Deciphering the Sunshine Act: Transparency Regulation and Financial Conflicts in Health Care.

The Physician Payments Sunshine Act ("Sunshine Act"), enacted to address financial conflicts in health care, is the first comprehensive federal legislation mandating public reporting of payments between drug companies, device manufacturers, and medicine. This article analyzes the Sunshine Act's uneven record, exploring how the law serves as an intriguing example of the uncertain case for transparency regulation in health care. The Sunshine Act's bumpy rollout demonstrates that commanding transparency through legislation can be arduous because of considerable implementation challenges. Capturing all the relevant information about financial relationships and reporting it with sufficient contextual and comparative data has proven disappointingly difficult. In addition, the law suffers from uncertainty and poor design as to the intended audience. Indeed, there is strong reason to believe that it will not significantly impact decision-making of primary recipients like patients. Yet the Sunshine Act nonetheless retains important and perhaps underappreciated value. From the almost four years of information generated, we have learned that industry-medicine financial ties vary significantly by physician specialty, and somewhat by physician gender. In many medical fields the distribution of top dollar payments tends to be heavily skewed to a few recipients, all of which have important implications for optimal management of financial conflicts and for health policy more generally. Accordingly, the Sunshine Act's greatest potential is not guiding decisions of individual patients or physicians, but its downstream effects. This Article traces how secondary audiences, such as regulators, watchdogs, and counsel are already starting to make productive use of Sunshine Act information. Public reporting has, for example, made more feasible linking industry payment information with Medicare reimbursement data. As a result, policymakers can more closely examine correlations between industry spending directed at individual physicians and their prescribing and referral decisions. Moreover, savvy counsel are recognizing that Sunshine Act information provides explosive evidence in private civil litigation and this Article explores the first wave of cases.

Industry Payments to Physicians for Opioid Products, 2013-2015.

To identify payments that involved opioid products from the pharmaceutical industry to physicians. We used the Open Payments program database from the Centers for Medicare and Medicaid Services to identify payments involving an opioid to physicians between August 2013 and December 2015. We used medians, interquartile ranges, and ranges as a result of heavily skewed distributions to examine payments according to opioid product, abuse-deterrent formulation, nature of payment, state, and physician specialty. During the study, 375 266 nonresearch opioid-related payments were made to 68 177 physicians, totaling $46 158 388. The top 1% of physicians received 82.5% of total payments in dollars. Abuse-deterrent formulations constituted 20.3% of total payments, and buprenorphine marketed for addiction treatment constituted 9.9%. Most payments were for speaking fees or honoraria (63.2% of all dollars), whereas food and beverage payments were the most frequent (93.9% of all payments). Physicians specializing in anesthesiology received the most in total annual payments (median = $50; interquartile range = $16-$151). Approximately 1 in 12 US physicians received a payment involving an opioid during the 29-month study. These findings should prompt an examination of industry influences on opioid prescribing.

Equity in Medicaid Reimbursement for Otolaryngologists.

Objective To study state Medicaid reimbursement rates for inpatient and outpatient otolaryngology services and to compare with federal Medicare benchmarks. Study Design State and federal database query. Setting Not applicable. Methods Based on Medicare claims data, 26 of the most common Current Procedural Terminology codes reimbursed to otolaryngologists were selected and the payments recorded. These were further divided into outpatient and operative services. Medicaid payment schemes were queried for the same services in 49 states and Washington, DC. The difference in Medicaid and Medicare payment in dollars and percentage was determined and the reimbursement per relative value unit calculated. Medicaid reimbursement differences (by dollar amount and by percentage) were qualified as a shortfall or excess as compared with the Medicare benchmark. Results Marked differences in Medicaid and Medicare reimbursement exist for all services provided by otolaryngologists, most commonly as a substantial shortfall. The Medicaid shortfall varied in amount among states, and great variability in reimbursement exists within and between operative and outpatient services. Operative services were more likely than outpatient services to have a greater Medicaid shortfall. Shortfalls and excesses were not consistent among procedures or states. Conclusions The variation in Medicaid payment models reflects marked differences in the value of the same work provided by otolaryngologists-in many cases, far less than federal benchmarks. These results question the fairness of the Medicaid reimbursement scheme in otolaryngology, with potential serious implications on access to care for this underserved patient population.

Professional Reimbursement by Medicaid for Cochlear Implants and Related Services.

Medicaid reimbursement rates for cochlear implants and related services fall short of the federal benchmark set by Medicare. The financial hardships of cochlear implant centers around the United States may be a repercussion of poor Medicaid reimbursement. In time, these reimbursement discrepancies could force additional Otolaryngologists and cochlear implant centers to not provide these crucial services due to financial limitations. Based on Medicare (MCR) claims data, current procedural terminology (CPT) codes used for cochlear implantation and related services were selected. Medicaid (MCD) and Medicare (MCR) payment schemes were queried for the same services in 49 states and Washington, D.C. The difference in MCD and MCR payment in dollars and percent was determined and reimbursement per relative value of work (RVU) calculated. MCD reimbursement differences (by dollar amount and by percentage) were qualified as a shortfall or excess as compared with the MCR benchmark. Marked differences in MCD and MCR reimbursement exist for all cochlear implant related services, most commonly as a substantial shortfall. The MCD shortfall varied in amount between states and great variability in reimbursement exists within and between audiology, surgery, and speech services. Shortfalls and excesses were not consistent between procedures or states. The variation in MCD payment models reflects marked differences in the value of the same work provided, which in many cases is far less than federal benchmarks. These results question the fairness of the MCD reimbursement scheme in cochlear implantation with potential serious implications on access to care for this underserved patient population.