The health-care economy is filled with unusual and even unique economic relationships. One of the least understood involves the peculiar roles of producer or “provider” and purchaser or “consumer” in the typical doctor-patient relationship. In most sectors of the economy, it is the seller who attempts to attract a potential buyer with various appealing factors of price, quality, and use, and it is the buyer who makes the decision. Such condition, however, is not common in most of the health-care industry.

    In the health-care industry, the doctor-patient relationship is the mirror image of the ordinary relationship between producer and consumer. Once an individual has chosen to see a physician — and even then there may be no real choice — it is the physician who usually makes all significant purchasing decisions: whether the patient should return “next Wednesday”, whether X-rays are needed, whether drugs should be prescribed, etc. It is rare that a patient will challenge such professional decisions or raise in advance questions about price, especially when the disease is regarded as serious.

    This is particularly significant in relation to hospital care. The physician must certify the need for hospitalization, determine what procedures will be performed, and announce when the patient may be discharged. The patient may be consulted about some of the decisions, but in general it is the doctor's judgments that are final. Little wonder then that in the eye of the hospital it is the physician who is the real “consumer”. As a consequence, the medical staff represents the “power center” in hospital policy and decision-making, not the administration.

    Although usually there are in this situation four identifiable participants— the physician, the hospital, the patient, and the payer (generally an insurance carrier or government)— the physician makes the essential decisions for all of them. The hospital becomes an extension of the physician; the payer generally meets most of the bills generated by the physician/hospital, and for the most part the patient plays a passive role. We estimate that about 75-80 percent of health-care choices are determined by physicians, not patients. For this reason, the economy directed at patients or the general is relatively ineffective.

    City College Union Inc

    Secretary/Typist

The Union is a student-run organization with a permanent staff of 20. Typing speed: at least 60 wpm.

    The ability to take shorthand dictation and a working knowledge of filling procedures are essential requirements.

    The basic salary for the position is $ 18,500 per year.

    Enquires to R. Barbar 387-5075.

    Emu Airline

    Secretary

    Emu Airline is now offering a part-time position for a secretary.

    The position offers at least 20 hours' work a week, with a view to full-time work in the future.

    Monthly salary is about $ 1,400.

    Phone 899-3264 for an appointment.

    Word Processor

    Operator (full-time)

    We need an operator to work in an office associated with the building industry. Only experiencedoperators are expected to apply.

Starting salary: $ 17,950 yearly.

    Apply in writing to:

    The Personnel Officer Hill Morgan Pty Ltd 38 Green Hill Rd. Kensington 2033.

    Sewing Machinist Wanted

    Jeans Industry

    We are an expanding clothing company located south of the city. Our products include jeans, skirts, shorts and so on. We are looking for sewing machine operators

    The factory works a 38-hour week over 4-5 days. Wages for this are $ 18,050 per year. Wages and conditions are in line with the current industrial award.

    If you are interested, come over and pick up an application form from Ripper Jeans, 23 North Ave, Beaudesert.

    Kay and Charles Giddens sold their home to start a bed and breakfast. Four years later, the couple now dishes out banana pancake breakfasts, cleans toilets, serves homemade cookies to guests in a bed and breakfast surrounded by trees on a mountain known for colorful sunsets.

    “Do I miss the freeways? Do I miss the traffic? Do I miss the trees? No,” says Ms. Giddens. “This is a phenomenon that's fairly widespread. A lot of people are rethinking their lives and figuring out what they want to do.”

    Simple living ranges from cutting down on weeknight activities to sharing housing, living closer to work and commuting(通勤) less, avoiding shopping malls, borrowing books from the library instead of buying them, and taking a cut in pay to work at a more pleasurable job.

    Vicki Robin, a writer, tells us how she deals with the changes in her budget, now far less than what she used to make.

    “You become conscious of where your money is going and how valuable it is,”Ms. Robin says. “You tend not to use thing up. You cook at home rather than eat out. You find your life is not a mess anymore, and you discover your living costs have gone way down.”

    Janet Luhrs, a lawyer, quit her job after giving birth and leaving her daughter with a babysitter for two weeks.“It was not the way I wanted to raise my kids,”she says.“Simplicity is not just about saving money ; it's about me sitting down every night with my kids to a candlelit dinner with classical music.”

    Ms. Luhrs now edits a magazines called Simple Living, which publishes tips on how to buy recycled furniture and shoes, and organize potluck（家常便饭）dinners instead of fancy receptions.

    “Simplicity is about conscious living and creating the life you want. The less stuff you buy, the less money goes out the door, and the less money you have to earn,” Ms. Luhrs explains.

    I left university with a good degree in English Literature, but no sense of what I wanted to do. Over the next six years, I was treading water, just trying to earn an income. I tried journalism, but I didn't think I was any good, then finance, which I hated. Finally, I got a job as a rights assistant at a famous publisher. I loved working with books, although the job that I did was dull.

    I had enough savings to take a year off work, and I decided to try to satisfy a deep-down wish to write a novel. Attending a Novel Writing MA course gave me the structure I needed to write my first 55,000 words.

    It takes confidence to make a new start — there's a dark period in-between where you're neither one thing nor the other. You're out for dinner and people ask what you do, and you're too ashamed to say, “Well, I'm writing a novel, but I'm not quite sure if I'm going to get there.” My confidence dived. Believing my novel could not be published, I put it aside.

    Then I met an agent（代理商）who said I should send my novel out to agents. So, I did and, to my surprise, got some wonderful feedback. I felt a little hope that I might actually become a published writer and, after signing with an agent, I finished the second half of the novel.

    The next problem was finding a publisher. After two-and-a-half years of no income, just waiting and wondering, a publisher offered me a book deal - that publisher turned out to be the one I once worked for.

    It feels like an unbelievable stroke of luck -of fate, really. When you set out to do something different, there's no end in sight, so to find myself in a position where I now have my own name on a contract（合同）of the publisher -to be a published writer - is unbelievably rewarding（有回报的）.

Your 2018 Reading List, Provided by Bill Gates

    Most of us can't live like billionaire Microsoft co-founder Bill Gates, but we can read like him. Gates recommended four books in 2018—though some were published earlier.

    Leonardo da Vinci, by Walter Isaacson (2017)

    The bestselling biographer of Steve Jobs and Albert Einstein researched deeply into da Vinci's contributions beyond art, highlighting the breadth of his scientific, technological, and creative output. “Leonardo nearly understood almost all of what was known on the planet at the time. That's mostly because of his curiosity about every area of natural science and the human experience,” said Gates.

    The Best We Could Do: An Illustrated Memoir, by Thi Bui (2017)

    Gates calls this graphic novel “really impressive”. Bui is the daughter of Vietnamese refugees who came to America after the fall of Saigon, and becoming a parent inspired her to look into her own parents' miserable history. “I was struck by how the experiences Bui illustrates manage to be both universal and specific to their circumstances,” said Gates.

    Lincoln in the Bardo, by George Saunders (2018)

    Saunders, a long-time short story writer, won high praise for this novel. The book imagines the ghosts that haunt (萦绕) the basement of Willie Lincoln, Abraham Lincoln's son, who died at 11 in real life. “Willie's death after the Civil War made the president have a new understanding of the grief he's creating in other families by sending their sons off to die in battle,” said Gates.

Origin Story: A Big History of Everything, by David Christian (2018)

    This new book is by the creator of Big History, a free, online social studies course. It traces history in wide, sweeping movements, starting with the Big Bang, and it provides, in effect, a short course in modern science. This is a brief history of the universe. “David gets a little stuck on the current economic and political problems in the West, and I wish he talked more about the role innovation will play in preventing the worst effects of climate change,” said Gates.

    The School has become aware that many students are being prevented from doing their work because of other students playing games and watching movies. We're sorry it's come to this, but we don't have enough resources to support everything, and our educational mission comes first.

    NO RECREATIONAL ACTIVITIES, SUCH AS GAMES AND MOVIES, ARE ALLOWED IN ANY OF THE LABS 8:30 AM TO 4:30 PM WEEKDAYS.

    Work on course-related game development is excepted. Note that it is usually very obvious whether game activity is recreational.

    MULTIPLE LOGINS AT THE SAME TIME ON THE SAME USER ACCOUNT ARE FORBIDDEN.

    If you have a course-related need for an exception to this rule, please contact the tech staff （supportatsignscs. carleton. ca）.

    For our general policy on lab usage, please see scs. carleton. ca/ labpolicy. Note that it includes:

    NO FOOD（except dry snacks and bottled drinks）

    NO PROPPING DOORS OPEN