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Many guys with low-chance prostate melanoma who undoubtedly in the past would have gone through instant surgical procedure or radiation are actually adopting a greater conservative "energetic surveillance" strategy, in keeping with an analysis of a new federal database by way of scientists from Dana-Farber melanoma Institute.
the use of energetic surveillance elevated from 14.5 p.c to forty two.1 percent of guys with low-risk prostate cancer between 2010 and 2015, talked about the researchers, led by Brandon Mahal, MD, from the branch of radiation oncology at Dana-Farber/Brigham and girls's melanoma core who led the look at posted by means of JAMA.
all through that same duration, the percentage of men undergoing radical prostatectomy (removing of the prostate gland) declined from 47.4 % to 31.three %. the use of radiotherapy for low-possibility sickness dropped from 38.0 % to 26.6 percent.
"What we be aware of from high level proof is that conservative administration of low-risk prostate cancer is linked to a extremely favorable prognosis," talked about Mahal. "Many guys with low-risk ailment are capable of be spared the toxicity of medicine so or not it's an important discussion to have between clinicians and patients."
country wide guidelines advocating conservative management as opposed to instant "definitive medication" with surgery or radiotherapy have been based in 2010 for men with low-possibility prostate melanoma. Low-chance disease is described as a small tumor restrained to the prostate gland it's assigned a grade of 6 on the Gleason scale following a biopsy; an early pathological stage, and a low PSA (prostate-particular antigen) blood stage.
Brandon Mahal, MD from the department of radiation oncology at Dana-Farber/Brigham and girls's melanoma center explains research findings on conservative administration for low-chance prostate melanoma. credit: Dana-Farber cancer Institute "This encouraging finding means that clinicians are more suitable adhering to present options and instructions for men with low-possibility prostate cancer, because the use of energetic surveillance in accurately chosen men will cut back quotes of overtreatment," mentioned Howard Soule, Ph.D., executive vp and chief science officer of the Prostate melanoma groundwork.
Mahal spoke of men with low-risk tumors have a "very, very low possibility of loss of life" from prostate melanoma, and that invasive treatments don't always increase survival odds. in the current look at, Mahal and his colleagues, together with senior creator Paul Nguyen, MD, a Dana-Farber/Brigham and ladies's melanoma center radiation oncologist, made use of a federal database that for the primary time distinct whether patients made use of watchful waiting or lively surveillance. (sufferers adopting a watchful ready approach are told to document indicators similar to changes in urinary habits, ache, or irritation, or bone ache that might mirror metastatic progression. energetic surveillance includes periodic comply with-up tests for PSA degrees, repeat biopsies, and exams via a physician every six to three hundred and sixty five days).
The analyze additionally published changes in medicine for top-risk prostate melanoma from 2010 to 2015—although the researchers had been a bit shocked by way of the findings. using radical prostatectomy increased from 38 p.c to 42.eight % all over that period, whereas radiotherapy lowered from 60.1 percent to 55 p.c.
"This shift in management patterns faraway from radiation therapy and towards more radical prostatectomy isn't supported with the aid of any fresh high-level reviews," spoke of Mahal. "This discovering is provocative and can be a focal point of debate."more information: JAMA (2019). DOI: 10.1001/jama.2018.19941 supplied with the aid of Dana-Farber melanoma Institute
citation: examine finds upsurge in 'energetic surveillance' for low-risk prostate cancer (2019, February 11) retrieved eleven February 2019 from https://medicalxpress.com/news/2019-02-upsurge-surveillance-low-possibility-prostate-melanoma.html
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Following remaining month’s tailings dam disaster at Vale’s (NYSE: VALE) Córrego do Feijão mining advanced, which left at the least one hundred forty useless, Amsterdam-primarily based accountable Mining basis issued a statement highlighting the findings of its 2018 dependable Mining Index record related to miners’ tailing dams.
in accordance with the report, many of the world’s biggest mining corporations are not in a position to ‘recognize and show’ how effortlessly they're addressing the hazards of tailings dam failure and seepage.
“The 30 mining agencies assessed in RMI 2018 scored a typical of handiest 22% on tracking, reviewing and performing to improve their tailings risk administration, with Vale scoring slightly above regular. Fifteen of the 30 groups confirmed no proof of preserving song of how effortlessly they're addressing these risks. And while 17 groups confirmed some sign of reviewing the effectiveness of their tailings risk management measures, no proof became discovered of any of those corporations publicly disclosing the extent to which they've taken systematic action on the foundation of these reviews, to increase how they tackle tailings-related dangers,” the document reads.
The RMF states that the deficiencies many miners show when it comes to sharing advice is not restrained to their tailings dams. In conventional, the organization’s analyze found that the majority companies fail to accurately share advice on how they're managing social and environmental dangers. In selected, they fail to provide meaningful website-degree performance assistance.
“Too frequently, workers, mining-affected communities, governments and buyers are stored at nighttime in regards to the risks concerned and how well agencies are addressing these hazards. agencies may well be reticent to publicly demonstrate this doubtlessly unsafe and sensitive assistance, yet it is people and communities whose lives and livelihoods rely upon enough protection measures being in region,” the file reads.“The decommissioning and elimination of upstream dams and the switch of tailings into safer storage facilities would require massive transparency and large expenses, so executive regulators and traders would need to support these efforts”
The dependable Mining foundation is satisfied that public disclosure would now not best shop lots of lives however would also enhance the safety of mining initiatives with the aid of permitting for the knowledgeable advice of the community which, in turn, would effect in enhanced talents of the terrain.
in accordance with a 2001 document via the foreign commission on massive Dams which found that 221 tailings dam failures might have been avoided, the RMF states that with the aid of in reality incorporating the enter of all stakeholders in the design, planning and constructing phases of their initiatives, miners can study to refrain from mining in areas the place tailings dam failures are undoubtedly to take place and obtain a shared zero-failure purpose to tailings storage amenities.
The basis's research, having said that, has proven that failure hazards are most excellent for giant, steep and old tailings dams in tropical zones the place seismic activity and severe climate events can precipitate dam collapses.
in the case of Vale’s facility, the RMF explained that it turned into developed as part of a collection of dams built upstream from the normal dyke, which makes it the most likely class of tailings dam to fail.
“Vale has now committed to decommissioning all dams developed via the upstream method and different businesses can obviously comply with suit,” the NGO recommended.
As industries strengthen, so too does the competencies base and useful guide that's passed all the way down to the next community of young specialists. in the scientific, desktop, or engineering fields as an example, you could truly see this evolution as know-how improves and affects our lives. however once we talk about anything like entrepreneurship,
My oldest son is graduating high school this year, and like many fogeys in the us, our household has been hyper-focused on getting ready him for faculty. however as we get nearer to that day, and his possibilities (and my investment) become actual, i ponder if I should be questioning the system extra. My son has been dabbling in enterprise on his personal since grade college, and i can see the entrepreneurial hearth transforming into within him. yes, a business school with a communications, administration or economics diploma and many others would construct a fine basis, but when being an entrepreneur is his top of the line direction, is 4 years or extra during this standard equipment the highest quality solution to equip him for the realm ahead?
i do know there has been a palatable upswing in celebrating and romanticizing the entrepreneur in our lifestyle. You’d be complicated pressed to discover a sports star or celebrity now not ‘running a business’ or ‘building a manufacturer’ within the low season. just a scroll through your fb feed will doubtless yield a lot of ‘facet hustle’ opportunities. It actually seems like each person is stepping into on the entrepreneurial bandwagon. however definitely, the facts inform a very different story. a couple of stories exhibit that entrepreneurship is at a historic low. sure, americans are beginning businesses at the lowest rate in 40 years! How is that viable?
traditionally, We have to face the incontrovertible fact that the next era has a distinct set of values when it involves their personal freedom, work life steadiness, and possibility/reward tolerance. They are searching for high-quality of existence previous and a clearer course to the upside of possessing their own business.
as a substitute of lamenting about the downfalls of this new age perspective, I decided to ‘lean in’ and interact. after I communicate to high faculties about company and entrepreneurship, i will consider the hunger in these classes for practical expertise and direct instruction. So I got down to see if any individual is chatting with this generation about being an entrepreneur on their terms.
I met a unbelievable younger girl named Amie Tollefsrud. She is a self-made entrepreneur that rather quickly after faculty realized her communique degree wasn’t leading her anyplace she wanted to be. So she set out to make it on her personal, becoming a nutritionist and assisting consumers on-line. She straight away learned that every useful factor she needed to prevail she changed into discovering on her personal through trial and error. As her enterprise grew, her success allowed her to shuttle the realm and work remotely. Amie, like many in her era, has no pastime in anything else that chains her to a desk.
at last, she all started teaching classes to other nutritionists on the way to launch their company on-line. She become getting so many inquiries she began helping other younger entrepreneurs from all company classes. Now, she teaches others a way to create their personal online lessons and market their business manufacturers. And when you get no degree or certificate for taking Amie’s or different lessons like hers, the real world guide without delay from the source is awfully attractive.
I additionally interviewed and hung out with Andrew 'King Bach' Bachelor, an incredibly ordinary social media influencer and entrepreneur. He remembers that one among his school professors advised the type, “The job you may have 10 years from now doesn’t exist today”. Barely five years later, it’s obtrusive he turned into appropriate. think about the changes to the landscape within the next five years.
When King Bach talks about the structure of his enterprise or his systematic use of social media, it sounds more like science or economics professor than an Instagram influencer making humorous video clips.
ordinary I consider that’s what our neighborhood should embrace. just like the other greater ordinary professions, we deserve to aggressively explore our ‘rising expertise’ and at all times advance our areas of schooling and practising. consider of it because the entrepreneur’s up to date pursuit of better schooling.
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Following last month’s tailings dam disaster at Vale’s (NYSE: VALE) Córrego do Feijão mining complex, which left at least 140 dead, Amsterdam-based Responsible Mining Foundation issued a statement highlighting the findings of its 2018 Responsible Mining Index report related to miners’ tailing dams.
According to the report, many of the world’s largest mining companies are not able to ‘know and show’ how effectively they are addressing the risks of tailings dam failure and seepage.
“The 30 mining companies assessed in RMI 2018 scored an average of only 22% on tracking, reviewing and acting to improve their tailings risk management, with Vale scoring slightly above average. Fifteen of the 30 companies showed no evidence of keeping track of how effectively they are addressing these risks. And while 17 companies showed some sign of reviewing the effectiveness of their tailings risk management measures, no evidence was found of any of these companies publicly disclosing the extent to which they have taken systematic action on the basis of these reviews, to improve how they address tailings-related risks,” the document reads.
The RMF states that the deficiencies many miners show when it comes to sharing information is not limited to their tailings dams. In general, the organization’s study found that most companies fail to adequately share information on how they are managing social and environmental risks. In particular, they fail to provide meaningful site-level performance information.
“Too often, workers, mining-affected communities, governments and investors are kept in the dark about the risks involved and how well companies are addressing these risks. Companies may be reticent to publicly reveal this potentially detrimental and sensitive information, yet it is workers and communities whose lives and livelihoods depend on adequate protection measures being in place,” the report reads.“The decommissioning and removal of upstream dams and the transfer of tailings into safer storage facilities would require massive transparency and massive costs, so government regulators and investors would need to support these efforts”
The Responsible Mining Foundation is convinced that public disclosure would not only save thousands of lives but would also improve the safety of mining projects by allowing for the expert advice of the community which, in turn, would result in improved knowledge of the terrain.
Based on a 2001 report by the International Commission on Large Dams which found that 221 tailings dam failures could have been prevented, the RMF states that by really incorporating the input of all stakeholders in the design, planning and building phases of their projects, miners can learn to refrain from mining in areas where tailings dam failures are most likely to happen and achieve a shared zero-failure objective to tailings storage facilities.
The foundation's research, on the other hand, has shown that failure risks are greatest for large, steep and old tailings dams in tropical zones where seismic activity and extreme weather events can precipitate dam collapses.
In the case of Vale’s facility, the RMF explained that it was built as part of a series of dams constructed upstream from the original dyke, which makes it the most likely type of tailings dam to fail.
“Vale has now committed to decommissioning all dams built by the upstream method and other companies can clearly follow suit,” the NGO suggested.
Good morning—Sabah Al-Khair! I am delighted to be back in Dubai, this city of tomorrow, where you—its economic leaders—are dedicated to realizing the vision of a better tomorrow.
This vision is predicated on prosperity that is shared by all, benefiting the poor and the middle class, citizens and immigrants alike; and opportunities that are open to all, including women. It is a vision of fairness over cronyism and partiality, and of trust that government policy is oriented toward the common good.
This is a big vision. But as Sheikh Mohammed bin Rashid Al Maktoum once said “The bigger your vision, the bigger your achievement will be…we cannot let fear keep us small. We have to be brave to be big.”
As you know so well, fiscal policy plays a vital role in creating and nurturing this vision of sustainable and inclusive growth—especially as encapsulated in the Sustainable Development Goals. This is because we need fiscal space for spending on health, education, social protection, and public investment—all key priorities in this region.
This is why I wanted to come back to the Arab Fiscal Forum—my fourth time now. In past years, I talked in detail about fiscal policy—the spending and revenue measures needed to achieve sustainable and inclusive growth. This year, I want to go one level deeper—into the foundations of fiscal policy and good fiscal management.
Because without a stable foundation, even the best policies can flounder. Without a stable foundation, fiscal policy will lack credibility.
In this vein, I will address two key pillars of good fiscal management: (i) strong fiscal frameworks; and (ii) good governance and transparency.Prelude: Global and regional context
Before I do this, let me say a few words about the broader economic context bearing on fiscal policy in the region.
Unfortunately, the region has yet to fully recover from the global financial crisis and other big economic dislocations over the past decade.
Among oil importers, growth has picked up, but it is still below pre-crisis levels. Fiscal deficits remain high, and public debt has risen rapidly—from 64 percent of GDP in 2008 to 85 percent of GDP a decade later. Public debt now exceeds 90 percent of GDP in nearly half of these countries.
The oil exporters have not fully recovered from the dramatic oil price shock of 2014. Modest growth continues, but the outlook is highly uncertain—reflecting in part the need for countries to shift rapidly toward renewable energy over the new few decades, in line with the Paris Agreement. With revenues down, fiscal deficits are only slowly declining—despite significant reforms on both the spending and revenue sides, including the introduction of VAT and excise taxes. This has led to a sharp increase in public debt—from 13 percent of GDP in 2013 to 33 percent in 2018.
At this juncture, the global expansion is weakening, and risks are rising. Just a few weeks ago, we released our revised forecasts. We now think that the global economy will grow by 3.5 percent this year, 0.2 percentage points below what we expected in October. And risks are up, given escalating trade tensions and tightening financial conditions. Unsurprisingly, a weaker global environment has knock-on effects on the region through a variety of channels—trade, remittances, capital flows, commodity prices, and financing conditions.
The bottom line: the economic path ahead for the region is challenging. This makes the task of fiscal policy that much harder, which in turn makes it even more important to build strong foundations to anchor fiscal policy.1. Fiscal Frameworks
The first building block of this foundation is a good fiscal framework. By this I mean the set of laws, institutional arrangements, and procedures needed to achieve a country’s fiscal policy objectives. Such a framework allows governments to map out budgets over the medium term in a way that reflects clear, consistent, and credible goals.
There is scope to improve fiscal frameworks in this region. Some of the weaknesses are short-termism and insufficient credibility.
On short-termism: given that inclusive and sustainable growth is an inherently medium-term goal, fiscal policy needs a medium-term orientation. Focusing on the immediate horizon makes it harder to implement critical but longer-term reforms in such areas as tackling high public wage bills, designing effective social protection systems, and getting rid of harmful fuel subsidies. Short-termism implies that fiscal policy amplifies rather than tames the waves of booms and busts—making it more difficult to achieve sustainable and inclusive growth.
Turning to fiscal credibility: I am referring to such factors as large amounts of spending kept off-budget and poor risk management. Across the region, it is common for sovereign wealth funds to directly finance projects, bypassing the normal budget process. And state-owned enterprises in some countries have high levels of borrowing—again, outside of the budget. Addressing these fiscal risks would not only enhance budget credibility and transparency but would help keep a lid on corruption. Budgetary credibility also calls for better risk management, with a more comprehensive budget based on realistic forecasts.
The good news is that numerous countries are already strengthening their fiscal frameworks—many with IMF assistance. Just to give some examples:
There is scope for further improvement. Perhaps the oil exporters could follow the example of other resource-rich countries such as Chile and Norway in using fiscal rules to protect key priorities such as social spending from commodity price volatility.
Strong fiscal frameworks have other important benefits. They form the basis for sound debt management. They also allow for better coordination between fiscal and monetary policies, so that the two arms of macroeconomic management work together, not at cross purposes.2. Good Governance and Transparency
Let me now turn to the second pillar of good fiscal management—good governance and transparency. In this context, governance refers to the institutional frameworks and practices of the public sector. Strong institutions are crucial for legitimacy, for fostering a clearer understanding of policy objectives among citizens, enhancing their voice, and generating buy-in for fiscal policy.
On the other hand, as many of you have said, weak institutions imply a weak policy foundation that could crack and crumble—because there is inadequate legitimacy and public accountability. Even worse, these cracks could also let corruption creep in. And you know so well, this is social poison—it feeds discord, disengagement, and disillusionment, especially among the young. The word corruption, after all, comes from Latin root for rotting, breaking apart—disintegration. And the word in Arabic, fasad, also connotes this idea of rotting or coming undone.
Corruption is the great disruptor of fiscal policy. Without trust in the fairness of the tax system, it becomes harder to raise the revenue needed for critical spending on health, education, and social protection. And governments might be tempted to favor white elephant projects instead of investments in people and productive potential. Add this up, and we have a recipe for unsustainable fiscal policy combined with social discord.
This a global issue—relevant for large and small countries, advanced and low-income economies, and the public and private sectors. Given this, it is no surprise that IMF research found that weak governance and corruption are associated with significantly lower growth, investment, FDI, and tax revenues—and higher inequality and exclusion.
Specifically, we found that improving on an index of corruption and governance by moving from the bottom quarter to the mean is associated with an increase in the investment-to-GDP ratio of 1.5–2 percentage points and a bump up in annual GDP per capita growth by half a percentage point or more.  We will have more analysis in the upcoming Fiscal Monitor, which will be devoted to the topic of the fiscal costs of corruption and the role of fiscal institutions.
What is the solution to weak governance and corruption? In the fiscal domain, it calls for heightened fiscal transparency—shining a light on all aspects of the budget and the public accounts. This would provide a more accurate picture of the fiscal position and prospects, the long-term costs and benefits of any policy changes, and the potential fiscal risks that might throw them off course. This region has some room for improvement here.
We know that these kinds of reforms pay off. Take the case of Georgia, for example. Until 2003, it was seen as one of the most corrupt countries in the world. But after that, it reformed its institutions and cracked down on corruption. This, along with tax reform, led to immediate improvements. Tax revenues increased from 12 percent of GDP in 2003 to 25 percent of GDP in 2008, as taxpayers had greater faith in the fairness of the system.
I should note that the IMF has been stepping up its engagement in the area of governance and corruption. Last year, we put in place a new framework predicated on a more systematic, evenhanded, effective, and candid engagement on these issues with member countries. We will be reaching out to leaders in this region to discuss how we can work together to implement this framework.
With better governance, we can replace the “disintegration” of corruption with the “integration” of all into the productive economy. We can replace fasad with islah—reforms to set things right, to reconcile people with one another.Conclusion
Let me wrap up. I have argued this morning that good fiscal policy requires good institutional foundations. And solid foundations in areas such as fiscal frameworks and governance give citizens confidence that fiscal policy serves the good of all, not just the wealthy or the well-connected.
Let me end with some wise words attributed to the great Ibn Khaldun, “He who finds a new path is a pathfinder, even if the trail has to be found again by others; and he who walks far ahead of his contemporaries is a leader.”
You are the pathfinders, the leaders, the visionaries. We hope that we can give useful guidance, but we look to you to find the right path to make this vision a reality.
 More specifically, those gains are associated with moving from the 25th percentile to the 50th percentile in an index on corruption and governance.
In a robust and frank conversation, the insurance legend provides unique insights into global trade, his past battles and what the future holds for the industry and his company.
In 1960, Maurice “Hank” Greenberg was hired as a vice president of C.V. Starr & Co. At age 35, he had already accomplished a great deal.
He served his country as part of the Allied Forces that stormed the beaches at Normandy and liberated the Nazi death camps. He fought again during the Korean War, earning a Bronze Star. He held a law degree from New York Law School.
Now he was ready to make his mark on the business world.
Even C.V. Starr himself — who hired Mr. Greenberg and later hand-picked him as the successor to the company he founded in Shanghai in 1919 — could not have imagined what a mark it would be.
Mr. Greenberg began to build AIG as a Starr subsidiary, then in 1969, he took it public. The company would, at its peak, achieve a market cap of some $180 billion and cement its place as the largest insurance and financial services company in history.
This month, Mr. Greenberg travels to China to celebrate the 100th anniversary of C.V. Starr & Co. That visit occurs at a prickly time in U.S.-Sino relations, as the Trump administration levies tariffs on hundreds of billions of dollars in Chinese goods and China retaliates.
In September, Risk & Insurance® sat down with Mr. Greenberg in his Park Avenue office to hear his thoughts on the centennial of C.V. Starr, the dynamics of U.S. trade relationships with China and the future of the U.S. insurance industry as it faces the challenges of technology development and talent recruitment and retention, among many others. What follows is an edited transcript of that discussion.
R&I: One hundred years is quite an impressive milestone for any company. Celebrating the anniversary in China signifies the importance and longevity of that relationship. Can you tell us more about C.V. Starr’s history with China?
Hank Greenberg: We have a long history in China. I first went there in 1975. There was little there, but I had business throughout Asia, and I stopped there all the time. I’d stop there a couple of times a year and build relationships.
When I first started visiting China, there was only one state-owned insurance company there, PICC (the People’s Insurance Company of China); it was tiny at the time. We helped them to grow.
I also received the first foreign life insurance license in China, for AIA (The American International Assurance Co.). To date, there has been no other foreign life insurance company in China. It took me 20 years of hard work to get that license.
We also introduced an agency system in China. They had none. Their life company employees would get a salary whether they sold something or not. With the agency system of course you get paid a commission if you sell something. Once that agency system was installed, it went on to create more than a million jobs.
R&I: So Starr’s success has meant success for the Chinese insurance industry as well.
Hank Greenberg: That’s partly why we’re going to be celebrating that anniversary there next month. That celebration will occur alongside that of IBLAC (International Business Leaders’ Advisory Council), an international business advisory group that was put together when Zhu Rongji was the mayor of Shanghai [Zhu is since retired from public life]. He asked me to start that to attract foreign companies to invest in Shanghai.
“It turns out that it is harder [for China] to change, because they have one leader. My guess is that we’ll work it out sooner or later. Trump and Xi have to meet. That will result in some agreement that will get to them and they will have to finish the rest of the negotiations. I believe that will happen.” — Maurice “Hank” Greenberg, chairman and CEO, C.V. Starr & Co. Inc.
Shanghai and China in general were just coming out of the doldrums then; there was a lack of foreign investment. Zhu asked me to chair IBLAC and to help get it started, which I did. I served as chairman of that group for a couple of terms. I am still a part of that board, and it will be celebrating its 30th anniversary along with our 100th anniversary.
We have a good relationship with China, and we’re candid as you can tell from the op-ed I published in the Wall Street Journal. I’m told that my op-ed was received quite well in China, by both Chinese companies and foreign companies doing business there.
On August 29, Mr. Greenberg published an opinion piece in the WSJ reminding Chinese leaders of the productive history of U.S.-Sino relations and suggesting that Chinese leaders take pragmatic steps to ease trade tensions with the U.S.
R&I: What’s your outlook on current trade relations between the U.S. and China?
Hank Greenberg: As to the current environment, when you are in negotiations, every leader negotiates differently.
President Trump is negotiating based on his well-known approach. What’s different now is that President Xi (Jinping, General Secretary of the Communist Party of China) made himself the emperor. All the past presidents in China before the revolution had two terms. He’s there for life, which makes things much more difficult.
R&I: Sure does. You’ve got a one- or two-term president talking to somebody who can wait it out. It’s definitely unique.
Hank Greenberg: So, clearly a lot of change is going on in China. Some of it is good. But as I said in the op-ed, China needs to be treated like the second largest economy in the world, which it is. And it will be the number one economy in the world in not too many years. That means that you can’t use the same terms of trade that you did 25 or 30 years ago.
They want to have access to our market and other markets. Fine, but you have to have reciprocity, and they have not been very good at that.
R&I: What stands in the way of that happening?
Hank Greenberg: I think there are several substantial challenges. One, their structure makes it very difficult. They have a senior official, a regulator, who runs a division within the government for insurance. He keeps that job as long as he does what leadership wants him to do. He may not be sure what they want him to do.
For example, the president made a speech many months ago saying they are going to open up banking, insurance and a couple of additional sectors to foreign investment; nothing happened.
The reason was that the head of that division got changed. A new administrator came in who was not sure what the president wanted so he did nothing. Time went on and the international community said, “Wait a minute, you promised that you were going to do that and you didn’t do that.”
So the structure is such that it is very difficult. China can’t react as fast as it should. That will change, but it is going to take time.
R&I: That’s interesting, because during the financial crisis in 2008 there was talk that China, given their more centralized authority, could react more quickly, not less quickly.
Hank Greenberg: It turns out that it is harder to change, because they have one leader. My guess is that we’ll work it out sooner or later. Trump and Xi have to meet. That will result in some agreement that will get to them and they will have to finish the rest of the negotiations. I believe that will happen.
R&I: Obviously, you have a very unique perspective and experience in China. For American companies coming to China, what are some of the current challenges?
Hank Greenberg: Well, they very much want to do business in China. That’s due to the sheer size of the country, at 1.4 billion people. It’s a very big market and not just for insurance companies. It’s a whole range of companies that would like to have access to China as easily as Chinese companies have access to the United States. As I said previously, that has to be resolved.
It’s not going to be easy, because China has a history of not being treated well by other countries. The U.S. has been pretty good in that way. We haven’t taken advantage of China.
R&I: Your op-ed was very enlightening on that topic.
Hank Greenberg: President Xi wants to rebuild the “middle kingdom,” to what China was, a great country. Part of that was his takeover of the South China Sea rock islands during the Obama Administration; we did nothing. It’s a little late now to try and do something. They promised they would never militarize those islands. Then they did. That’s a real problem in Southern Asia. The other countries in that region are not happy about that.
R&I: One thing that has differentiated your company is that it is not a public company, and it is not a mutual company. We think you’re the only large insurance company with that structure at that scale. What advantages does that give you?
Hank Greenberg: Two things. First of all, we’re more than an insurance company. We have the traditional investment unit with the insurance company. Then we have a separate investment unit that we started, which is very successful. So we have a source of income that is diverse. We don’t have to underwrite business that is going to lose a lot of money. Not knowingly anyway.
R&I: And that’s because you are a private company?
Hank Greenberg: Yes. We attract a different type of person in a private company.
R&I: Do you think that enables you to react more quickly?
Hank Greenberg: Absolutely. When we left AIG there were three of us. Myself, Howie Smith and Ed Matthews. Howie used to run the internal financials and Ed Matthews was the investment guy coming out of Morgan Stanley when I was putting AIG together. We started with three people and now we have 3,500 and growing.
“I think technology can play a role in reducing operating expenses. In the last 70 years, you have seen the expense ratio of the industry rise, and I’m not sure the industry can afford a 35 percent expense ratio. But while technology can help, some additional fundamental changes will also be required.” — Maurice “Hank” Greenberg, chairman and CEO, C.V. Starr & Co. Inc.
R&I: You being forced to leave AIG in 2005 really was an injustice, by the way. AIG wouldn’t have been in the position it was in 2008 if you had still been there.
Hank Greenberg: Absolutely not. We had all the right things in place. We met with the financial services division once a day every day to make sure they stuck to what they were supposed to do. Even Hank Paulson, the Secretary of Treasury, sat on the stand during my trial and said that if I’d been at the company, it would not have imploded the way it did.
R&I: And that fateful decision the AIG board made really affected the course of the country.
Hank Greenberg: So many people lost all of their net worth. The new management was taking on billions of dollars’ worth of risk with no collateral. They had decimated the internal risk management controls. And the government takeover of the company when the financial crisis blew up was grossly unfair.
From the time it went public, AIG’s value had increased from $300 million to $180 billion. Thanks to Eliot Spitzer, it’s now worth a fraction of that. His was a gross misuse of the Martin Act. It gives the Attorney General the power to investigate without probable cause and bring fraud charges without having to prove intent. Only in New York does the law grant the AG that much power.
R&I: It’s especially frustrating when you consider the quality of his own character, and the scandal he was involved in.
In early 2008, Spitzer was caught on a federal wiretap arranging a meeting with a prostitute at a Washington Hotel and resigned shortly thereafter.
Hank Greenberg: Yes. And it’s been successive. Look at Eric Schneiderman. He resigned earlier this year when it came out that he had abused several women. And this was after he came out so strongly against other men accused of the same thing. To me it demonstrates hypocrisy and abuse of power.
Schneiderman followed in Spitzer’s footsteps in leveraging the Martin Act against numerous corporations to generate multi-billion dollar settlements.
R&I: Starr, however, continues to thrive. You said you’re at 3,500 people and still growing. As you continue to expand, how do you deal with the challenge of attracting talent?
Hank Greenberg: We did something last week.
On September 16th, St. John’s University announced the largest gift in its 148-year history. The Starr Foundation donated $15 million to the school, establishing the Maurice R. Greenberg Leadership Initiative at St. John’s School of Risk Management, Insurance and Actuarial Science.
Hank Greenberg: We have recruited from St. John’s for many, many years. These are young people who want to be in the insurance industry. They don’t get into it by accident. They study to become proficient in this and we have recruited some very qualified individuals from that school. But we also recruit from many other universities. On the investment side, outside of the insurance industry, we also recruit from Wall Street.
R&I: We’re very interested in how you and other leaders in this industry view technology and how they’re going to use it.
Hank Greenberg: I think technology can play a role in reducing operating expenses. In the last 70 years, you have seen the expense ratio of the industry rise, and I’m not sure the industry can afford a 35 percent expense ratio. But while technology can help, some additional fundamental changes will also be required.
R&I: So as the pre-eminent leader of the insurance industry, what do you see in terms of where insurance is now an where it’s going?
Hank Greenberg: The country and the world will always need insurance. That doesn’t mean that what we have today is what we’re going to have 25 years from now.
How quickly the change comes and how far it will go will depend on individual companies and individual countries. Some will be more brave than others. But change will take place, there is no doubt about it.
More will go on in space, there is no question about that. We’re involved in it right now as an insurance company, and it will get broader.
One of the things you have to worry about is it’s now a nuclear world. It’s a more dangerous world. And again, we have to find some way to deal with that.
So, change is inevitable. You need people who can deal with change.
R&I: Is there anything else, Mr. Greenberg, you want to comment on?
Hank Greenberg: I think I’ve covered it. &
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