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The United States devotes a larger share of its GDP to health care and spends more on health care per capita than any other country. The sheer size of the total spending on health care, at approximately $3.5 trillion in 2017, puts significant pressure on all payers and crowds out other forms of public and private spending.

In this brief commentary the authors suggest that, as part of the effort to deal with this pressure, the United States should look at borrowing a cost containment strategy from other countries: the use of hard caps on spending growth. The authors draw on our their experience of working with decision-makers over the last 20 years on the topic of priority setting to put forward some ideas on whether there is potential for application of trade-offs in the United States.

As hard caps force choices to be made, a necessary condition for successful implementation of this policy is the presence of an effective priority-setting framework to ensure that the right choices are made in operationalizing spending limitations. Work on this topic elsewhere can provide some insight into the use of a criteria-based framework for priority setting that purports transparency in decision-making to achieve value-based decisions.

Other countries still have much work to do, but there is a substantial track record of using formal priority-setting approaches that could potentially inform practice in the United States. We suggest that there are key segments of the US healthcare system where the adoption of formal priority-setting frameworks to guide trade-off decisions is feasible. Piloting such activity in these contexts is the next natural step in this line of inquiry.

This study aims to analyze the innovation overview of the Brazilian industrial sector using data published by innovation survey – PINTEC. The aim was to provide a macro and updated diagnosis of the innovation scenario in Brazil and build reflections for further studies.

The authors used information from the years 1998–2014 covered by PINTEC to analyze innovation indicators, namely, innovation types, problems and obstacles, novelty degree, established partnerships and interactions, as well as governmental incentives. This study is exploratory; thus, descriptive methods were used for data presentation through analyses and presented through figures and tables.

The results show that innovation of the Brazilian industrial sector is concentrated mainly in the acquisition of machinery and equipment, innovations that already exist in national or global markets, interactions for the innovation process with suppliers and governmental support for financing machinery and equipment acquisitions.

This study has relevance, as its results provide important subsidies for policy-makers to incorporate the needs and overcome challenges of innovation in Brazil.

The climate crisis presents a global threat. Research shows the necessity of joint communication efforts across different arenas—media, politics, business, academia and protest—to address this threat. However, communication about social change in response to the climate crisis comes with challenges. These challenges manifest, among others, in public accusations of inconsistency in terms of hypocrisy and incapability against self-declared change agents in different arenas. This increasingly turns public climate communication into a “blame game”.

Strategic communication scholarship has started to engage in this debate, thereby acknowledging climate communication as an arena-spanning, necessarily contested issue. Still, a systematic overview of specific inconsistency accusations in different public arenas is lacking. This conceptual article provides an overview based on a macro-focused public arena approach and decoupling scholarship.

Drawing on a systematic literature review of climate-related strategic communication scholarship and key debates from climate communication research in neighboring domains, the authors develop a framework mapping how inconsistency accusations of hypocrisy and incapacity, that is, policy–practice and means–ends decoupling, manifest in different climate communication arenas.

This framework creates awareness for the shared challenge of decoupling accusations across different climate communication arenas, underscoring the necessity of an arena-spanning strategic communication agenda. This agenda requires a communicative shift from downplaying to embracing decoupling accusations, from mutual blaming to approval of accountable ways of working through accusations and from confrontation to cooperation of agents across arenas.