From TM Lutas, who keeps me honest, in an email to me:

I haven't read the article you talked about here on the PRC's barefoot docs. I thus can't entirely be sure whether I'm misreading things or perhaps you are. The indiscriminate use of antibiotics is one of the biggest international public health threats we've got going, far outweighing the danger of SARS or even H5N1 which has got me scared to death already. The problem is that tossing out antibiotics when inappropriate is like providing combat training classes to gang members. It's just a very bad idea that's going to come back in spades to haunt us all.

In other words, if the doctors aren't trained sufficiently to know when *not* to give antibiotics, their actions will likely pick up the pace of new disease plagues in future, possibly beyond our ability to discover new antibiotics to replace the old ones. That's Gap enhancing, not Core enhancing behavior.

I do wonder if there's a meta-category for reforms that you think are going to help you get into the Core but really pull you further away from it. . .