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Here’s how we did it: In step one, we created financial models of thousands of possible HIV management programs, each with different permutations of the elements constituting a complete program, from medications and treatment delivery to health facilities and ongoing wellness plans. Each such program is a possible treatment portfolio. Thus, portfolio A might consist of importing 2,000 capsules of drug A from India at a fixed contract price; importing 1,000 capsules of drug B from Belgium at market price; building five HIV/AIDS clinics owned and managed by the mining company; employing all nurses from company X; and giving each patient one of each pill once a day. Treatment portfolio B might be similar but require building fewer clinics while outsourcing for the remainder. Portfolio C might consist of outsourcing all treatment to managed health care company Y for a total fee of $10 million – and so on. (The actual portfolios we modeled have many more variables than described here and make forward projections.)

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During proxy season last spring, a debate about executive compensation erupted that was notable for its ardor and its vacuity. Clearly something is rotten in the state of executive pay. Amid growing worry about the competitiveness of corporations in the developed world, an increasing number of top executives bring home eight- and nine-figure paychecks. There is a growing gap between the remuneration of senior managers and that of ordinary workers.

At the same time, bankers and traders on Wall Street earn fortunes compared with the pay of the men and women who run companies in nonfinancial industries. A handful of top dogs receive lavish treats even when their companies’ stock prices roll over and play dead.

Much of what passes for debate about this topic has been the intellectual equivalent of rounding up the usual suspects: cozy CEO–director relationships, inattentive institutional investors, short-termism, and stock options. All of these are partly guilty. Anyone who has followed my writing with a stalker’s avidity knows that I have a particular bone to pick with stock options, whose purpose is to align managers’ thinking with that of owners but whose effect is to align their interests with those of traders. Stock-optionaccounting sophistry aside, if the goal is to make managers shareholders, why not just pay ’em half their comp in company stock itself, bought in the market at the opening every payday?