The Management Mythbuster

Healthcare - answering the wrong questions - a personal perspective

It does not matter which side of the health care debate you are on, truth has long been subjugated by politics and posturing.  It seems that the latest scare tactics for those opposed to any change is to darkly warn that the U.S. will become like the U.K. That intellectual giant, Sarah Palin, went so far as describe the U.K. National Health Service as "evil" evoking Darth Vadar like images of anyone over 55 being left to rot rather than waste valuable resources. I cannot compete in the supposed facts being thrown about but what I can offer is some personal experience having lived for 30 years under the evil system and that past 18 years in the land of the free but chronically under-insured.

- Both my parents lived (and died) under the British system and I cannot fault the system for the care they received.  Yes the waiting lists were long for knee and hip replacements (much shorter now) but the quality of care was perfectly acceptable and the medical staff the equal (from my dumb consumer perspective) to that found in the U.S.

-Basic medical care through the General Practitioner channel was much more effective in the U.K. Doctors will still visit homes and access was easy.  In the U.S. everything seems to require a referral to a specialist. Notwithstanding I have generally received great health care in the U.S. and it used to offer value for money - not anymore.

- The U.S. system seems test and drug happy - no one feels like they have received effective treatment unless at least one MRI is ordered and two prescriptions written.  Tests are much less frequent in the U.K. Of course this is not always a good thing but the again you don't get a $3,000 MRI bill confirming what the cheap X-ray already showed.

- From a personal perspective I pay around four times more in the U.S. for family health care than the equivalent tax burden would be in the U.K.  When I moved to the U.S. in 1991 it was around twice as much but the lower U.S. tax rates more than made up for the difference.  However, my total tax burden in the U.S. is now close to what it would be in the U.K. (even with the Bush tax cuts) so the extra U.S. cost is a reduction in income and hence spending power.  No doubt this is going to get worse as I pay for my share of Chevrolet, AIG, and a few thousand Las Vegas condos further hampering any consumer-led economic recovery.

- The one fact that seems tough to avoid is that the U.S. spends almost double the amount of GDP (17%) on health care than the U.K. but fails to cover 47 million people.

To my simple mind there are only two things I care about:

1. The U.S. needs to offer universal health care to its people in the same way everyone has the right to education and national defense.

2. Current health care costs are so far out of whack that radical redesign of the process is needed.  How can the U.S. spend more of GDP and cover less of its people than any other developed nation in the world?  An effective system should cover everyone at a total cost of around 10-11% of GDP (40 percent less than today).  This is the challenge American ingenuity and entrepreneurship should be tackling. Unfortunately it seems that our politicians are the ones tasked with doing it and they do not exhibit these character traits in abundance.   So put the right people on the job and give them a share of the benefits. 

I feel sorry for the post officel but not too sorry!

Postal services all over the world have my sympathy. First of all, they are run by the government although  on second thoughts, isn't everything nowadays (Marx, Karl not Groucho, must be smiling from that place that dead communists go to); and second they have to put up with us complaining all the time - no wonder "going postal" doesn't mean buying a first class stamp.   

However, my sympathy is tempered by problems of their own making.  What do you make of FedEx and UPS generating $88 billion of revenue combined by charging 10-15 times more than the postal service to do the same job?  And second why do they make things so damn complicated?  I wander into the post office wanting to post a letter and the questions come at me think and fast: Do I want priority mail, delivery confirmation, insurance, signature receipt, a tracking number, or some extra stamps?  Sorry I just want my letter to get to Granny in less than a month - thank you.

It's not just me, my darling wife attended a two-hour training course on the art of bulk mailing this morning as part of her work for a local non-profit.  I was bewildered as to how it could take two hours to teach someone how to send lots of letters at the same time but according to Donna, two hours was not nearly enough.  Apparently the bulk mailing process is akin to applying for U.S. citizenship (a process I know well!). There are rules and regulations for every aspect of the process and numerous permits and licenses that must be obtained. Once you are legally approved to practice bulk mail, you then have to do 90 percent of the work yourself such as sorting the mail by post code.  In my naivety I thought they had really cool machines to sort mail but I guess there is no substitute for the human touch. After listening to her tale of confusion,  I recommended she just send spam to everyone instead. 

I thought the car industry was dead

I bought a car yesterday - how's that for my own personal stimulus package?  I thought it would be nice and quiet as I would surely be the only person in America buying a car - but I was wrong.  The dealership was heaving and it wasn't even raining outside.  People were not just looking they were buying.  Families, young couples, retirees they were all doing their bit. 

Of  course I didn't get a great deal - I never do. I knew I'd screwed it up when they agreed to my "offer" without any attempt to squeeze a few more dollars out of me.  I think I must have the letters "MUG" stenciled on my forehead.  It's funny how you never here anyone boasting that they got screwed when they bought a car.  People are always telling me what a great deal they got and how they are such a clever negotiator.  Men in particular love to boast about their car-buying skills.  I suspect they do this because they cannot boast about their sexual prowess when happily married with kids.  Well I have no skills - in the car buying department that is. I always pay too much. I rationalise this by comforting myself that its good for the economy.

Of course, I was not in American car dealership but then again you'd already worked that out hadn't you?

Restores your faith in human nature doesn't it?

It has been a great few days for restoring my faith in the absolute stupidity of humanity.  Just when I thought honesty, truth and integrity were making a comeback! To wit:

• The Japanese finance minister resigns after his hangover cure fails miserably at the G-7 summit.  At least he had the guts to admit to imbibing but then spoiled it all by denying being drunk and blaming some medicine for his haggard state.
• Alex Rodriguez restores our faith in the dishonesty of athletes by finally admitting to using steroids.  Of course he did not know what they were and was very young and naive at the time.  Not naive enough to avoid the $252 million contract of course. Apparently there are over 100 others who got caught which based upon normal statistics means the list of clean players must be very short indeed.  Probably not enough to staff the Cleveland Indians outfield!
• The esteemed Senator from Illinois admits to soliciting donations for Rod the Rogue Governor despite early denials.  Its not that he lied that bothers me; its that he failed to raise any money - what sort of politician is this guy?  He deserves to be sacked for being such an incompetent fundraiser.
• Back in Blighty, the Home Secretary, Jacqui Smith assures us she "followed all the rules" in claiming over $200,000 in housing allowances for her family home by designating her sister's flat in London to be her primary residence despite only spending a couple of nights a week there.

I suppose I should admit to my own failings, so here is my mea culpa:

• I failed to by my darling wife a Valentines Card until Saturday afternoon; worse I made up for it by writing an excruciating poem for her!
• I have rolled through at least sixteen Stop signs in the last week.
• I stayed up until 1am one night last week getting destroyed by youngsters while playing Call of Duty on the Xbox - they really should be in bed at that time and lets us old geezers stumble around after each other
• I've probably consumed an excess glass of wine or five, all in the comfort of my own home I hasten to add
• I filed my tax return yesterday and tried my best to be honest and accurate. After all Timothy Geithner is my hero.

That's all folks!

Valentines Day -- Why do we fall for this rubbish?

Romance? Fuhgedaboutitt.  Valentines Day is all about one thing and you don't need a degree in psychology to guess what that is, especially if you watch adverts from the companies seeking to profit from your guilt, sorry love, for that special person.

Pajama gram guarantees that she will get her clothes off (hardly a stretch I think) for you if you purchase one of their offerings which range from "soft to sexy." The company thoughtfully includes a handy "do not disturb" sign in the package.  I guess that's to ensure she gets an uninterrupted night's sleep in her new PJ's.  Beyond pajama's everyone else from Victoria's Secret to Ambiance is even less subtle about the "guaranteed" result of your spending.

If nightwear isn't your thing, Vermont Teddy Bear is the answer.  Their TV ad is one of those really cheap affairs that looks like it could be the opening scene of one of those films where the first scene is the only one in which clothes are worn.  The spot guarantees that the bear of your choice will elicit girlish squeals from your Valentine and envy from all her friends.  Of course this will all but guarantee that she will get bare (or is it bear?) for you.

In these web-enabled times perhaps you should go for the personalized domain name for your loved one.Go Daddy is thoughtfully offering you 10 percent off this truly 21st century valentine.

It was so much easier in the old days when all you needed was a single red rose but even one of those costs too much in these harsh economic times so I think I will settle for delivering a cup of tea in bed to my beloved.  That usually works!

Anything to look forward to in 09?

So another year dawns full of hope, or maybe its just blind fear.  It's not the happiest of times as we confront continuing economic woes; however it all pales beside the challenges many face so we should not get to down.  What does the year ahead hold? Who knows but here are a few ideas to get you started:

- Politicians will go on a pork-free diet as they dispense trillions in economic stimulus; on a related note Illinois becomes a beacon of ethical political government as Iowa takes over the state

- Hillary Clinton personally negotiates peace in Gaza but not before braving rockets and sniper fire as she flies over the troubled territory at 40,000 feet thereby fulfilling at least one of her campaign claims; unfortunately the peace last only three days but its a start

- Reality shows are banned from television and writers are forced to develop characters and craft stories for the viewing public - now there's a radical thought

- GM actually brings a car to market that people want to buy; however on further investigation its found to be a Toyota Camry in disguise

- the French invade the Channel Islands thereby securing their first military triumph in centuries; Britain allows the French to stay in return for giving up Carla Bruni to become Prince William's wife and hence a future Queen of England. Nicolas Sarkozy is reported to holidaying in Alaska and is arrested for stalking the Governor.

- the New York Yankees win the World Series but no one cares

- Apple introduces the iV a virtual reality where house prices actually go up and people can afford to pay their mortgages; Chrysler makes really cool cars; Microsoft releases software that works first time; health care costs go down; and the Cleveland Browns go undefeated.  Sales are lackluster as consumers complain that its not realistic enough.

- David Axson's new book, Half The World Away, finally gets published and sales are astronomical. J.K. Rowling and Dan Brown demand recounts before accepting that a new literary giant has emerged on the scene.  Axson remains the same humble being and only grudgingly accepts a place in Barack's cabinet as his newly appointed Czar of economic regeneration for Bath, Ohio thereby becoming the 412th Czar appointed during the Obama administration's first year.  

And os it goes on...should be fun shouldn't it?

As if 2008 wasn't long enough already!

Its been a long, hard year and there are still 22 days to go.  The torrent of bad economic news shows no sign of slowing down and the general world mood seems to be one of resigned depression and now to cap it an international consortium of the world's timekeepers (did you even know there was such a consortium?) has decided that 2008 is too short! 

Even with 2008 being a leap year, it's not long enough; we are a second short as apparently the Earth is slowing down!  I guess it must be the extra weight from all the obesity that now exists on the planet or maybe its just overburdened with debt and shrinking assets, after all we've been ripping off the planets natural resources for centuries now and if I was Earth I'd be losing some momentum wouldn't you? 

So 2008 will be the longest year since 1992; so make good use of the extra second...

The pain and the glory

Last Wednesday at the age of 46 I made my debut as an American Football player.  The occasion was a Dad's versus Lads game of touch football at my son's scout camp.  Of course, brains and experience triumphed over youth and speed as we cruised to a 21-0 victory.  We did steal one player from the opposition who just happened to be an incredibly fit and very large high school senior to be, but the real revelation was the performance of yours truly.  In a game for the ages, your humble correspondent scored all three touchdowns with a series of ever more spectacular receptions of which Jerry Rice would have been proud.  I also effortlessly nabbed two interceptions, one of which was converted into a touchdown.  Did I hear the words MVP?  

Of course all this goes to show is what a ridiculously easy game American Football is, when an overweight ex-rugby player can so thoroughly dominate on his first outing. Best of all my son was actually quite impressed by his father's performance; my darling wife failed to see my heroics as after a few minutes she could watch no more for fear my heart would give out!  

At the game's conclusion it was high-fives and chest bumps all round as sweat oozed from my every pore.  Its been a long time since I felt an adrenalin rush like that.  Of course there was a price to pay and for the last two days I have been barely able to walk as my left knee decided to expand in size and ice became my constant companion.  At least I now have something in common with Tiger Woods. Like Tiger I think I should also shut it down for the year. In fact I think I will call it a career in gridiron and retire with my gaudy statistics in tact.  With numbers like these, it should all but guarantee me enshrinement just down the road in Canton...

The art of the quote!

I love quotes -  the art of succinctly conveying intelligence with a few smartly chosen words is both art and science.  Some folks are human quote machines such as Mark Twain and Winston Churchill, others merely encapsulated wisdom in their choice of one or two pithy phrases. The three that follow popped up while I was researching something completely different but that's how these things go isn't it?  

The first is from a 19th century German poet (not an oxymoron apparently) named Heinrich Heine, which if nothing else proves that Germans can not only be artistic but also witty - who'd of thought it! The second comes from the Big Brain himself, Albert Einstein, and offers insight into his wry take on the world beyond his hair. Finally we have an American entry from Elbert Hubbard, who I think must have been referring to politicians in his offering...

"Ordinarily he was insane, but the had lucid moments when he was merely stupid."

"Only two things are infinite, the universe and human stupidity, and I'm not sure about the former."

"Genius may have its limitations, but stupidity is not thus handicapped."

Word wars!

What's in a word?  Apparently a lot. Remember Bill Clinton's tortured definition of what constitutes sex or Obama's comment on "bitter" blue collar Americans. While not aspiring to such heights I have just emerged relatively unscathed from a skirmish with the dictionary and thesaurus. Let me enlighten you...

I sit on a not-for-profit board populated by a great group of people; these folks have raised millions in recent years and oversee a tremendous organization yet our last three board meetings have tested our unity. 

Like any effective organization we periodically review our mission, vison and strategy to make sure it remains relevant.  This year a sub-committee of the Board has worked dilligently to update the mission statement to better reflect core values around topics such as citizenship and environmental responsibility.  A couple of months ago the proposed mission statement was presented to the board.  All hell broke loose, not because anyone disagreed with anything substantive but over the use of a single word.  Should it be empathic or empathetic?  The debate was fierce as the massed ranks of literary scholars took sides.  Which was the appropriate expression of the values we wished to exhibit? We agreed on the root - empathy but there was no common ground thereafter.  This was Coke vs. Pepsi, good vs. evil, Ali-Frazier all rolled into one.  the debate became heated and our Chairman had no option to call for a "timeout"  suggesting that further research be done.  The battle lines had been drawn and the trenches were under construction.  Debate simmered in the corridors and throughout cyberspace.  Each camp marshaled their own experts who offered testimony as to the merits fo empathic versus empathetic but no definitive answers emerged. The two groups exhibited little empathy for each other which should have rendered the debate moot.  But positions had been staked out and another board meeting passed with much debate but little resolution.  We were now in near crisis mode as the deadline for approval approached.  A motion was made and passed to provisionally approve the mission statement with the caveat that the empathy issue be resolved to everyone satisfaction; this was a bit like Israel and Syria agreeing to peace subject to resolving the  Golan Heights issue.

Debate continued but no resolution appeared to be at hand.  The deadline was last night's board meeting; however last minute negotiations appeared to break dow; then at 7.18am yesterday morning there was a breakthrough.  An email soared through cyberspace presenting a radical solution. Forget empathy, what we really needed was compassion.  The reaction was stunning.  In the space of a few hours we were reunited. no more empathic or empathetic, the answer was compassionate!  The motion was put to the warring factions and acceptance was unanimous - peace reigned again and we headed to the bar.