“When You’ve Got Your Health You’ve Got Just About Everything” – Reflecting on the ACA (and T.R. Reid)
News Item: Supreme Court Lets Health Law Largely Stand
WASHINGTON — The Supreme Court on Thursday left standing the basic provisions of the health care overhaul, ruling that the government may use its taxation powers to push people to buy health insurance.
News item: Stockton, California, To File For Bankruptcy Protection
Stockton, California, said it will file for bankruptcy after talks with bondholders and labor unions failed, making the agricultural center the biggest U.S. city to seek court protection from creditors.
“Retirees are not going to be happy,” said Dale Ginter, who represented retired Vallejo workers in that city’s bankruptcy. “My prediction is that retiree health care is cut. I wouldn’t be surprised to see it cut to zero.”
The news hit this morning that the Supreme Court upheld the ACA act (frequently called “ObamaCare”). Regardless of your position on this, it might be good to take a look at the over all question: what about health care?
The city of Stockton, CA just decided to declare bankruptcy partly because of looming health care obligations of their retired employees. Other cities are in the pipeline for this problem, which will undoubtedly continue to spread.
In an increasingly out-sourced world, with people working at jobs that are not quite like the jobs of yesteryear, a growing percentage of Americans simply do not have/can not afford health care.
Of all the books I have read about the actual problem, “what can we do about health care?”, the best book I’ve read is The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care by T. R. Reid (New York: The Penguin Press. 2009). T. R. Reid is a respected and experienced journalist. He also has lived and worked as a journalist in many different foreign countries. He also has a bad shoulder. From the book:
“On the personal level, I was hoping to find some relief from my ailing right shoulder, which I bashed badly decades ago as a seaman, second, class, in the U.S. Navy. In 1972, a navy surgeon (literally) screwed the joint back together, and that repair job worked for a while. Over time, though, the stainless-steel screw in my clavicle loosened; my shoulder grew increasingly painful and hard to move. By the first decade of the twenty-first century, I could no longer swing a golf club, I could barely reach up to replace a lightbulb overhead of get the wineglasses from the top shelf. Yearning for surcease from sorrow, I took the bum shoulder to doctors and clinics in countires around the world.”
An international journalist, with a bum shoulder… This unique perspective certainly gives Mr. Reid a unique perspective from which to study this issue. Here are a number of key quotes from his book:
Government and academic studies report that more than 20,000 Americans die in the prime of life each year from medical problems that could be treated, because they can’t afford to see a doctor. That doesn’t happen in any other developed country. Hundreds of thousands of Americans go bankrupt every year because of medical bills. That doesn’t happen in any other developed country either.
Efforts to change the system tend to be derailed by arguments about “big government” or “free enterprise” or “socialism” — and the essential moral question gets lost in the shouting.
All the other developed countries on earth have made a different moral decision. Countries that are just as committed as we are to equal opportunity, individual liberty, and the free-market have concluded that everybody has a right to health care — and they provide it. One result is that most rich countries have better national health statistics — longer life expectancy, lower infant mortality, better recovery rates for major diseases — than the United States does. Yet all the other rich countries spend far less on healthcare than the United States does.
The primary issue for any healthcare system is a moral one.
If we want to fix American healthcare, we first have to answer a basic question: should we guarantee medical treatment to everyone who needs it?
All the developed countries I looked at provide health coverage for every resident, old or young, rich or poor. This is the underlying moral principle of the health care system in every rich country – every one, that is, except the United States.
How many people go bankrupt because of medical bills? In Britain, zero. In France, zero. In Japan, Germany, the Netherlands, Canada, Switzerland: zero. In the United States, according to a joint study by Harvard Law School and Harvard Medical School, the annual figure is around 700,000.
For all the money America spends on health care, our health outcomes are worse on many basic measures than those in countries that spend much less.
The United States is the only developed country that relies on profit-making health insurance companies to pay for essential and elective care…
All the other developed countries have decided that basic health insurance must be a nonprofit operation. In those countries, the insurance plans – sometimes run by government, sometimes private entities – exist only to pay people’s medical bills, not to provide dividends for investors… The U.S. private insurance industry has the highest administrative costs of any health care payer in the world.
And here is the simple summary of his solution:
• Problem: Too many people without health care.
• Solution: Health care for all.
The ACA is now the established law of the land. There will still be many political battles to come. But, for me, there is always the simple brilliance of the Geritol commercial that I remember from so many years ago (watch that old commercial here):
“We’ve got so much to be thankful for. We’ve got our health and when you’ve got your health you’ve got just about everything.”
The older I get, the more I realize just how true these words are. And health care is pretty connected to the whole idea of “you’ve got your health…”
“It is not the strongest of the species that survives, nor the most intelligent that survives. It is the one that is the most adaptable to change.” Charles Darwin
Max Mckeown presents his material within a three-part framework that focuses on these strategic objectives: How to recognize the need to adapt? (Chapters 1-6), How to understand necessary adaptation? (Chapters 12-17), and How to adapt as necessary? (Chapters 12-17). As Abraham Maslow suggests with his “Hierarchy of Needs” (usually portrayed in the form of a pyramid), man must first survive before giving thought to security; and only when secure can man consider “self-actualization” (i.e. personal fulfillment). Mckeown’s primary objective in this book is to help his reader to understand when, how, and why to adapt “faster and smarter than the [given] situation changes.” He accepts Darwin’s concept of natural selection but asserts, “Adapt or die is not the only choice. In the future, you can try to maintain what you already have, or you can attempt to transcend the constraints of your situation. We’re part of a long chain of adaptive moves. Each move has changed the circumstances of our ancestors, until we arrived.” How to learn how to adapt?
In response to that question, Mckeown provides an abundance of information, insights, and counsel. Here are a few of the dozens of passages in his narrative that caught my eye:
o Why all failure is failure to adapt
o How to embrace “unacceptable wisdom”
o Why stability is a “dangerous illusion”
o Why learning fast is better than failing fast
o How to think better together
o Why hierarchy is “fossil fuel”
o How to “get your ambition on”
Mckeown is well-aware of the importance of survival to countless individuals as well as to countless organizations and even countries throughout the world. However, his hope — one that I share — is that those who read this book will aspire to accomplishing more, much more than survival.
The key, in my opinion, is first developing and then applying a mindset that recognizes the need for adaptation, understands what adaptation requires, and possesses imagination and (yes) courage sufficient to separate thinking repetition — perpetuating what James O’Toole so aptly characterizes as “the ideology of comfort and the tyranny of custom” – from adaptive iteration. Change may be inevitable but progress is not. The need to adapt is inevitable but being able to do that effectively is not.
I introduced this brief commentary with a statement by Charles Darwin and now conclude it with another: “In the long history of humankind (and animal kind, too) those who learned to collaborate and improvise most effectively have prevailed.”
Here is a brief excerpt from an article written by Suzanne Lucas for CBS MoneyWatch, the CBS Interactive Business Network. To check out an abundance of valuable resources and obtain a free subscription to one or more of the website’s newsletters, please click here.
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(Money Watch) COMMENTARY Everyone has horror stories about bad bosses. Then when we become the boss, we tend to think that we’re only doing what is necessary and, by the way, that employees cause all the problems.
Thing is, part of a manager’s job is to handle bad employees; an employee shouldn’t have to handle a bad boss. So how do you know if you are one? Here are [two of] five signs that you’re failing in your job as a manager.
1. Your employees lie to you. This may sound like a bad employee problem, but why do they need to lie to you? Do you make unreasonable demands? Punish people excessively for mistakes? Interrogate them over why they need time off? These things all create a culture where your employees feel the only way they can get what they need is to lie. A culture of openness and understanding makes for employees who will speak honestly with you.
2. No other managers want to poach your employees. A good manager develops good employees. Other managers want good employees. If you are developing good employees, your peers will express interest in working with them. If you spend more time trying to get rid of bad employees than trying to keep your good ones, the problem may be with you.
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To read the complete article, please click here.
Suzanne Lucas spent 10 years in corporate Human Resources. She’s hired, fired, and analyzed the numbers for several major companies. She founded the Carnival of HR, a bi-weekly gathering of HR blogs, and her writings have been used in HR certification and management training courses across the country.
To read her other articles, please click here.
How and why to avoid or break free from a cycle that grows (unintentionally) vicious
Ignore the title of this book. It serves only the publisher’s marketing purposes. Focus instead on the subtitle: “How to Break the 24/7 Habit and Change the Way You Work.” As is also true of most other business books, the subtitle is informative. It reveals why Leslie Perlow wrote the book. Clearly, she agrees with Charles Duhigg’s observation in his book, The Power of Habit: “We now know why habits emerge, how they change, and the science behind their mechanics. We know how to break them into parts and rebuild them to our specifications. We know how to make people eat less, exercise more, work more efficiently, and live healthier lives. Transforming a habit isn’t necessarily easy or quick. It isn’t always simple. But it is possible. And now we know why.”
In Perlow’s book, the smartphone is not the problem nor is how the smartphone is used. Its use (actually abuse) is a symptom of the root problem: A mindset that ignores or under-appreciates the nature and extent of what can be controlled in terms of, for example, setting priorities, allocating resources, managing time, and renewing energy. Duhigg asserts – and I agree — that we must create a better habit for changing habits just as Clay Christensen urges us to think more innovatively about innovation and Jon Katzenberg urges us to change how we think about change.
What Perlow offers in this book is a non-nonsense, practical, results-driven process by which to turn off electronically, while improving the work that is done. She calls the process PTO” because – at the core, when people work together to create `predictable time off’ [PTO], people, teams, and ultimately the organization all stand to benefit as do, I presume to add, an organization’s past, current, and prospective customers. Also, establishing and then sustaining a PTO culture will make the organization significantly more attractive to the people it hopes to obtain in what is indeed a “war for talent.”
The specifics of the PTO process are best revealed in context, within the narrative, with a real-world frame-of-reference that Perlow so carefully establishes for them. However, I do want to cite a few of the dozens of passages that caught my eye:
o “The [Initial] Transformation” (Pages 31-33)
o “Two Teams: A Study in Contrasts (54-58)
o “The Cycle of Transparency” (67-68)
o “The Benefits of Openness” (75-77)
o “Eliminating Bad Intensity” (95-96)
o “The Perils of Resistant Leaders” (117120)
o “Getting Started: Guidelines for Team Members” (156-158)
o “Diffusing Throughout our Organization (177-178)
o “Going Forward with Facilitation” and “Practices of effective Facilitation” (194-196)
o “Toward a More Humane Workplace” (204-205)
No brief commentary such as this could possibly do full justice to the scope and depth of the information, insights, and wisdom that Leslie Perlow shares in this volume. That said, I hasten to suggest that it would be a fool’s errand for a reader to attempt to apply everything learned from the material provided. My suggestion is to re-read the book slowly and carefully (especially Chapters 10-12, Part IV), underlining the key passages you may have missed the first time, then draw up a list of 2-5 strategic objectives (no fewer than three, no more than five) that the PTO process can help your organization to achieve. Next, review the material in the book that is most relevant to what specifically must be done to achieve the objectives. Game on!