Archive for politics

Angry Birds occupy Capitol Hill?

(c) 2011 Walt Handelsman | Newsday

Heaving scrums from coast to coast are occupying public squares to protest what seems to be the greatest concentration of personal wealth since the Gilded Age at the end of the 19th century. Their ire is directed at Wall Street, which does bear some of the blame for the epic meltdown of the US – and global – economy over the last four years.

The biggest share of the blame, however, really belongs on another street entirely: K Street. The street of lobbying dreams, chock full of high-dollar law and PR firms that work Capitol Hill relentlessly on behalf of everything from AARP to zoologists.

Individual taxpayers have no access to K Steet influence, unless they’re members of an interest group – like the aforementioned AARP – that has enough chedda to hire a lobbying firm.

Congress, both the House and the Senate, depend on special interest money to mount successful election campaigns.

The electorate – the taxpayers, we individual voters who head to the polls to hold our noses and do the best we can with the choices offered – are offered those choices for national office based on who can raise the most money, and spend it to get our attention.

And now that corporations are people – thank you, Citizens United – they are under no restraint whatsoever when it comes to political donations.

Have you completed the calculation yet? Here’s what it boils down to:

Corporate $ + K Street (Congress) = We’re Screwed

That may seem simplistic, but it captures the essence.

Do not mistake me – I am a capitalist. I believe that every citizen – including corporate ones – has the right to appeal on behalf of his or her interests to elected officials. Where we find ourselves today, though, is at a very broken place.

Most Americans see their financial futures as, if not stormy, at least cloudy with a chance of bankruptcy. They see their children’s future prospects sinking, since the college degree required for an entry level corporate gig will now saddle those kids with a level of debt that will keep them living on ramen noodles well into their 30s.

How does the American Dream work in that scenario? How does hard work – to get a degree, to start a career, to start a business – actually work to advance your cause if most of the marketplace is on the ragged edge of broke?

A commitment to re-tooling our educational system to a 21st century model (instead of the 19th century “train factory workers” model currently in place) and a simultaneous commitment to bringing our national infrastructure up to date would be a step in the right direction. Unfortunately, the occupants of Capitol Hill are more interested in bleating about the lack of jobs than actually creating jobs by taking those actions.

We have a broken bureaucratic biosphere, and we’re choking on sewage. The gridlock on Capitol Hill has reached Nero-with-a-fiddle proportions, with no progress in sight on any issue. Congress isn’t actively doing anything other than saying why it can’t (won’t?) do anything, and we’re at a stasis point until the 2012 election … ?

What’s missing here is balance. There has to be a balance struck between totally unrestrained free markets – can you say Enron? – and government redistribution of wealth via the tax system. There has to be a balance struck between “do for yourself” and a safety net for the most helpless among us.

The only path that I see to that balance is term limits … for Congress. They were real good at setting term limits on the occupants of 1600 Pennsylvania Avenue: two terms, yer out. Winning a House or a Senate seat, however, can mean lifetime employment as long as you can keep getting re-elected.

Even if you can’t keep getting re-elected ad infinitum, you can take advantage of the revolving door connecting the US Capitol to K Street.

The real problem? The folks who have to draft and pass term limits legislation are … Congress. Yeah, they’d have to stamp themselves with expiration dates. Which they are demonstrably loath to do.

And their re-election ad campaigns – financed largely by their buddies on K Street and their pals in state capitals across the land – will work hard to scare us into the horrors that will befall us should we fail to vote them back in to “finish the job.” Which “job” is likely to be more gridlock, followed by another round of “re-elect me to finish the job.”

A quote attributed to Winston Churchill says that “America will always do the right thing, but only after exhausting all other options.”

I hope we are about to exhaust the last of our options before demanding that Congress actually conduct the business of the people. Let’s occupy K Street to help drive that message home.

That’s my story, and I’m stickin’ to it …

Herman Cain image

photo credit: Toby Harnden|Daily Telegraph

The quadrennial silly season known as the US Presidential race has been in full cry on the Republican side for about six months now, with some highly entertaining spectacle already on display. Unfortunately, a popular favorite, Herman Cain, who had built up quite a head of steam as a leading contender, has been somewhat sidelined by accusations that have put his campaign in PR-crisis-management mode.

First, let me make it clear that I have no dog in this fight. I’m still waiting for the Logic Party to form, and meanwhile am a member of the No Labels movement – in other words, I’m apolitical outside the voting booth. Inside the voting booth, I hold my nose and do the best I can under the circumstances.

My purpose here is to point out the three simple, yet critical, steps Cain and his campaign communications team should have taken to, if not 100% avoid this epic mud-fest, at least keep it at small-mud-puddle level.

  1. Vet the candidate fully. Pretend you’re on the oppo research team of another candidate and vet the bejabbers out of your guy. Or gal. Go after anything that could possibly lurk as a Nannygate, or sexual harassment, or financial/business ethics challenge. The Cain team is steeping in a big bucket of #epicfail right now, because according to London Daily Telegraph US editor Toby Harnden, oppo research leakage was what led to the Politico piece that started this mud-fest.
  2. When you know the worst, plan the response. When you’ve got all the skeletons out of the closet and into the living room, start figuring out how to make them look less threatening. In this instance, simply putting the story out themselves would have taken much of the power of it off the table. “Allegations were made, this was the result, the candidate denies that there is any truth to them, but the decision was made at the time to settle the suit/issue/whatever” and move on. Never, ever let a big story about you get out there, unless you’re the one putting it out there. If one does, particularly at this stage of the game, you’re in crisis-response mode at the cost of core-message mode. Cain will now have to talk about this every day, or look like he’s dodging talking about this … every day. Not a path that’s likely to wind up at 1600 Pennsylvania Avenue.
  3. When caught out, make a full statement and then move on. Cain is caught in a cycle of no-comment/denial/bimbo-eruption/feeding-frenzy. This is a really bad place to be, because at this point pretty much anything he says will be discounted as reluctant disclosure. If his campaign had rigorously acted on Tip #1, Tip #2 would have been pretty easy, and Tip #3 might have been completely unnecessary. He’s now going to be chewed on daily until the bimbo eruptions subside. He can keep up the no-comment/denial protocol, but that will keep him in the feeding-frenzy box for the foreseeable future.

I feel for the guy. I covered every Presidential race from 1980 to 2004. As I put it in my bio: I covered wars, Presidential campaigns, and Presidential campaigns that turned into wars. Politics is a rough, nasty, no-holds-barred business – the higher the office, the sharper the knives and the bigger the guns you’ll be up against.

Failing to recognize that, and failing to get in front of any negative information in your past by revealing it yourself first, guarantees painful war wounds.

That’s my story, and I’m stickin’ to it …

Healthcare providers are waking up and realizing that they need to partner with their patients to get better outcomes for their facilities and practices, and for their patients. As Accountable Care Organizations (ACOs) get more and more press, the healthcare delivery side is the entity being held accountable.

Patients must step up to the bumper on accountability, too.

Two phrases have entered the medical lexicon thanks to the Patient Protection and Affordable Care Act, a/k/a “healthcare reform.” PPACA is not actually healthcare reform, it’s health payment reform, but I digress. The two phrases are “patient-engagement,” and “patient-centeredness.” Doctors are being told that they must engage with patients, and offer care centered on their patients’ needs … but that engagement and centeredness message is not being simultaneously driven toward patients.

Therein lies an opportunity for #fail.

Patients need to take responsibility for their health, their actions, and their care. I’m not saying that we should shut up, sit down, and do what we’re told. What we must do is ask questions, work to understand the answers, and then do what is in our own best interest, health-wise.

That does not include ignoring instructions to cut down on salt or saturated fats. It most certainly does not involve living on drive-thru meals and expecting a prescription to resolve your expanding waistline or blood sugar numbers.

In this month’s HealthLeaders, Joe Cantlupe talks about how doctors are making more robust suggestions to their patients, with the goal of turning medical care into a true partnership between patients and providers.

Healthcare providers need to step up and work with their patients, turning healthcare into a team sport.

Patients MUST step up and take responsibility for their choices as well as a full share of decision-making.

That’s my story, and I’m stickin’ to it …

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It has become accepted wisdom that public schools in the US are failing their students.

I confess to believing some of that conventional wisdom: I think we’re losing generation after generation of inner-city and rural kids with sub-par schools and technology. I also think that inner-city schools have become both a dumping ground for teachers who shouldn’t be teaching, and a road to exhaustion and defeat for teachers who arrive fired up and get ground under the wheels of budget shortfalls, bureaucracy, and bullsh*t.

But I digress.

The Washington Post Answer Sheet blog shared a post by Will Fitzhugh, editor of the Concord Review – the world’s only English-language quarterly review for history academic papers by high school students (smart kids + smart teachers = intellectual advancement for all!) – that puts the blame for poor student performance at the feet of … students. The title of the post: “Teachers Not Enough? Who Knew?”

And he’s 110% right there.

I’m now going to sound like the geezer I’m becoming, but just roll with me for a minute here. When I was in school, my job was to go to school, do my work, and learn. That was my job. The one that would set the stage for all the jobs coming after, the one without successful completion thereof I would be stamped with the storied “L on my forehead” and consigned to the career-and-success scrap heap. It was up to me to learn as much as I could, and use that knowledge to forge my way in the world.

Am I nuts, or does it seem as though students in K-12 now believe it’s the responsibility of the school to pry open their brains and pour in knowledge without much in the way of student effort? And that expectation is being driven by parents, and the community at large?

I watched the documentary Waiting for Superman recently, and found it compelling. However, something nagged at me as I watched it, and after, that only became clear when I read Fitzhugh’s Concord Review post: the film left the viewer with the impression that schools, parents, and the community were responsible for the entire education cycle. What was left out was the obligation for students to work to learn.

I’m not saying that a kid in a failing inner-city school who fails to learn is solely at fault for his/her lack of academic progress. As a society, we must make sure that each of our kids has the chance to learn as much, and go as far, as s/he possibly can in life. Charter schools can be a terrific answer for places where public schools are letting down the kids who try to learn there … but they’re not the only, or even the first, answer.

That first answer is: kids, school is your job. Act accordingly. Pay attention, do your work, do not expect to have learning pass through your ears and into your brain without any effort on your part. Life requires that you be present, pay attention, and act to further your own progress. You will not be borne through life on Cleopatra’s barge, much as your helicopter parents might have led you to believe that was your destiny.

Work. It’s what makes things happen. So go do some.

That’s my story, and I’m stickin’ to it …

 

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medical tourism imageNo, not how far you’d go in the Denzel Washington/John Q/hold-a-hospital-hostage sense. In the get-on-a-plane-toward-care sense.

Medical tourism has seen an exponential rise with patients in the US as health care costs and the number of uninsured patients have risen over the last 15 years. In a TIME magazine piece in 2006, Curtis Schroeder, CEO of Bumrungrad Hospital in Bangkok – somehow, I don’t think he’s Thai – said that in 2005 their census of US patients rose 30% (to 55,000).

That trend has continued, even with the advent of “health care reform” – health insurance reform, really – since health care costs have continued their hockey-stick rise, with no end in sight, for two decades.

50 years ago, patients from across the globe saw health care in the US as the holy grail. Now, US patients are traveling to Costa Rica, Thailand, Mexico, New Zealand, even Cuba to get access to high-quality, low-cost care.

US companies have started to explore medical tourism, and some are offering  incentives to their employees – incentives including getting to pocket some of the savings gained from traveling abroad for treatment. Not enough, however, to make medical tourism a healthy industry here in the US of A.

An August 2011 article in Workforce Management includes a story about a nurse in Louisiana (irony is our favorite thing here at Mighty Casey Media) who traveled to Costa Rica a few years ago for dental work, including oral surgery. She paid $2,700 out of pocket for what would have cost her $10,000 at home, with her employer covering $1,500 of her care expenses. Her net cost for the procedures was $1,200, plus her travel expenses – which travel was negotiated and arranged by a broker, Companion Global Health Care Inc.

I’m sure that, even after travel expenses, her savings were still solidly in the thousands of dollars.

So why aren’t more US companies encouraging their employees to take advantage of medical tourism? According to the CEO of Companion Global, David Boucher – who certainly has a dog in this fight, and who is quoted in the Workforce Management article linked above – the rising costs of health care make the health-tourism choice a no-brainer. He says that their customers are seeing a 2- or 3-to-1 return on investment for medical tourism, and patients – their customers employees – are very satisfied with the quality of their care.

However, according to Joe Marlowe, senior VP of health and productivity at the risk-management and HR consulting firm Aon Hewitt who’s also quoted in the WM story, employers are risk-averse, particularly at the idea of making themselves liable for medical care far from home that turns out badly for the patient.

What do you think? Would you travel 8,000 miles for a knee replacement, or 3,000 for chemotherapy, to save a significant amount of money and still receive high-quality care? Or would you want to be closer to your support system – family, friends – while receiving care?

I would most certainly travel to Bangkok or San Jose for a knee replacement. Not sure about oncology, since that follow-up can be so long-term.

You? I really would like to know.

That’s my story, and I’m stickin’ to it …

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I’ve been fascinated by the Wikileaks/Afghan Papers story since it started to gain traction in June 2010. One of my gurus, the endlessly entertaining and thought-provoking Clay Shirky, posted a New Year’s Eve gift on his blog looking at the differences between the Pentagon Papers case and its 21st century doppelganger, Wikileaks.

Clay’s most cogent point – and he has many – is this one: there’s a big difference between “international” and “global” when it comes to actors in this little drama. The example he uses to illustrate this point: the difference between making LSD and cocaine. LSD can be made in a lab anywhere, therefore it’s global. As global as the distribution of cocaine is, it’s still tied to a place: the South American mountains where coca leaves are grown.

Bradley Manning, whose violation of the UCMJ means he’s screwed for at least a couple of decades, make him very much a “local” boy. Julian Assange, since he holds a passport – and all of us, in order to move around the globe, gotta have one of those – might be able to maneuver more easily than Manning, but he’s still under the flag of Australia. If they choose to either arrest him or revoke his citizenship…well, he’s screwed, too, since he’s just “international.”

Wikileaks, however, is the essence of “global” – servers all over ever’where, no one’s officially in charge, even if Assange is the creator and face of Wikileaks – so how on earth will anyone, even the US government, be able to prosecute a case against it?

Plenty of entertainment value in this story, still unfolding.

And that’s my story, and I’m stickin’ to it…