Archive for the ‘Current Affairs’ category

Finding the Cure…for Bullying

January 21st, 2011

No workplace bullying - Nick Jacobs - healinghospitals.comThis week, NBC’s Today Show featured another story about bullying. As I have have mentioned in previous posts here and elsewhere, I believe that bullying is the quintessential cancer on our lives in places of business, in the military, politics, and relationships of all types.  The good news – actually the very good news –  is that there has been some incredible work being performed on this topic through the efforts of Dr. Matt Masiello at my former place of employment, the Windber Research Institute in Windber, PA.  Grants through the Highmark Blue Cross Foundation of Pittsburgh have fueled this initial effort and the academic and quantitative analysis being done by Clemson University has documented this work.  I believe that this joint effort is a magnificent  example of what can be done to change the future course of events currently being controlled by bullies.

The Today Show story that I saw featured the Massachusetts school where, due to cyber-bullying, a young girl committed suicide last year.  Apparently, another girl is now having the same experience at the same school. With the help of programs like this comprehensive anti-bullying program, the former Secretary of Education from PA, Jerry Zahorchak, (now Superintendent of the Allentown PA school system), embraced the effort to quell and discourage this type of destructive behavior.  And the program, under the direction of Dr. Matt Masiello has successfully been introduced across the  entire State of PA. (Matt had started the Allegheny County’s Goods for Guns program in 1994, when he was the head of pediatric intensive care at Allegheny General Hospital. To date, this program is responsible for collecting more than 11,000 illegal guns from the streets of Pittsburgh.) Matt has had the same success with this anti-bullying program. Now, both Massachusetts and Maryland are looking into embracing this effort.

This anti-bullying program is based on a European program with which Dr. Masiello had become familiar.  This is a school system-wide effort that is very well documented and results in tremendous awareness and reduction of bullying at all grade levels.

The trainers bring a group of teachers and administrators together in the school system, and then “train the trainers” as to how this effort can become part of the philosophy of the school.  They start the training in the spring, typically launch the school wide effort in the fall and run it for at least a year. During that time, detailed records are kept measuring outcomes.

Matt Masiello, MD - Windber Research Institute - Nick Jacobs - Taking the Hell OUt of Healthcare

Matt Masiello, MD

Matt is a wonderful physician, a truly giving person and a saint of a man who is the only U.S. representative on the board of the World Health Organization’s Health Promoting Hospitals program. I hired him before I left Windber Research Institute, and he has worked tirelessly to address both this problem and the problems of childhood obesity.

The Olweus Bullying Prevention Program (Olweus.org on the web, @Olweus on Twitter) has impacted more than 400 school districts and 20% of all school-aged children in Pennsylvania. It has also had up to a 50% reduction in student reports of bullying …and bullying others.

For more information, please contact me or Dr. Matthew Masiello at the Windber Research Institute.

Michael & Marisa’s anti-bullying song – “The Same”

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Making Sense of Tucson

January 11th, 2011

It was 1991 when one of  my professors at Carnegie Mellon University began discussing health policy in the United States.  He told us about Arizona, where the state government had decided to stop paying for transplants.  Then he went on to explain that desperate families were moving from Arizona to Pittsburgh, just so they could establish residency in Pennsylvania, and their loved one could receive a transplant.

At around that same time, an outspoken politician from Colorado, former Governor Richard Lamm, who ran for President of the United States on the Reform Party, described the travesty of Medicare vs. Medicaid.   He described the older generation as committing “generational murder” because, even though many times there was no hope  for their survival, for extending their life or for having any quality to their life, we, as a nation, spend 60% of our Medicare dollars on the last  30 or so days of life.  He advocated being honest and allowing people to decide if they wanted palliative care.

What he also pointed out was that, as a country, we continue to have one of the highest infant mortality rates in the industrial world. The reason, he theorized, was because the seniors voted and the young mothers didn’t and no politician would dare vote against that senior coalition.  (This is not about death panels, it is about honesty in healthcare. It is about transparency and explaining the facts to the families so that they could make rational decisions.) None of his words were well received, but nevertheless, they were filled with candor and embraced very difficult ethical views.

Giffords Tucson tragedy - Nick Jacobs, FACHE - Healing Hospitals

The bottom line?  It is a very sad situation when we have to, in effect, sentence people to death at any age because resources are not available to save them, but this is emphatically not about rationing of care, because rationing infers giving everyone a little less.  This is about making a government decision to take away everything. So, this is about making rational  resource allocation, not based upon the number of votes needed to get re-elected, but based on the value of a life at any and all ages.

Finally, the elephant in the room?  Those people killed and wounded in Arizona were killed and wounded because of a man who is most likely mentally ill.  We, as a country, must begin to address this mental health issue with parity, with commitment and without judgment.  No family is without some member who is suffering from some mental health issue, but  this discussion is still ignored, hidden or buried.

So, when the pundits ask if it is about the rhetoric? We don’t know. When they ask if it is about the availability of weapons and ammunition?  The answer seems to fall under that same category. BUT, when the question is properly directed toward mental health?  The answer seems to be absolutely, yes without a doubt.

During this time of reflection, let’s get serious about the very real and very big challenges that this nation faces. We must, as a nation, take these challenges head-on and deal with “problem solving,” and if this Congress does not begin to take action and begin to solve problems, then we must vote again in May and November to continue to make our voices heard.

Unless we can begin to talk with each other with dignity and respect, we will not make progress.  Until we begin to respect the other person’s point of view and understand that debates are healthy again, we will not make progress. Our leaders need to debate, but at the end of that debate, it is essential that they walk out of the room together and agree that they are all here to do a job, and that job is to solve problems.

My heart goes out to all of those families who were impacted by this awful tragedy.

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Wikileaks and Transparency

December 9th, 2010

LONDON (Dec. 8th) —Held without bail in Wandsworth prison, Julian Assange has been deprived of his trusty laptop, so the WikiLeaks founder can’t supply an inside scoop on life behind bars. But if the pro-transparency campaigner could leak just one word about conditions in Britain’s biggest jail, he would probably settle for “cramped.”   (via AOL NEWS)

Wikileaks' Julian Assange at TED - Nick Jacobs, FACHE

At my last CEO position, there were about 650 employees on the hospital side and another 50 at the research institute, but in the position that I held as the Chief Communications officer immediately before that,  there were over 4,500 employees.  Any one of those employees could  potentially have become PFC Bradley Manning.  Manning is the young man being accused of leaking millions of pieces of information to Assange’s Wikileaks. Every disgruntled, well-intentioned and sometimes naive employee who either had an “axe to grind” or who simply embraced a philosophy of openness would have potentially presented a major problem to any organization that was built around secrecy at all costs.

In my 20+ years as a hospital administrator, there were hundreds no, thousands of incidents that could have been “leaked” to family, friends and the media regarding incidents that may or may not have been problematic.  My memory goes immediately to an online discussion forum where the death of Congressman John P. Murtha was being dissected by a group of Bethesda Residents;  specifically, young U.S. Navy physicians who were venting and expressing their fears regarding their “being held responsible for the death of this powerful Congressman.”  The amazing thing to me was the it was a running dialogue that was, yes, online. The discussion topic thread was etitled Did we kill Congressman Murtha? The anonymous user names went through case-by-case analysis of other undeserving patients who did not emerge with their lives from surgeries at the hospital over the previous weeks and months.  These were individuals who, according to their estimations, should have. Imagine my shock when I came upon the casual page which, at minimum represented a potential HIPAA violation.

Well, it’s all about transparency, my friends, and this movement is only the beginning.  Unlike Kevorkian’s efforts which were almost single-handed, this is a movement, a viral, well-funded, philosophical movement that feels like “Damn the torpedoes, full speed ahead.” And it’s “coming to a theater near you.”   Not unlike the content of the sensitive documents that have been appearing online recently where peoples’ lives are at stake,  hospitals and physician offices face many of the same realities every day.  How many people, like PFC Manning, may not be truly insane or wish to destroy the government, but simply believe that their assistance in exposing the truth will “set us free?

Transparent Butterfly - Nick Jacobs, FACHE - Healing HospitalsAs business leaders not many decades ago, we were urged to treat every e-mail and every comment as if it was being reported by Mike Wallace on 60 Minutes.  Of course, not many of us did, nor could we stick to that difficult rule of communicating, but think of the potential ramifications if Mr. Wallace had been as potentially ever-present as Mr. Assange.

What is my formula for success?  It’s always been the same.  Be as transparent as you can possibly be. Seems simple, but try it sometime. Don’t break the law. Don’t give out information that is inappropriate as in personally destructive regarding individuals, but be as open about your operation as you can possibly be.  Encourage an environment of openness when it comes to issues, mistakes, etc. and the frustration levels will go down, down, down…sometimes to the point of having employees telling you, “I wish I didn’t know so much.  Life was easier when I was in the dark.”  That’s when you’ll know you are beginning to provide a truly transparent business environment.

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Light Up Night

November 20th, 2010

50th anniversary Light Up Night - Nick Jacobs, FACHE - HealingHospitals.comMy apartment is about two blocks away from Pittsburgh’s Cultural District and the same distance from the Sports District where the theaters, stadiums and plenty of restaurants are all nearby. Last night was the 50th anniversary celebration of “Light Up Night,” when the Holiday trees, choirs, and seasonal celebrations begin. Literally tens of thousands of people make their trek into the City for this special night. Zambelli puts on its finest fireworks display of the year, while lighted, horse drawn carriages, food vendors, and music fill the city. It is intended to be a special night for families, and last night was no different. Except for a few distractions.

Because my place is on a main drag and literally one apartment up from street level, activity sometimes feels like it is taking place directly in my living room. Most of the time, this reminds me that I’m alive and it is stimulating, exciting and always evolving. Last night, however, things were somewhat reminiscent of a war zone. Literally a block away, the Clemente Bridge was the staging point for some magnificent fireworks and the crowds were everywhere.

Not long into the celebration, however, it began to feel like Chicago during the filming of the Blues Brothers. Sirens were raging past my apartment at the rate of one a second to what could have been a gun battle. Instead, it was one gun and one victim with plenty of other potential participants standing by ready to mix it up. Then, a few minutes later, another burst of sirens went in the other direction toward an Irish Pub about a block from my apartment. There, another man had been shot. When the news came on, it was apparent that every available policeman in the City had been called to the Wood Street scene to attempt to keep things from boiling over as young men were escorted in handcuffs toward waiting police vans.

I am NOT a sociologist, but it seems very clear that this is just the beginning of what could literally escalate into a form of anarchy as we continue to pursue our current philosophy of greed in this country. While working on a grant a few months back I saw a statistic that was mind numbing. Young African American men in what are considered high crime areas of this city are experiencing an unemployment rate of about 75+ percent. The national average for young black men is about 45 percent and in Pittsburgh, with a few point differentiation due to my sometimes less-than-precise memory, that more global average jumps to about 55 percent.

This week, however, we heard that unemployment compensation would probably not continue to be extended, and last week we heard that education was only one of the potential targets for domestic budget cuts. Not unlike the hospital employees who consistently take all of the premium parking spaces so that their walk into the building is the very closest possible, there seems to be a breakdown in logic. If we don’t correct the problems that we have in our education system; if we don’t help people who have, for no reason of their own become jobless or disabled; if we stop caring about the middle class, and stop helping the poor to establish themselves; where will it lead as a nation?

My personal belief is that we can cut both domestic and military budgets; we can delay some gratification, and we can tweak some of the laws that allow profits to benefit the one or two percent of us who are clearly now in the elite class of protected citizens. The question is, can we do this in a way that does not destroy those who are struggling to survive? Take away the parking places, and you discourage patients from using your hospital which leads to lay-offs. Take away the safety nets, and we might soon have an out of control population that will cost us more than any of the tax breaks or safety net cuts give us. Let’s cooperate in repairing this mess. PLEASE.

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Things People Are Thinking About

October 14th, 2010

Every few weeks or so, I take the time to read articles produced by The Pew Research Center, a non-partisan fact tank. Pew does not take sides in policy disputes, but they do provide a valuable information resource for political leaders, journalists, scholars and citizens. I believe that I come under that last category, citizen. The only requirement that Pew has relative to their findings is that their sources are cited accurately and in context.

Recently, they provided some fun statistics:

For example, among the public, one-in-four (25%) believe in astrology (including 23% of Christians); 24% believe in reincarnation, nearly three-in-ten (29%) say they have been in touch with the dead; almost one-in-five (18%) say they have seen or been in the presence of ghosts. If none of those statistics surprise you, then you clearly are not me.

Here was another great poll finding: 87% of scientists say that humans and other living things have evolved over time and that evolution is the result of natural processes such as natural selection, but only 32% of the public accepts this as true. (From the work of Jodie T. Allen and Richard Auxier, Pew Research Center)

Conference on Climate Change, Poznan, Poland

Well, this next poll was even more interesting to me. As both a business person and a humanist, it has been difficult for me to hear large numbers of my friends and acquaintances literally “going off” about how ridiculous global warming is. They say things like, “Global warming and global cooling happen all the time; it’s just a natural course of events.” Others say, “Al Gore filled us with lies about global warming for his own financial gain.” Finally, I have heard over and over, “Well, we can’t do anything about it anyway, so why worry.”

Then there’s the opposite side where experts say things like, “If we stopped using all fossil fuels right now, the earth will continue to heat for another 60 years, and all of the devastating floods and fires that we’ve seen this year were the result of only a 1 degree increase in the world’s temperatures, and in 60 years we will heat up by 5 degrees.”

What did Pew find about the current global attitudes about climate change?

Pew - global attitudes about global climate change - Nick Jacobs, FACHETheir international polling shows that publics around the world are concerned about climate change. In the recent spring 2010 Pew Global Attitudes survey, majorities in all 22 nations polled rate global climate change a serious problem, and majorities in ten countries say it is a very serious problem. There are some interesting differences among the countries included in the survey. Brazilians are the most concerned about this issue: 85% consider it a very serious problem. Worries are less intense, however, in the two countries that emit the most carbon dioxide — only 41% of Chinese and 37% of American respondents characterize climate change as a very serious challenge.

Even though majorities around the globe express at least some concern about this issue, publics are divided on the question of whether individuals should pay more to address climate change. In 11 nations, a majority or plurality agree that people should pay higher prices to cope with this problem, while in 11 other nations a majority or plurality say people should not be asked to pay more.

These findings remind me of numerous other examples of confusion created by the short term winners and losers in what are serious economic discussions. There are 1.5 B Chinese, and over the next several years, many of them are going to want a car. Regardless of your own personal stand on this issue, that’s some serious potential pollution.

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Evolution or Devolution?

July 16th, 2010

There’s a part of me that celebrates each and every day because I’m evolving. For example . . . being a mature person usually feels pretty good.  I’m more settled, less angry, less needy, less . . . well, you get the idea.  On the other hand, I would never want to own a, vintage car.  Why?  They usually don’t have air conditioning, air bags, seat belts, or CD changers. . .with auxiliary jacks for MP3 digital audio players.  Driving one would be taking several steps backwards in safety, comfort, and style.

How else have I evolved?  Let’s see.  I have air bags.  Okay, maybe they’re not air bags,  but I have a protective coating of extra stuff around my organs. (I’ve gained at least one additional pound a year for the past 30 years.)  Oh, and I am a lot smarter, too.  In fact, my IQ test gained at least 10 points over the last few decades.  (It would probably have been 20 points higher if I hadn’t been on cholesterol medication, but I’d probably be dead and that higher IQ wouldn’t help much.)  On the other hand, the fish oil is supposed to make your brain work better.  Mom used to say, “Nicky, eat your fish.  It’s brain food.”  (Forget the fact that it was deep fried and heavily battered.)

Nick Jacobs, FACHE at the beach with his grandchildrenThis evolution thing could all be summed up by saying that I’m finally starting to mature.  Even though I’ve missed it by decades; it’s happening now.  I’m wiser.  Honestly, there couldn’t be that many things left to learn about running stuff; four decades is a lot of  experience.  I’ve learned about politics, human relations, sociopaths and wonderful souls; and I’ve learned about construction, child birth, heart attacks and ground moles.  I’ve lived through the birth of my kids, my grandkids, and my friend’s kids.  I’ve lived through the deaths of every aunt, uncle, and a few cousins; friends, neighbors, mentors and a half dozen family pets, and I’ve held both of my parents in my arms as they passed, too.

Having observed all of this, what is the devolution?

On NPR the other day, there was a short story that the American public’s view of capitalism has deteriorated.  The exact percentage of those still embracing capitalism was about 44% and those who think it’s outlived its appropriateness was around 47%.  (I guess the other 9% might have thought that capitalism had something to do with that white building in Washington D.C.)  Interestingly, before I heard this story, my impression of capitalism had devolved as well.  In fact, the litany of sins observable to me because of the extreme capitalist approach that we have embraced is long and includes:  BP, Enron, Tyco, Bernie Madoff, and the fat food industry . . . I mean, the fast food industry.

But then I read a rant by Jonah Goldberg of National Review Online:

“Every good thing capitalism helps produce — from singing careers to cures for diseases to staggering charity —  is credited to some other sphere of our lives. Every problem with capitalism, meanwhile, is laid at her feet. Except the problems with capitalism — greed, theft, etc. — aren’t capitalism’s fault, they’re humanity’s. Socialist countries have greedy thieves, too.”

So, what’s the answer?  It seems simple enough.  Once again, from Mom, “It’s moderation.”  The far right and far left seem to be providing a daily whipsaw of entertaining cable news shows from Beck to Olbermann and from Hannity to Maddow, but these extreme views are not helping us solve the problems.  In fact their rhetoric contributes to this devolution.  Does Rush really believe everything that he says or does he say it because it’s so outrageous that he can continue to earn nearly $38 million per year?  And Keith? And Glenn?

I like my air conditioning, my air bags, and my computer assisted brakes, but I’m really getting tired of “bags of air,” greedy anybodys and anythings.

Let’s be less angry, less needy, and more settled . . . come on, guys, grow up.

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Big Bird vs. The Status Quo

June 4th, 2010

Feeling “funny,” is something that would describe me pretty well today. Not ha ha funny, stomach ache funny. I’m thinking that Abraham Lincoln, Franklin Roosevelt, John Wayne, Amelia Earhart, and even Hawkeye Pierce from MASH may have ruined me. They stood up for what they believed, right or wrong, left or right. They had chutzpah, nerve, and . . . well, you know.

So, what’s making me feel funny? It’s those darn birds. Those birds have touched my heart. Tell me this; how can you not feel empathy for the baby birds being oiled down in their nests, and how about the tiny little birds that are still flying around a few feet from the oncoming disaster with absolutely no clue as to how bad things are going to be in a very short amount of time. I’ll admit that, unlike my mom, I’m not a passionate bird lover, but those big, oil soaked birds are really getting to me.

I’ll be the first to tell you that I’m allergic to shell fish, and even though, according to some oil company spokesperson, “Louisiana isn’t the only place that has shrimp,” according to my memory, their shrimp was some of the best in the world. So, if you’re not a big bird fan, how about a big shrimp fan, or a big fan of places where people live? How about a big fan of being able to sit on the beach or of jobs; fishing jobs, tourism jobs, even oil jobs? What will it take to get our leaders to show some real passion? I’m thinking Sesame Street.

We all know that getting the kids involved has helped remind us to start wearing our seat belts and bike helmets, to stop drinking and driving, and now texting and driving. Maybe we need Sesame Street to get our country to finally scream out from the top of their lungs, “S-T-O-P it.“ Could you imagine Big Bird or better still the President of that oil company dressed as Big Bird all soaked in oil being pushed out into the Gulf and gasping for air as he slowly is washed away forever? It would make the time they did the “Mr. Hooper is dying thing” seem tame.

One of my favorite sayings is “The problem is never the problem,” and the problem here is, once again, the status quo. It’s that philosophy of “don’t change ANYTHING because I’m personally comfortable with my life.” Just this week, a group of scientists who literally have brought 44 people out of deep, irreversible comas; soldiers, policemen, firemen, coal miners, and little boys and girls had their federal grant blocked because the status quo scientists and doctors involved said that “It was not the traditional methodology for treating coma patients.” Yikes, tell that to the people who lived, many of whom are back to leading functional lives. Come to think of it, that would be a good Sesame Street show, too. Oscar the grouch in Critical Care with tubes, the Cookie Monster administering the Last Rites, and Bingo Bango he’s awake and grouchy again.

Is it possible that no one wants to stand up for what they believe in and take it on the chin anymore? Somewhere there still must be some lines, some sacred requirements that we must meet in order to qualify as human beings on this planet? Could you imagine how different those John Wayne movies would have been? “It’s okay, pilgrim, let ‘em rob the bank. We need their support for re-election.” How about Neil Armstrong? “You want me to do what?” “Are you crazy?”

I still feel funny. Where the heck is Big Bird and Hawkeye when you really need them? We’ve had seagull management in this country for far too long now as they “Fly in, squawk, poop on our heads, and fly back to D.C. “ Pelicans UNITE!

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Moving Through Healthcare’s Version of the BP Oil Spill

May 27th, 2010

Who could have ever guessed that the United States of America would fall so far behind in education, childhood death statisticsscientific research, manufacturing jobs, and even overall, general healthcare?  Yes, of course, we are still a wonderful, strong country with incredible resources, but somewhere along the line, the train seems to have jumped off the track just a little, or is that like being a little pregnant?  No one would ever have conceived that a spark plug would be worth more than GM stock, but that’s exactly what happened last year.  Or how about the fact that large investment banks responding to the mandate to increase home sales by spreading the risk internationally could have helped put this entire world on the verge of a national depression?

For years now I’ve written about the need to provide some type of safety valve for the uninsured, underinsured, and those struggling to make it from layoff at age 58 to Medicare at age 65.  Not unlike the Kennedy-Katzenbaum bill, (you know, that HIPAA bill that was just meant to provide health insurance portability), we have healthcare reform legislation.  The really challenging thing about this new bill is that it was primarily written by policy wonks fifty percent of whom will not be working in Washington D.C. in a few years, and worse than that, it will be interpreted by policy wonk lifers who will be there long after we are all dead.

So, the “Healthcare Oil Spill” has been addressed.  What will it mean?  What does it mean?  How will it impact all of us?  That remains to be seen.  The good news is that 30 million more people will finally have a safety net. The bad news is that there are still two wars going on that are draining our treasury.  There is still financial chaos among the countries lovingly referred to by the EU as the PIIGS (Portugal, Ireland, Italy, Greece, and Spain), and, along with this group,  spending in the United States  has been out of control for at least nine years.

What will happen is anyone’s guess.  How things will be interpreted is anyone’s guess.  How the law will be enforced is every one’s guess, but in  a recent round table discussion at the Mid-State HFMA meeting, we heard four CFOs discuss the challenges that they currently face and will continue to face as life becomes even more complex.  After that session, I’m thinking that lots of mud pushed in the head of the well might just be the cure!  Goodness knows there was enough mud thrown around during this last election cycle.  Maybe we could redirect it back to the source?  I do know for sure that one thing is clear: CHANGE is INEVITABLE, the train is back on the track, and it’s coming straight toward our physicians, hospitals, and nursing homes.

How do we cope with that change?  Make sure that every ounce of fat is cut from the system.  Take a look at the list below and contact SunStone Consulting for the next steps:

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Gotta Love This Guy (Oh, yeah, and this is an editorial comment)

March 1st, 2010

As we begin to emerge from the bottom of a V-shaped recession, we all pray that it does not evolve into a W-shaped recession. Having been a witness for the majority of this economic challenge rather than an officer in charge, I’ve observed several significant issues that have impacted the hospital industry.  They have included the downgrading of bonds, a serious lack of access to capital financing, cutbacks in elective surgeries and elective donations to our health care foundations,  All of which has resulted in a deep degree of uncertainty as to when  all of this will be over.

V, L, W, U or L-shaped recovery vs. recession

The fact that many of the economic practices that got us into this mess have still not been discontinued or are being reshaped into the newest version of the scam du jour does not bring peace of mind to the vast majority of us, a deeply concerned citizenry.  Add to that the billions and now trillions that we are committed to repay over the next several generations, and one has to wonder about the ability of our current political system to respond appropriately to these challenges.

Warren E. Buffett

Warren Buffett’s annual letter to Berkshire Hathaway shareholders criticized Wall Street executives and board members in a way that most of us would liked to have expressed, but which only Buffet could articulate. This is because his comments are clearly supported by his business acumen and investment skills.  He broadsided the leadership of Wall Street for failing to control risk and for avoiding  what very clearly should have been the “severe” consequences of these failures.  He chastised the bankers in particular for designing and implementing their own industry’s doom and then piling the losses onto investors, while they themselves have managed to maintain lavish lifestyles.

“It has not been shareholders who have botched the operations of some of our country’s largest financial institutions,” Buffett wrote. “Yet they have borne the burden, with 90% or more of the value of their holdings wiped out in most cases of failure. Collectively, they have lost more than $500 billion in just the four largest financial fiascos of the last two years. To say these owners have been ‘bailed-out’ is to make a mockery of the term.”

“The CEOs and directors of the failed companies, however, have largely gone unscathed…Their fortunes may have been diminished by the disasters they oversaw, but they still live in grand style. It is the behavior of these CEOs and directors that needs to be changed: If their institutions and the country are harmed by their recklessness, they should pay a heavy price – one not reimbursable by the companies they’ve damaged nor by insurance.”

With his sentiments firmly ensconced in my mind, I have to wonder about the current rounds of outrageous health insurance increases perpetrated upon the customers of many of our largest and most profitable insurance companies.  As a hospital CEO, I learned very early on that no matter how low we held our charges, those savings would not be passed on to the patients because the middle man controlled this aspect of the “business.”  Incentives are completely upside down in the system at many levels, and the political commitment to truly work toward meaningful change seems not only misguided but also seriously uninformed.

Blair House health summit, February, 2010

Bottom line?  We need to be heard.  We need to work toward systems that make sense: protection from catastrophic financial situations brought on by major illnesses or accidents, primary care that truly helps the patient manage their health challenges at a reasonable cost, and a complete change from a sickness-based to a wellness-based reimbursement system that is not dependent upon the insurance companies for the decision making proposition.

Sometimes right is truly black and white, and until we embrace palliative care, incentivize individuals for taking care of themselves, and deal with tort reform, progress will be only a delusion.

U.S. Health Care Reform Timeline: 1910-2010

U.S. Health Care Reform Interactive Timeline: 1910-2010

Click image above to view full-size, interactive timeline. (Will open in a new web browser window.)

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Staying Humanly Grounded and Healthcare Reform

December 26th, 2009

Each year I put up the tree and begin to believe that it is magic. The room feels and looks warmer. Often, I’ve considered leaving it up all year as a symbol of joy, love, and happiness, but when I returned home last evening it hit me that it was not the tree as much as it was the carefully wrapped packages beneath it. Once they were gone, the room seemed void of its magic.

It hit me that those packages represented anticipation, love, and sharing in ways that truly touch your soul. Those acts of love represent the essence of that entire experience, price or cost don’t really matter.  It’s the giving.

Healing Hospitals: little girl in hospital bed with caring doctorI try to end every night by reading CarePages from a local children’s hospital website; stories of young children that have many times reached the end of effective treatment and are waiting to meet their destiny decades before their time might have been.  The outpouring of the deep, soulful hurt that their parents, siblings, and grandparents are experiencing from this journey is always profoundly moving to me.  In many of these instances, the only gifts that we have left to give them are our  love and support.  That, however, is not the case for the majority of our fellow men in this country.

It won’t be long until the final product of the healthcare reform effort will appear.  We all know by now that it will be a patchwork quilt of sometimes horrendous compromise.  We can also count on the fact that the negative rhetoric will reach decibel levels typically heard only when standing in close proximity to a jet engine.  The pundits will parade up and down the isles of righteousness, and they will be spouting off their theories regarding what should have happened.  At the end of the day, however, when we approach our bathroom and bedroom mirrors for that last inevitable look, we must all dig into our humanity and ask one very real question: “Will it be better for the uninsured than it had previously?”

As a former hospital CEO, it became evident to me in the first six months of my administrative training that only those without insurance were destroyed by the system.  Only those who were not under Medicaid or an other insurance were hit with the awful burden of paying for everything at the full, retail price.  The fallout was clear.  Due to the risk of having to pay full costs to the hospital, they either were too frightened to go for treatment until it was too late, or they lost what little they had; their homes, their savings, and their possessions.

In a country with such unbelievable abundance, where not just the number but also the quality of the cars, clothes, and even pets that we own are held up as barometers of success, we have often allowed our fellow man to suffer and die for economic reasons.

That fact is no more obvious than at any children’s hospital in Pennsylvania, where you’ll see parents from conservative states where childhood transplantation surgeries were always denied, so as to avoid increased taxes.  You’ll see these parents waiting in line to establish residency here so that they can at least have a chance to save their child’s life.

Healing Hospitals: Mother kisses son in hospital bed

Regardless of your politics, regardless of the dysfunctional (mal-)functioning of our government, in which some of our representatives and senators have taken us to the brink of collapse due to their inability to co-operate; regardless of these issues, we are looking at the beginning of health care reform.  I just pray that we don’t revert to the inhuman practices of our recent past.

It’s time for a human win.

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