Today, we're experiencing what I consider a healthy debate on the business of Healthcare in America. With so many sides involved in the argument, the details tend to become unclear. There is a growing rift between the system of healthcare and the business of healthcare. Initial finger-pointing, the immediate response, has now given way to an intensely detailed discussion of the facts concerning the state of health in the US, or perhaps more appropriately, how healthy we are as a nation. However, with each side armed with suggestive reports and similar opinion-delivery-systems, it is easy to see how the average person could be led out or even exclude themselves from the debate.
The structural problems with healthcare in America reminds me of another business that has struggled it's way back to relevance after many errors in judgment. The game of baseball... or rather, the business of baseball. I'm sure correlations may exist to many other businesses, and some may be more closely related, but baseball serves as a clear litmus for the effort to improve relevance in businesses dealing with public dollars. Common people pay for the relevance of baseball and healthcare alike.
The owners of baseball vary from media conglomerates and corporations to individual franchise owners (did you know Nintendo owns the Seattle Mariners?). All have a stake in the well-being of the league, since they, as owners, seek the reward of all that comes with having the team they own be winners.
The owners of healthcare tend to be a much more varied list of doctors, practitioners, hospitals nurse-residential-and-social assistance providers, and insurance companies. The definition of the job description of these "owner" entities varies widely based on their section of the business. The difficulty in this area is that the "league" that is the healthcare sector in America doesn't seem to have a clear objective.
Business managers in baseball (GMs) manage the hierarchy of decisions and talents that produce the bottom line profits for the owners. Both the GM and the owner have a vested interest in the team's well-being as well as that of the league in general, so that profit may be maximized as fans show support for "their" team.
Business managers in healthcare (HMOs) manage the hierarchy of doctors and other care providers to produce bottom line profits for the owners also. This is where a breakdown occurs with the baseball metaphor, because the fans (or patients) are so far removed from the discussion, where team decisions are public knowledge.
Club managers in baseball are responsible for holding teams accountable for the fans. Managers must reconcile the business needs of the GM, as well as deciding on strategy and motivating the players to reach their goal. In this case, political influence, while present, doesn't hide the fact that there are good club managers and temporary club managers (as well as good and temp GMs).
Club managers in healthcare are the office administrators and various chiefs of staff that keep the balance of revenue and expenditure so that the providers can focus on the business of making the patients more healthy.
Baseball players are the talent by which the game is made more interesting, and therefore viable as a business. Players decide their level of commitment, also, and deal directly with the fans, and reporters to the fans - who judge their performance, as well as the performance of the club as a whole - thereby directly affecting the relevance of the league. In essence, the fans and players make the game... the business decides how it will be presented.
Healthcare players, or talent, are the people who apply the knowledge they seek or sought with great effort from systems of education designed (hopefully) to produce the best doctor, practitioner, nurse, etc... which makes the contribution of the patient more justified. After all, if Joe down the street could offer the same care, we'd be the healthiest nation in the world (which we are not). The healthcare providers are the show, and business decides how it will be presented (or accessed).
And finally we reach my level... the common person's level... the fan level. Fans are the people who support the industry through financial contributions in the form of tickets sales, merchandising and ad dollars, and local taxes for updated facilities, by which the team they support may succeed to the benefit of everyone involved in the venture. The "win, win" nature of fan support makes it the single biggest contributor of long term success for any team.
The common person's level when it comes to healthcare is that of the patient. Patients support the industry though payment of insurance premiums, co-pays and doctor, clinic or hospital fees. The primary means of support, though, comes from benefit packages offered by employers. Employers pay the lion's share of healthcare premiums, and represent the single biggest account for the industry. The reason people support the current industry is that they seldom see the money that's spent in their name, and they fear that something might go wrong with their bodies that would require a medical professional to "fix" them.
The another disconnect in the baseball/healthcare metaphor is that I know a helluva lot more people that would rather go to a ballgame that a doctor's office. The perpetuated stigma that clinics and hospitals are bad or sick places has brought to a head the argument over the importance between healthcare and the business of healthcare in America. The fan principle still applies though. The common person's level of involvement directly reflects the judgement of the resulting product. Before you take a side and argue one of the points of view available, ask yourself just how healthy do you want to be? Is medicine a "fix," or a "process?"
Baseball teams are forced to adjust constantly in many different areas in order to stay relevant to the fans. In a nation that ranks 45th in the world in life expectancy, how relevant is health?
Friday, August 14, 2009
Saturday, August 8, 2009
Health and Patriotism
On July 29, 2009 The Palm Beach Post ran an article on page 6A by Dr. Charles Krauthammer, entitled "Why Obamacare is sinking," which was Dr. Krauthammer's response to the President's plan to provide nationwide Healthcare, and the incorporation of the Congressional Budget Office (CBO) report on the cost of the initial bill from the House of Representatives.
The view of the article appears to be an historical look at the end of "Obamacare" and what brought about its demise. It begins with the author calling the President of the United States "the master rhetoritician," thus implying that the debate is merely insincere political banter. As I recall, President Obama made a thorough speech about Healthcare reform in which he said that people who are discussing the fate of this sector of the economy and America's future need to understand that the Healthcare system is the biggest problem related to the stagnation of our economy and must be fixed this year. The President said, "Make no mistake, Healthcare reform will happen... and it will happen this year."
Rhetoric means that the speaker is using words merely for the sake of their oratory value, and cares only about the way in which they say things... not that the person is saying something in support of their own belief. Thusly, Dr. Krauthammer believes that the President of the United States plans to talk about reforming Healthcare in convincing and grand order, though he does not truly wish the best system be available to the people of the United States of America, all of which he represents.
Dr. Krauthammer was apparently spurred to action by the release of the CBO report that says House Bill 3200 increases "cost in the range of $1 trillion plus," and based on this, the man who was elected President of the United States has been revealed as a "master rhetoritician." Since the specifics on how that money will be allocated, and the cost savings from revamping our Healthcare system (which ranks 37th in the world and is more than 15% of GDP) have yet to be determined, it seems a bit premature to call the effort to reform Healthcare sunk just yet… especially since we've only taken the first step toward working on it. Of course deciding to spend money costs more money, but we haven't even been able to consider what we're getting yet.
C-SPAN coverage of Senate Committee meetings in each of the 5 committees show that both Republicans and Democrats are considering all the possibilities in an effort to create a completely new system that will work for the majority of Americans (roughly 98%). The US Senate is in no way considering adopting a Healthcare system established by any other country, as their systems were established based on each individual country's circumstance. If the talk on Capital Hill consisted of a series of Senators discussing which country we were going to borrow a system of Healthcare from, I think Americans would see that their representatives lacked the capabilities for such a task. No, Americans from all areas of the country are considering many if not all aspects of what this legislation will mean, and those who suggest otherwise might better be called "rhetoriticians." Senators are working though their fall breaks in committee to get this done.
I disagree with the rather smug analysis that the effort to reform Healthcare is merely political rhetoric. As a common American, I realize that if I get Healthcare coverage guaranteed by the government to be affordable, I am then untethered by one of the most important parts of the necessity of work. People don't stay where they work all their lives anymore, and companies realize they are better served by that fact. Your average person stays in their career for less than 5 years today, where it was 25-35 years in recent history.
It would be a tremendous relief to know I may leave a workplace once I am able to see my usefulness wane, without the worry of losing my Healthcare coverage or paying through the nose for COBRA. Often times people must work until they die (quite literally) to have Healthcare for themselves and their family. Someone telling me there might be a way for me to not share that fate has my undivided attention. Those who tell me I shouldn't want this security are out of touch with my reality. I am starting out in life (32yo), and I won't choose to live in a manner I can clearly see isn't working.
Dr. Krauthammer says "Didn't Obama promise a new politics that puts people over special interests? Sure. And now he promises expanded, portable, secure, higher-quality medical care -- at lower cost! The only thing he hasn't promised is to extirpate evil from the human heart. That legislation will be introduced next week. (6A)"
1) Obama is speaking as clearly and forthrightly as I have ever seen a President speak, using pointed addresses on TV, the Internet, and in town-hall meetings about a subject of tremendous importance to me (one of the 200,000,000 workers in America making less that $58,000/yr). The President is setting goals, and leaving a clear path of accountability for the betterment of health for all Americans. I never thought I would qualify as a special interest group to President Obama, but I'm honored.
2) Americans like me need a Healthcare system that is expanded, portable, secure, of higher-quality and at a lower cost. If I can keep track of 100 or more people on a social networking site, why can't doctors keep track of 10,000 or more patients on a medical networking site? (Or even allow people to be able to access their own medical records online so that their history isn't lost or delayed if they move)
3) Though it may not be possible to remove or cleanse the human heart of evil, it is possible and quite necessary to create a new Healthcare system that works for most (if not all) Americans this year. It seems that this process would help to extirpate the evil of privately owned corporations and insurance companies keeping quality Healthcare from the average American.
I would ask Dr. Krauthammer (and anyone else with an interest in stopping me from getting security for my health and the health of my family) to claim who they actually represent, for it is not me or anyone I know. If anyone could convince the majority of people to be against this process by discussing the specifics, then we would not be talking about it. If Dr. Krauthammer is trying to convince me that because the CBO says that a bill that authorizes spending money on Healthcare is going to cost money, and that fact is reason enough for me to not want the security that this reform will afford the future of the nation I love, then he is sorely mistaken. I am aware of the discussion beyond persuasion from insignificant reports bent to try to mean something politically.
America, and the World, is changing. We are all vastly more aware of each other regardless of our location or walks of life. If our elected officials and "leaders" are unable to foster the security we demand for future generations, then perhaps they should remove themselves from the conversation, lest they be removed. The use of scare tactics will not dissuade me from wanting something I can see is best for my country going forward.
A patriot stands up to discuss the best direction of the country. A tyrant tries to prevent such thoughts. Where do you fit in?
The view of the article appears to be an historical look at the end of "Obamacare" and what brought about its demise. It begins with the author calling the President of the United States "the master rhetoritician," thus implying that the debate is merely insincere political banter. As I recall, President Obama made a thorough speech about Healthcare reform in which he said that people who are discussing the fate of this sector of the economy and America's future need to understand that the Healthcare system is the biggest problem related to the stagnation of our economy and must be fixed this year. The President said, "Make no mistake, Healthcare reform will happen... and it will happen this year."
Rhetoric means that the speaker is using words merely for the sake of their oratory value, and cares only about the way in which they say things... not that the person is saying something in support of their own belief. Thusly, Dr. Krauthammer believes that the President of the United States plans to talk about reforming Healthcare in convincing and grand order, though he does not truly wish the best system be available to the people of the United States of America, all of which he represents.
Dr. Krauthammer was apparently spurred to action by the release of the CBO report that says House Bill 3200 increases "cost in the range of $1 trillion plus," and based on this, the man who was elected President of the United States has been revealed as a "master rhetoritician." Since the specifics on how that money will be allocated, and the cost savings from revamping our Healthcare system (which ranks 37th in the world and is more than 15% of GDP) have yet to be determined, it seems a bit premature to call the effort to reform Healthcare sunk just yet… especially since we've only taken the first step toward working on it. Of course deciding to spend money costs more money, but we haven't even been able to consider what we're getting yet.
C-SPAN coverage of Senate Committee meetings in each of the 5 committees show that both Republicans and Democrats are considering all the possibilities in an effort to create a completely new system that will work for the majority of Americans (roughly 98%). The US Senate is in no way considering adopting a Healthcare system established by any other country, as their systems were established based on each individual country's circumstance. If the talk on Capital Hill consisted of a series of Senators discussing which country we were going to borrow a system of Healthcare from, I think Americans would see that their representatives lacked the capabilities for such a task. No, Americans from all areas of the country are considering many if not all aspects of what this legislation will mean, and those who suggest otherwise might better be called "rhetoriticians." Senators are working though their fall breaks in committee to get this done.
I disagree with the rather smug analysis that the effort to reform Healthcare is merely political rhetoric. As a common American, I realize that if I get Healthcare coverage guaranteed by the government to be affordable, I am then untethered by one of the most important parts of the necessity of work. People don't stay where they work all their lives anymore, and companies realize they are better served by that fact. Your average person stays in their career for less than 5 years today, where it was 25-35 years in recent history.
It would be a tremendous relief to know I may leave a workplace once I am able to see my usefulness wane, without the worry of losing my Healthcare coverage or paying through the nose for COBRA. Often times people must work until they die (quite literally) to have Healthcare for themselves and their family. Someone telling me there might be a way for me to not share that fate has my undivided attention. Those who tell me I shouldn't want this security are out of touch with my reality. I am starting out in life (32yo), and I won't choose to live in a manner I can clearly see isn't working.
Dr. Krauthammer says "Didn't Obama promise a new politics that puts people over special interests? Sure. And now he promises expanded, portable, secure, higher-quality medical care -- at lower cost! The only thing he hasn't promised is to extirpate evil from the human heart. That legislation will be introduced next week. (6A)"
1) Obama is speaking as clearly and forthrightly as I have ever seen a President speak, using pointed addresses on TV, the Internet, and in town-hall meetings about a subject of tremendous importance to me (one of the 200,000,000 workers in America making less that $58,000/yr). The President is setting goals, and leaving a clear path of accountability for the betterment of health for all Americans. I never thought I would qualify as a special interest group to President Obama, but I'm honored.
2) Americans like me need a Healthcare system that is expanded, portable, secure, of higher-quality and at a lower cost. If I can keep track of 100 or more people on a social networking site, why can't doctors keep track of 10,000 or more patients on a medical networking site? (Or even allow people to be able to access their own medical records online so that their history isn't lost or delayed if they move)
3) Though it may not be possible to remove or cleanse the human heart of evil, it is possible and quite necessary to create a new Healthcare system that works for most (if not all) Americans this year. It seems that this process would help to extirpate the evil of privately owned corporations and insurance companies keeping quality Healthcare from the average American.
I would ask Dr. Krauthammer (and anyone else with an interest in stopping me from getting security for my health and the health of my family) to claim who they actually represent, for it is not me or anyone I know. If anyone could convince the majority of people to be against this process by discussing the specifics, then we would not be talking about it. If Dr. Krauthammer is trying to convince me that because the CBO says that a bill that authorizes spending money on Healthcare is going to cost money, and that fact is reason enough for me to not want the security that this reform will afford the future of the nation I love, then he is sorely mistaken. I am aware of the discussion beyond persuasion from insignificant reports bent to try to mean something politically.
America, and the World, is changing. We are all vastly more aware of each other regardless of our location or walks of life. If our elected officials and "leaders" are unable to foster the security we demand for future generations, then perhaps they should remove themselves from the conversation, lest they be removed. The use of scare tactics will not dissuade me from wanting something I can see is best for my country going forward.
A patriot stands up to discuss the best direction of the country. A tyrant tries to prevent such thoughts. Where do you fit in?
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