Enlightened Conflict

Health care in 2017 from a business perspective

March 22nd, 2017

take the extra time to do things right the first time

 

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If you don’t have time to do it right, when will you have time to do it over?

 

—-

John Wooden

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American healthcare is getting quite tiring. Shit … I have written about it in 2009 and even recently wrote about it <Healthscare > as recently as January 4th 2017.

it is complicated complex not simple Life world 

All you have to do is turn on the tv or maybe go to some politics driven website and you will see gobs of articles & pundits yapping about the upcoming vote on repealing the Affordable Healthcare Act <Obamacare>.

 

Suffice it to say the new plan is not being particularly well embraced by its own party as they have aspiring to the finish line vote tomorrow.

 

To me this whole discussion and action plan shows the lack of business leadership knowledge which exists in politics and government. And, yes, that includes the President <who should know better if he was truly a business person>.

 

Let me address some key issues from a business perspective.

 

 

Time.

 

30 days.

That’s about the amount of time this repeal plan of action has been discussed <just ignore the last 7 years which they should have been thinking about it … or even the additional month or so if you wanted to begin on inauguration slow down take time do rightday>.

 

30 days for something like this is insane.

 

Okay. It is just stupid.

 

This is unlike how the Affordable Care Act <ACA> was implemented, which – just to remind everyone — was debated for almost an entire year in both houses of Congress with 79 hearings in the House alone and a number of amendments incorporated in the process … and hospitals, associations and insurers were all brought in.

 

But you know what?

 

Any business person with half a brain would tell you trying to build a plan of action which would turn a company 180 degrees around <or at least something that would change maybe 20% of the entire revenue stream> and gain alignment is going to take more than 30 days.

 

Any business person with half a brain would tell you pushing through this kind of change without alignment, education and some aspects of agreement is not only foolish but deadly.

 

Any business person with half a brain would take a step back and say “lets take the time we need to get this right.”

 

Promises delivered.

 

I have noted before business leaders only have to earn this lesson once … a bad promise delivered is never remembered as a promise delivered … just  promise i something bad delivered.

 

Leaders get paid to make good decisions not deliver bad promises. I have made many ‘promises’ <more often ‘plans of action’ than promises> and yet still stood up in front of people and sucked it up and said “I did not know this then, I know this now, and we will not do the plan I said … but rather here is where we go from here” when I had to.

Why? Every business leader knows honesty wins more often than wasted energy.

 

Just doing something because you said you would do it is … well … stupid business.

 

Any business person with half a brain is very careful making promises but exponentially more careful about the promises you choose to fulfill <because one is just words and the other is action>.

 

 

Phased plans.

 

Speaker Ryan has said not to worry — there will be a “second” and “third” phase that will fix everything.

 

Uh oh.

Future plans. Need I remind everyone that the Affordable Healthcare Plan was a plan intended to adapt <have other ‘phases’> to the market and make adjustments to accommodate what happened when the plan actually hit the market?

Everyone should be reminded of this.

 

December 2009 I wrote my first thoughts on the affordable healthcare act and the thoughts remain exactly the way I believe …

 

Sure.

The way it’s conceived – all the weird aspects they had to build in upfront to try and make the system work from the get go,  the complex subsidy system that rocket scientists cannot even explain, odd benefit levels, an unwieldy sign up system, just to name a few, absolutely suck.

But, if we see the program as fluid <which any sane business would do> it will evolve until we settles into better solutions and better affect. As I said back in 2009 … the initial plan ain’t gonna be perfect <any business person worth a shit could have told them that>.

perfection progress

 

Obamacare would most likely be humming along quite nicely if Congress had made the necessary adjustments in real time <like any business person with half a brain would have>. Instead phase 2, 3 … or … well … any phase … never occurred as congress haggled over the plan itself.

 

All I can tell you is that if this American Healthcare Frankenstein of a plan is actually implemented everyone, Republicans & Democrats, better decide this time “in for a penny in for a pound.” That is where the Affordable Healthcare Act stumbled … not everyone invested.

 

All I can tell you is that any business person with half a brain would be hesitant to offer a phased plan to an organization that has a history of getting stuck in phase one.

 

Look.

 

I certainly know that if you are a 100% free market healthcare believer that tweaking the current plan doesn’t have a lot of appeal to you. But we have a plan, flaws and all, that has a strong foundation which creates the potential for something better than what was <healthcare going into 2008 was shit>.

 

time to do it right do it overI certainly know that the ACA needs to be tweaked.

 

I certainly know that the ACA should have been tweaked years ago.

 

I certainly know that the ACA could be fixed fairly quickly and efficiently.

 

And I certainly know that any new plan will not be perfect and will also need tweaking.

 

But what I absolutely now is that the current plan is not good and any business person with half a brain would stop the insanity, step up to some microphone and outline a reason why giving the American people the best alternative takes time.

 

Slow down.

Stop.

 

Get this right … because this is NOT about keeping your job or eve keeping your promises … this is about people’s live and their healthcare.

 

 

the ongoing Trump crap show (a diary)

January 5th, 2017

 bullshit type

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“Bullshit is a greater enemy to the truth than lies are.”

 

Harry Frankfurt

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Well.

 

If I got paid by the word with regard to everything I have received about

Trump and everything I have written in response about the ongoing Trump shit show <almost 18000 words in one week on the asshat himself> … well … suffice it to say I would most likely be lounging outside the Deux Magots with a funny looking beret on my head sipping on some French espresso living the large life.

 

 

That said.

 

 

I admit

 

When I share my thoughts I am not quite sure if my Trump frame of reference is “amateur trying to do a professional’s job” or sheer incompetence or bullshit languagedangerous naiveté <simplistic thinking applied to a complex issue> or lack of understanding of how to lead, purposeful ignorance or he is just a purposefully ignorant dumbass … regardless … all of it always through the filter that “strength is only conveyed through an obvious façade of unwavering thin skinned bombastic narcissism”.

 

In addition … I never really know if I am assessing lies or bullshit.

To lie assumes a presumption the person actually knows the truth <and I often seriously doubt he knows what the hell he is talking about> while bullshit, by contrast, does not know or care whether what s/he says is true or false. The liar possesses knowledge of the truth, while the bullshitter ignores it entirely.

 

What I do know <and I’m concerned> is that the other morning on tv I saw a panel of journalists/news anchors simply laugh out loud over a preposterous trump tweet lie … and move on. He has normalized lying to such an extent they don’t even bother to respond or comment … just snicker at the absurdity of it all.

 

And all the while, as they snicker and dismiss, it is only The Donald who can tell the truth while everyone else is automatically lying.

 

Black is white.

Up is down.

In is out.

 

In this alternative world Trump creates an alternate truth … and somehow we are actually letting it become real.

This cannot be normalized nor can it be deemed accepted. The Trump shit show has to be publicly reviewed as constant bullshit.

 

Regardless.

 

The people who ask me about Trump bring up valid points and express valid thoughts. Love Trump or hate Trump he has made people talk about what matters.

 

Here is a random sampling of thoughts shared with me  … and thoughts I have shared in return:

 

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  1.  Americans don’t think America is great.

The gap between rich and poor has grown wider.

As have black and white relations.

Hollywood thinks it’s great, because they’re in the stratosphere of pay.

Someone makes $2.5 million a month.  A month!

Good for him. Bad for middle class who can’t relate.

 

  1.   Most people don’t like the Clintons or the Bush’s.  They’re just slimy people.

 

  1.   Trumps vision is this:   Every deal must be great for America. Not even. Better. That’s winning.

We’ve been losing to the Chinese for years. Losing manufacturing jobs, losing companies to Mexico, etc. The fact that he wants those companies going to 3rd world companies to pay a tariff on their products coming back in to America, is genius. A fair penalty for not giving Americans here a job.

 

  1.   What’s nice about Tweets over Speeches is they’re his own words. Not rehearsed scripts written by others. It’s real. Raw. Right or wrong. It’s honest.

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The thoughts are valid … if slightly misguided. But I answer every email I get and try and address each thought one by one.

 

Why?

 

The discussion is all that matters. The moment we stop talking with each other and debating with each other is the moment we stop listening and … well … we stop. Period.

And that is not good.

 

 

Trump’s message, dumbed down for America, is simple:

Make America great again.

 

*** uhm. This only works if enough people believe America is in enough of a shithole that it isn’t great now.

 

And he is a master at creating shithole perceptions:

election choices dimensions self interest

-Create more U.S. jobs <by implying unemployment is horrible levels … and it is not>

 

-Re-negotiate bad trade deals <by implying globalization is bad … and it is not>

 

-Make friends again with Israel & Russia <uhm … we are supportive of Israel with unwavering security support … oh … implying we should be friends with Russia … who by the way needs us … and we do not need them>

 

-Why?  Because the enemy of my enemy (ISIS) is my friend <oh … if it were only that simple … it is easier to just say islam is bad>. Oh … also … by implying ISIS is an actual existential danger to us AND by implying it is a bigger issue than it is <that’s called ‘selling through fear’>.

 

-Stop illegal immigration (somehow-most likely a fence and more border patrol) <if it were actually a big problem … I would agree … he implies it is a big problem>

 

-Eliminate the bad parts of ObamaCare. Most of which, “only works, if you don’t.” <which, oddly, Clinton & Obama wanted to do and Republicans did not>

*** I would note on Obamacare … imagine where we would be if everyone had done what Kasich had done on day one … rather than fight it … he moved forward to see how it could benefit his people. If it had been embraced on day one it would be fine and have less fixes needed.

 

Other issues discussed?

 

Tariffs.

 

They weren’t good then and they are not good now.

All they do is raise the costs to us, the working people, as the company passes them along back to us. His tariff only on US company importing back in to US is almost as non-genius as his “tariffs on China.”

 

Its simplistic drivel that suggests you can penalize companies for competing in a free market.

  1. The issue isn’t cheap labor … it is varying cost of living nation to nation. In a global economy unless everyone has the same cost of living <and standard of living> there will always be other places cheaper to create the shit you want to create. Tariffs only exacerbate the issue.
  2. 90% of jobs outside of USA will never come back. We need to get over that. Those jobs are cheaper through automation in US if we demand they bring them back.
  3. Tariffs kill many small businesses who can only compete with cheaper goods outside of USA.

 

You cannot bring back jobs. And, practically, he doesn’t really care about the overseas jobs <and he shouldn’t> … everything he is talking about is about bringing back money. Which he is gonna need with his budget plan <that part is actually ok>.compete Authentic Self

 

Authentic.

 

Sigh.

 

What a sad state of affairs if we are using ‘like Trump because he is authentic.’

Authenticity has never hit such a low.

Especially if it is combined with ‘raw & honest.’ I will give him raw … but honest? He is not just a liar … he creates an alternative universe. And, please, please don’t say ‘all politicians lie.’ The majority use selective truths and facts. At least their ‘lies’ are mostly a distortion of the entire story. Trump authentically creates an entirely new story <lie>. He is singlehandedly destroying the concept of authentic.

 

Twitter & tweeting.

 

…. by the way, saying “he should make speeches not tweets,” is like me saying, “we should do television ads  not social media!”   The world has changed. Forever.

 

*** wrong. Leader’s words matter. And how and when you use words matter. If he tweeted his vision, if he tweeted words that led ?? sure. Maybe. But he has quotes using navigatedivided so much thru his rhetoric he needs, as a leader, to establish a construct for what he plans. His tweets appeal to his rabid base who say ‘do whatever you want.”

But most people want a leader to lead.

He needs more than 140 characters to explain. And, no, the world has not changed forever in this case. Twitter is a supplemental communication tool. It does not live in a vacuum. It cannot. It supplements, or compliments, events and stories and content. He needs to offer content.

 

China.

 

Well. They have a significantly lower cost of living and standard of living for their workforce. Their government subsidizes their private businesses. They are US economy from maybe 100 years ago.  TPP was our best way of curbing China … anything you may think is bad tradewise with China now … will get worse without TPP.

Unless we demand everyone to stop wanting to own a home and to need $70,000 a year to live … competing with China will always be difficult <and the same with any of the developing countries>.

The other thing people seem to forget is … if you are a global company the closer you can put your manufacturing to the sale … the lower the distribution costs.

I am not suggesting trade deals do not always need to be tweaked <not trashed or even renegotiated>. Market dynamics demand shifts in deals to maintain balance. But the overall goal should always be win win. Especially for USA. Because we have the largest economy … and we have the largest buying capability … we win if the tide rises higher.

 

Great.

 

The majority of people actually do think America is great <numbers show that>. And even middle class America does <albeit if you look at just the Republican numbers they think we are in a complete shithole>.

What many people have been convinced is that someone has it better than they people forget own greatnessdo … and they get grumpy about that.

Heck. We barrage people with so much negative crap even if they are happy they have been convinced they should be unhappy.

 

This may be the greatest example of the gap between perception and reality I have seen in my lifetime.

Small groups of people are desperately in worse shape, some people are in good shape but have not improved, most people are doing fine but hearing all the talk about the top 1% and feel entitled to some of what they got. That is reality. we have a higher standard of living than any country of any size in world. We live longer, are, other than fat, in good health, best and largest economy in the world, low unemployment, low overall violence <with isolated pockets which people distort to a larger view>.

 

That is Trump’s most egregious flaw. He distorts “the one” into “the many.” He implies an isolated situation is indicative of the greater whole. And he does it with such hyperbole <and lies> even if most people do not believe it … it elevates whatever perception you may already have a little higher <therefore … he drags more people closer to believing we are in a shithole … not great>.

 

Winning & trade deals.

 

Oh. If it were only as simple as you suggest. Trade deals are not just trade deals … they encompass foreign policy as well as alliance issues. Regardless. Even if they were only trade … in a global world a ‘deal’ wins when it is balanced … you call it ‘even’ … one side does not win. If you do try and negotiate something like that you create imbalance in the relationship <which creates anger & frustration> and creates the kind of ‘why America is hated’ feeling which seeps into the population which … well … creates terrorists.

We seek mutually beneficial deals in which American companies benefit. The issue isn’t trade deals … it is deciding what we want the American economy to be and how we can insure the American worker benefits. Companies, in general, do not care about the labor force unless they need them. It is, frankly, not in their interest to care.  Their interest is to be competitive in the marketplace and make money.

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job i am the greatest confidence trumpMy own guess is that Theresa, having sussed in advance that her interlocutor is a blithering saddo, will put him at his ease with an extravagant compliment about his non-existent personal magnetism. “That thing on your head is divine,” she will be already saying during the soup course. “So elegant, yet so masculine.

How do you keep it in place? Surely only the strongest industrial adhesive can contain something so powerfully virile?”

By that time, she will be breathing in his ear and he eating out of her hand. Cue violins.

 

—-

Clive James

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  • So as an Independent who loathes politicians and lawyers in general, I, like so many others are willing to give him enough rope to hang himself.  Which, he may do.  But my goodness, give it a chance.  Because as even Obama says;  “We want good things to happen. Because if he fails, we fail.”

 

*** I have never suggested I want him to fail. All I have ever done is demand he lead. I don’t want to give him rope to fail because if he fails … we all hang.

 

 

  • I LOVE that he’s pissing off Republicans, Democrats, Bush’s, Clintons, and everything in the political establishment. So do a ton of Americans.  No more politics as usual, and all these cozy-wink-wink jobs are going away. No wonder they’re all freaked out.  I say, throw them out!

 

Well.

 

No one of any consequence is hysterical <although I would suggest if I saw any of my employees hysterical I wouldn’t laugh or shrug it off as silly … I would sit back and wonder what I had done to create it>.

They are freaking out not because it is affecting status quo … but rather because <a> he shows no sign of being a leader and <b> he shows little sign he knows what he is getting into to.

 

No one is pissed off. These are people who take their jobs seriously and have serious jobs to do.

They are all concerned he is not qualified and not doing anything to insure he can meet the bare minimum to fulfill his obligations as a president.

 

If I wanted to hire a change agent I could have hired him as a consultant. He got hired to be a president.

People absolutely fear what they do not know.

 

Ultimately, that is my point. A good leader abhors uncertainty in their organization. It creates dysfunction and inefficiencies.

 

  • It’s amazing to me how many people criticize him, before he’s even been in office one day. What happened to Liberals wanting everyone to have a fair chance to prove themselves?…

 

This has nothing to do with liberals. People I know say the republicans are mortified by his behavior and uncomfortable with his lack of leadership skills to date.trump-money-winning-god-we-trust-captalism

 

And that is why you shouldn’t be amazed. Being president isn’t about ‘getting a chance.’

This is a country and not a business. And it is certainly not a real estate business with no culture and just “Trump personality” as a guiding compass.

 

But even if I do view this as a business leader … he has done nothing to show leadership, explain his vision <except in tweets>, explain that he understands the depth & breadth of what is demanded of his position <diplomacy>, or even made an effort to explain to the significant majority of the country who did not vote for him <democrats + independents + nonvoters> how he plans on uniting everyone after he was so divisive in the campaign <and continues to use words that divide>.

 

He sees uncertainty as a plus. And maybe in his little world of real estate it is … but in the bigger world where his words drive company value up & down, his tweets create diplomacy issues and his silence permits everyone to guess what he will do … there has to be some undergirding of certainty to hold it all together.

Any business leader will tell you that. He looks like, and acts like, a rookie in a leadership position. He is making the type of leader mistakes we make in our first big promotion.

 

On top of that … I wrote about this days before the economic piece I wrote … he acts like a president now but acts like his actions have no repercussions until inauguration. He is the president elect and not a citizen sitting at the corner of the bar bitching about ‘those damn politicians.’

 

And if you think everyone else globally is sitting around waiting to see what he really is gonna do … well … you are nuts.

 

While I criticize him incessantly for his words and his lack of understanding that words matter. I criticize him mostly for his lack of leadership. He has never run a company with an organizational culture. He has only run a transactional company. He would not know how to run a real company if you … well … tried to teach him.

 

As I wrote in my piece … I would have him work for me and I would direct him to do things because he is transactional. He would be great at sales and duking shit out on a transaction by transaction basis. But I would never, ever, permit him to run an entire business organization. our only hope is, just as I wrote, the cabinet people can see beyond the simple transactions and weld together a new global economy without costing us too much with regard to our overall role in the world beyond simple economics.

 

I criticize him because he deserves criticism. He is not a thin skinned brat. He is not a tweeter in chief. He is responsible for 320 million people. He is responsible for a country that currently resides at the hub of the global wheel.

 

 

In addition I often find in this discussion we end up confusing two issues:

 

Accepting responsibility and Implementing responsibility.

 

responsibility does not matter but it doesI have no doubt this administration will implement some things that will be good <I am just not sure at what expense … as I have written several times>

 

But as any leader worth a shit will tell you … in order to most effectively implement, particularly change, you need to accept responsibility, earn the trust in the responsibility and ultimately align people in a direction. Then you will be judged fairly in the ‘first year in office.’ He is showing he has never run a real organization before.

 

In business terms … he just got promoted to a fragmented organization in which one department adores him. This is exactly what happens when a sales EVP gets promoted to CEO of a service driven organization. Sales is known for saying whatever they need to say to make the sale … and the rest of the organization gets stuck fixing it or making it work. A good leader in that position stands up and lays out his guiding principles, his vision for what he wants to do and asks <yes, ASKS> everyone to contribute and give it a chance. A good leader says “if we all move forward, point out what needs to be fixed as we move forward, we can do this.”

 

A good leader knows if you do not prime the pump attitudinally … accept the responsibility … you are destined for a dysfunctional bitchy organization.

 

He should give three speeches. Not taped. Not tweeted. Speeches.

 

  • Explain his campaign rhetoric. “I may not say the right thing every time but apply this filter with everything because my intent always remains “x” …” <note: albeit I tend to believe he has no idea what he is saying in some incomprehensible word salad>

 

  • Explain his vision. <and I really do not care if it is economic at the expense of other shit … just state it>.

 

  • Explain change management. Any leader worth a shit will warn people of what is coming. If he plans on doing a lot in 100 days … warn everyone. If he wants to set some expectations for year one. Tell everyone. Any good leader knows you purposefully set the ‘judge me by’ goalpost … because if you do not everyone will judge you differently.

 

In addition … if he does this he calms global parties who are now scrambling to do their own thing. He doesn’t just need a ‘year to judge’ internally, domestically, he needs to calm global partners now.

 

He can do all of his now and stop the ‘fear’ and divisiveness <but he has not people response to changechosen to do so>.

 

And he needs to do it NOW because Obama is so well respected by the majority of USA and the world … and he is acting so differently from Obama … he needs to show people the bridge. Any good leader knows, if you are significantly different from the leader you are replacing, you need to calm some employees … and manage the excitement of others.

 

I don’t ‘give’ a leader anything.

I expect a good leader to lead.

 

And maybe the worst? He doesn’t even seem to understand the repercussion of his style. He assumes he has been crowned and everyone will automatically respect & trust <despite the fact he had a crappy reputation running his own department in the business> and he is oblivious to how his words divide and not unite.

 

He may be an excellent transaction dealer. And I hope he is.

Because he absolutely sucks as a leader.

 

Anyway.

 

I will continue to try and watch all the news stations and read shit online when I can <usually when I am sitting on an exercise bike in the gym and can watch CNN, MSNBC & Fox at the same time> … but Fox is a little tough to swallow most of the time.

 

I think much of the conversation is all stupid.

 

I think conservatives laughing at liberals is stupid.

I think liberals laughing at conservatives is stupid.

 

It’s all stupid because we all want the same thing … some just like different tactics than others. And getting angry over tactics is … well … stupid.

trump-welcome-to-the-circus-debate

But I think Trump is the stupidest because a good leader would have resolved all of this already … and he has done nothing.

 

And I am too tired of talking about how twitter is not a main communication tool <especially for a leader>, that Trump does not know how to lead, that his main go-to tactic is to appeal to people’s fears & doubts, and that I worry his personal opinions are more important than trying to appeal, and benefit, 320 million people.

 

But I will keep talking to whomever will listen about this until we make good progress and get what we should expect from our leaders.

Enlightened Conflict