Liberty and Health Care—The American Dream

Is the Right, right? That’s the question we all need to consider. Today we hear the urgent hand-wringing cry that true health care reform that would protect all Americans and lower the cost burden of health insurance on our businesses is both unaffordable and un-American. Well is it? Consider the ideal of the American Dream. The fundamental promise that where we start in life doesn’t determine where we finish. Let’s look at the core ideals of our founding and then whether our national priorities need to re-enthrone what we are all about. Let’s begin with liberty.

Liberty is more than an absence of laws. That is simply anarchy. If liberty contained no other values than the freedom to be left alone we would create a “Lord of the Flies” society where those with power simply impose their will on those who have fewer resources. Our American concept of liberty is found in equal protection of the law. The ideal is that all of us have an equal chance at a decent life. No, there are no guarantees of personal wealth and effortless bliss. We have a staunch revulsion toward income redistribution and protecting people from the consequences of their own poor choices. But we also have passion for fairness; we hate bullies and raw deals. We are also audacious and outrageously optimistic. In fact, we are so bold that our founders created a nation based on the idea that we should strive for a society that created the greatest opportunity for personal happiness. They well understood no one could hand us happiness on a silver platter or even a check for a zillion dollars. In fact, it is actually the true pursuit of happiness that makes us wise enough to eventually see that the effort-filled journey comprised of learning, doing and loving is what makes us happy. Happiness is found in its genuine pursuit. Amazing.

But the founders and wise successors like Lincoln also understood that our quest to build a society with maximal opportunity required us to reduce the causes of avoidable suffering. Avoidable suffering is usually caused when powerful interests oppress the less powerful because it makes them richer. The practical wisdom of our founders understood that the concentration of wealth and power is a force of gravity that if left unchecked concentrates political influence, which destroys equal protection of the law and the basic underpinning of society to create a level playing field for all. This requires a genius-like balance. If government gets too big then its vary corruption by private power amplifies their power. But if government is too weak then the hidden aristocracy of the financially powerful will inevitably exploit the unrepresented common citizen.

So a proper role of government for the best society is to continually renew efforts to create fairness and legal equality for all citizens. This is not child’s play. The forces we deal with are titanic and those who use the propaganda of bumper stickers to convince us voters to support the very policies that hurt our own chances for happiness are clever and loud.

This is what we know from worldwide research (World Values Survey). A level playing field for citizens to pursue happiness is created when we have universal access to 1) quality education, 2) reliable health care, 3) clean water, air and land, 4) business capital, 5) infrastructure, especially transportation, telephones and the internet, and 6) equal protection under the law. In any society in the world if those six things are available citizens will thrive.

Today, we are hurting in a big way from providing three of six. Our education system is broken as each year we dump at least a million 18-year-olds into the streets degree-less, semi-literate and bound usually for jail. Our health care system has become an interlocking cartel that prospers from the status quo. Our banking system has little capital for job-building small business but plenty of dough for bonuses.

The core reason is actually the same. The concentration of power in too few self-interested people. In education we are crippled by accountability-resistant unions and archaic laws that starve funding from our poorest schools. In health care the anti-trust exemptions and corporate sponsorships of elections have vaporized honest competition and made real cost control impossible. And in banking the financial center has moved from Wall Street to Washington.

So what might we do? Government has proven most effective NOT BY DIRECTLY PROVIDING SERVICES but by passing new laws and effective regulations and enforcing them. These regulations must also include robust anti-trust provisions that prevent too-big-too-fail and too-rich-to-ignore special interests from compromising the regulation. As independent “I can take care of myself” Americans we have a revulsion against regulation. But research confirms that the right kind of regulation is exactly what permits equality of opportunity and high living standards. For instance, regulations that create an equal standard for all businesses generate innovation and breakthroughs. Cars would not have seatbelts or airbags, our rivers and air would be sewers, our drugs scary, our food unlabeled, our credit cards ruinous and our workplaces toxic if we citizens, through our government, hadn’t insisted on regulating the self-interests of those whose are willing to cause suffering to get richer. Every time we have tried to make America fairer for everyone in a big way, the voices of the powerful have wrapped themselves in the flag and pretended to care about yours and my freedom. Every time these voices told us that freeing slaves was confiscating the wealth of the slaveholders. It’s unconstitutional! They argued that prohibiting child labor would bankrupt us. They said unemployment insurance would make us free loaders and all highways should be toll roads. In the 1960’s they said giving African Americans the freedom to eat and sleep in any restaurant or hotel was a violation of property rights. These are arguments without moral merit. Not only because they strike at the very root of what makes us American, but also because we all deserve an equal chance at life.

Today millions of Americans are uninsured, underinsured or a layoff away from it. We must do many wise things to correct this. Government’s role should be to remove the grip of special interests and to create regulations and incentives to control costs and increase coverage. Doing nothing for all who are suffering is what’s un-American. After all, what kind of country are we?

In health care we need to consider 4 things:

1. Make all citizens part of one giant covered group where we all pool our collective health in one risk pool as this will reduce the overall costs to business and society as well as our individual costs.
2. We need a national citizen co-op to offer an alternative coverage to private insurers whose internal overhead and salaries have swelled 10% in the past year alone and whose profits have increased 250% in the past decade (Union Tribune).
3. Control costs by instituting quality control and six sigma practices like the Cleveland Clinic, Intermountain Health Care and the best of the best do.
4. Teach, promote and reward health and wellness lifestyles everywhere.

Perhaps the thing that makes me saddest about this whole health care debate is that there is no voice for moral priorities. We need to stop our talking points, pouting and fear mongering to use our innovative ingenuity to truly create a future where we can all thrive instead of being told we can’t by those who already have everything they need. That is the oldest lie in politics. I called my Congressman’s office and told them they better do something positive to change the future. Complaining and whining just don’t get it.

Egomania–Over Believing Our Strengths

Who would have thought Toyota would be brought to its Prius knees because of quality problems?  Who would have thought one of the most disciplined athletes of our time, Tiger Woods, would be so sexually reckless?  Certainly not many of us would have predicted Toyota’s or Tiger’s challenges.  And while it’s tempting to be critical or even condemning, their trials have a common thread that are at the root of all our challenges.  It’s simply this.  Often our greatest failings are found in over-believing our strengths.  And when our strengths are extraordinary we can’t help but think we’re special.  We delude ourselves into thinking that our specialness exempts us from failure, so we ignore the signs of it until it overwhelms us.  The saying is, “Nothing fails like success.”  Which means that extraordinary and consistent success forms mental cataracts that eventually blind us to our failings and weaknesses.  This becomes worse when we are surrounded by an entourage of flatterers who make our blindness darker.

The catastrophe of Toyota is rooted in organizational ego disorder (OED).  For years Toyota led the world in automotive and manufacturing quality.  Business leaders, engineers and researchers from around the globe made pilgrimages to Toyota to learn the secrets of continuous improvement.  Toyota truly set world standards of quality so when drivers started complaining their cars were potential killing machines due to something frighteningly called sudden acceleration and Prius’s, of all cars, had broken brakes, it was natural for Toyota to blame the drivers.  The thinking goes, “We build the best cars in the world; therefore nothing could be wrong with the cars.  It must be our customers.”  When we think we’re invincible or even extraordinary at something we can hardly resist becoming the last place to look when something goes wrong.

First we deny there is a problem.  Next we blame others for it, and finally we say it doesn’t matter.  These three ego defenses give us three off-ramps to seeing the truth and making changes.  When something is going wrong, denying the problem is guaranteed to escalate its damage.  The wisest among us embrace the truth, welcome feedback and hunger for improvement.  Blame of course is always tempting. “She drove me to it” is the common excuse for infidelity or cheating at anything.  Blame is inviting because we are world class at it.  It’s usually rooted in some truth.  The best excuses are always supported by our carefully selected evidence.  After all, I am sure some drivers do step on the gas instead of the brakes when they panic and every spouse provides ample reasons to seek a “better” partner.  But so what?  We aren’t off the hook for all the evidence we choose to ignore.

But our worst ego-failing is the last.  Saying bad stuff doesn’t matter because I am great is the ultimate moral failure.  We’ll see if Tiger can make a heroic comeback.  It’s very tempting for people who are truly great at something to give themselves a free pass on all the things that cripple them.  Just ask any successful politician, singer, actor or sports star.

So what’s the best thing we can do? Be hungry learners.  Seek feedback.  Always invest in our own growth.  Invest in our strengths but always manage our weakness.  Make no excuses.  Don’t blame or rationalize.  Who you are, what you do, what we say all matters.  Most of all we need to take responsibility to clean up our own messes.  That is the essential first step of becoming a decent human being.  And remaining decent is a daily challenge for all of us.

The Problem is About Bigness Itself–Threatened by Dinosaurs

I do leadership consulting for a living. I am fortunate to work with enlightened large companies helping to revolutionize their leadership training to a 21st century model where value is created by creating a sustainable future. What I’ve witnessed in the past 3 years is nothing short of astonishing. While big companies are far from perfect they are making rapid and amazing progress at inventing new products and services that are healthier, sustainable and benefit humanity. But this is far from the norm. There are many, many leaders that pathetically don’t get it. Their self-interest and wholly materialistic view of enterprise is the only Kool-Aid they drink. Increasingly they are desperate to survive, and they have become gigantic parasites sucking the life-blood of our economy and our future.

We used to think that business and government operated with a healthy tension that led to both a vibrant economy and a constrained government, but that is now a sad illusion. Now they simply feed on each other in a new kind of “state capitalism.” Please, please know that this is both an impulse of Republicans and Democrats. We know that by looking at what people do rather than what they say.

According to the Economist, the biggest expansion in the American state since the 1960’s was driven by none other than George Bush. As a give-away to drug companies he expanded a huge drug entitlement program of Medicare at retail prices. He also created the biggest new bureaucracy since World War II called the Department of Homeland Security. He also greatly expanded no-bid contracts to defense and other government contractors. 7000 new pages of government regulations were installed and wiretaps and financial data mining of our bank accounts became government-as-usual.

Since the financial meltdown taxpayers have had to bailout our big financial institutions and auto companies while no one pays any consequences.

Meanwhile both Democrats and Republicans are locked in an ideological cage fight played out in our hyperactive media while our nation convulses in dry-heaves of meaningless sound bites. If children are to thrive we need something more.

But that will be difficult. The marriage between big governments and big business is even greater in other big economies like China and Russia whose governments routinely “buy” private companies, decide who gets capital and who is pushed aside. (Most of these nations’ global companies are in fact owned by their governments!)

Meanwhile, a Saudi Prince (remember the Saudi Arabian government owns all the Saudi oil reserves) is the second largest stockholder in News Corp., which owns Fox “news” and the Wall Street Journal (see Fortune). He is also the largest stockholder in Citigroup, one of our too big failed banks. If you wonder whether this foreign quasi-state investor has much influence at News Corp. or Citicorp, Vikram Pandit, CEO of Citigroup, remarked that Prince Alwaleed’s view of his performance would determine whether he keeps his job! Prince Alwaleed announced he is opposed to new taxes on big banks to recoup U.S. taxpayer support. Big surprise. Isn’t it interesting that a foreign Prince has that kind of influence over the leadership of one of our largest failed banks? More influence than the taxpayers who kept Citicorp afloat.

This is just a symptom of the twisted new world of State Capitalism where the financial power brokers of Wall Street have moved from New York to K Street in Washington D.C.

Now we’re in a brave new world, sanctioned by our Supreme Court that opens the door to global corporations supporting their favorite U.S. political candidates. Welcome to bizarroworld where free speech has become bought and paid for speech by global corporations who claim to have the same rights as individual citizens. How do you like that Thomas Jefferson!

It’s long been observed that when companies are growing, brimming with innovation and new products they spend little on lobbying. However when big corporations grow dull and profits are shrinking they “invest” millions in Washington to impact laws and regulations to tilt the playing field, restrain competition, gut anti-trust laws and create special tax breaks. They simultaneously tout free markets while they work like demons to rig things for personal benefit.

So the problem we face is not only about big government; it’s about bigness itself. Dinosaurs were huge. Their inability to adapt caused them to go extinct. Now we have the dinosaurs of big government and big business mating creating offspring that is simply devouring all the assets and resources of generations of work.

What is the best we can do? State Capitalism is the global rage. It reigns almost everywhere from Japan, China, Malaysia, the Middle East, Western Europe and of course our own bloated version of it. Its failures will be painful and drawn out. The most important issues are personal ones that impact you and your loved ones. My view is don’t expect the system to change soon. There is too much juice in it to voluntarily reform itself. It’s time to live prudently, become multi-skilled in work that ignites our passions and focus on all the things we do control. There will be great churn in the economy and great opportunities to out-run the dinosaurs. It’s a day of constant innovation and, if viewed correctly, unprecedented opportunity. There are still great companies to work for that are innovative, treat their employees well and are thriving even now (Fortune Magazine’s 100 Best Companies to Work For). Remember, it’s our day-to-day life that matters, and in every epoch there are those that adapt, thrive and pursue their dreams. Be one of those. Life is risky. Take charge.

Elevate Your Mood – Count Your Blessings

If you want more energy, think about what you are grateful for. That isn’t just a fairytale. Researchers from Pennsylvania Positive Psychology Department have concluded after looking at rings of research that the single most way to elevate our moods is to count our blessings. The most effective thing I’ve found is to think about one thing you are really grateful for and then embrace it, lick it, smell it, and feel the feeling of gratitude. Let it come over you like someone is pouring hot warm syrup, and really feel your gratitude. That is when you will feel good!

Chocolate, Sex, and Sunshine are Drivers of Optimism

I wrote an article some time ago called, Chocolate, Sex, and Sunshine. I know it sounds crazy, but they are actually drivers of optimism. You see the antioxidants, and flavonoids in chocolate stimulate comfort chemicals in our brain that elevates our mood. And sex, no not the promiscuous random or casual type, but sex in a committed marriage that is frequent makes people more healthy, have stronger immune systems, better emotional relationships, and more optimism, and yes, Dr. Oz agrees with that. And sunshine gives us Vitamin D. As a person who has been out in the sun all his life we are smart to be cautious about skin cancer. On the other hand, lots of people today are sunshine deprived and Vitamin D is essential to our immune system and our full functioning. If you want to read the entire article just let me know via email and I will send it to you. I would be very interested in your response.

The New Normal vs. Old Normal

Saturday, I was at Chapman University in Orange County as a delegate for The Innovation and Humanity Summit. I was able to address the group, along with a panel that included the senior vice president of strategy for Pepsi, a genius professor from Northwestern University Kellogg Graduate School of Management, who is the founder of their Kellogg Innovation Network, and a brilliant strategy consultant from Santa Cruz, whose article on innovation appeared on the cover of the Harvard Business Review recently.

We were talking about the new normal versus the old normal. The easiest way to explain it is this; the old normal is the Hummer.  That’s what you get when you view business purely as a materialistic enterprise. When your vision is nothing but numbers you produce vehicles like the Hummer. The new normal is represented by the Prius. This is the development of products that consider people, the planet, and sustainability. Toyota has sold over 1 million Prius’s and now intends to create a whole line that will include cars of many shapes and sizes.

The old normal rewarded hard work, loyalty, and productivity. In the new normal it doesn’t matter. You can be hard working, productive, and creative, but be downsized with a huge knife in your back no matter what. This is business operating at its worst. There were some things about the old normal that were good, and therefore we need a new normal. All we’ve done is succeed in creating a work force of frightened zombies; people who feel they have no control over their economic destiny and therefore are shut down. Fear is rampant in our work place. Executives feel off the status while workers feel off in security. But, fear has made us un-creative, non-collaborative, and pessimistic. If the way that we conduct business produces fear, then we are conducting business in a way that prevents us from being prosperous. It is a vicious cycle.

The answer is that nobody is going to take away our fear but ourselves and the only way to take away our fear is to realize that we are all entrepreneurs; all the CEO’s of our own lives. Our current job is not our career. The people who understand this the best are some of the leaders of Chapman University who have installed entrepreneur classes throughout their curriculum. That is right! If you take dance or music you will study entrepreneurism so that you can set up your own dance/music studio and create your own economic engine. Everyone it seems is going to need to know something about marketing, finance, and about creating value in demand.

We all need to become brands of what it is we do that creates value. I believe that the only way to overcome our fears to become more independent economically. It is great that a university in Southern California has recognized that and is helping to train a new generation of workers who have the self-confidence to take care of themselves.

Gutless Leadership and Health Care Suicide

One of my close friends is a hospice volunteer. Lately he is supporting a vibrant, full-of-life 80-year-old woman who’s got a bad heart and who’s chosen to die as fast as possible. She’s in an independent care facility that costs a lot so she’s decided to voluntarily starve herself to shut off expenses so she can leave some money to her full-grown children. I know. He’s tried to talk her out of it, but she’s determined. She wants to die because she can’t afford to live. Welcome to America.

Meanwhile our leaders do anything but lead. The Democrats are sissies. The Republicans are bullies. I think most of us are sick of toxic, dysfunctional, ego-bloated politicians pretending to lead our nation.

As I have stated months ago, as well as many great comments from the rest of you, (see Outraged at the Politics of Health Care and Will Marre’s Radical Solution to Health Care) the fundamental problem with a financially unsustainable health care system is that the profit motive is its key driver. This creates a crazy maze of confusion, waste, cost, and suffering. Today’s price of health care is driven by cartels and rich interest groups who compete like Gladiators for a piece of yours and my pie.

1. Thanks to the near elimination of antitrust safeguards, 7 big private insurers control over 80% of health insurance in our nation. These companies are designed to take in as much money as possible from you and pay out as little as possible. They make the insurance claims process confusing and time consuming for patients and doctors, which increases costs and time. This also discourages many people and even physicians from making totally legitimate claims, which increases profits by tens of millions annually. Of course we also know that insurance company claims representations are rewarded for denying claims or finding unethical loopholes to deny payments for treatments to insured persons for trivial reasons causing systematic suffering and in some cases avoidable deaths. Lately insurance companies have been raising premiums in huge chunks to make as much as they can before they are regulated. The obvious conflict between investor interests and our nation’s health care is so great it is breaking our economy.
2. Drug companies have created a closed, unfree market in the U.S., which allows them to charge many times, often 10 times, more for a drug than it costs in other western countries. The idea that Merck drugs in Canada may not be as safe as the same drug in Minnesota is an insult to all of us. The argument that American consumers need to pay higher prices to support U.S. drug companies’ research is simply wrong. U.S. drug companies spend much more on consumer advertising than all of their drug research combined. If business believes in free markets and globalism, then let’s have it. Free trade and a common world price for all drugs.
3. The medical profession has too many incompetent doctors doing procedures they shouldn’t be doing simply because these procedures pay well. It has long been known that the most expensive and difficult procedures are done at the lowest total cost and have the best results when they are done in well-equipped hospitals that specialize in those treatments by doctors who do hundreds of those procedures per year. If you need a heart bypass, go somewhere where they do hundreds of them. These “Centers of Excellence” save money and lives. The medical profession also needs to do a much better job of getting rid of incompetent doctors that cause the majority of malpractice claims. It would also be wise to establish special health courts to curb the abuses of trial-lawyers who game the system to win big awards on the basis of emotion rather than science and responsibility.

I could go on, but who would listen?

The core solution I believe is a universal insurance exchange that is set up as a national non-profit co-op “owned” by all American citizens run by competent executives and properly rewarded employees who have one goal—make sure that the most people have access to the best health care. This can be done with excellence and efficiency. Employees should be rewarded for quality and keeping people healthy not for denying sick people coverage.

We need something more than the best we get from compromising with the huge health care industry that has spent $425 million lobbying against us in the past 4 months. There is a role for private insurance companies, but we must level the playing field by creating a force of citizen power to create realistic and sustainable economics for health care. (The rest of my proposals are in previous blogs.)

Today our health care strategy is a mess because we are trying to turn a rusting ocean liner into a rocket ship. No matter what modifications we make to the rapidly sinking boat, it will never fly.

We must have a whole new system. One that gives people choice and confidence. One that rewards people for healthy lifestyles. One that is uniquely American. Not run by the government but by well-informed citizens who can blend the best of our fierce independence, distrust of bureaucracy and our collective heart for our common good.

I do not claim to have all the answers. But I am disgusted with Democrats who turned what should have been a health care revolution into a poison stew of who-knows compromises. The “brand” of the Democrats is whiny, victim, poor me thinking. They are also ready to compromise because they have no visible backbone and few ideas they are ready to fight for. The Republicans sicken me. Their “brand” is arrogant know-it-alls who only want to lower taxes, fight wars, remove regulations and promote a new aristocracy. Their “I’ve-got-mine and no-one’s-going-to-tell-me-what-to-do” mind set is a cowboy philosophy completely at odds with the higher purpose of society.

As far as health care goes, I am most impressed with Jesus’ advice. When the Samaritan came upon an enemy who was left for dead by the side of the road, he didn’t say, “Well, he probably deserved it.” Instead he took him in and got him medical attention and paid his bills. It seems clear to me that moral maturity demands we seek to reduce all avoidable suffering. If that were our motive and we didn’t compromise with the moneychangers, we just might come up with something simple, practical and affordable.

I, for one, don’t want the status quo. I don’t want some two-bit, best-I-can-get superficial leftovers approved of by the special interests. I am sick of hearing what’s possible.

What I want is a radically new way of looking at this challenge and the leadership courage to make our country a better place to raise our children.

How about you?

–Will Marre

An Economic Revolution

A few mornings ago I was on 2 morning shows on Fox 5 and CW 6 talking about my participation and innovation in the Humanity Conference that is coming up. I will be speaking there with 40 other world-renowned experts in sustainability, social innovation, and a new form of enterprise. It is a very exciting time. The world is going through an economic revolution and there are many good people doing good things to create a better world.

We are in a Productivity Bubble

We are going through a productivity bubble. Large corporations are announcing their bloated earnings through Wall Street analysts this week. What has happened? Companies are making money by wide margins; wider margins than normal because they have laid off so many people. Productivity is four times higher than normal because so few employees are being paid to produce the revenue that companies are generating. In the end this is only exploitation.

Education – Our Greatest Investment

At a time when education budgets are being eroded it is actually a time to recommit to education. Education is the one thing that leads everyone to a better life, more life satisfaction, stronger marriages, a longer life, and less crime. The more educated people are, the more they contribute to the economy. It’s a virtuous cycle. It is time to commit to equal levels of education. The Hallam Charter schools send nearly 100% of their graduates to college. Education is our single greatest investment. We are foolish indeed to shortchange it.

« Previous Page — Next Page »