A Nation At Risk This 4th of July!

Posted on | July 2, 2017 | Comments Off on A Nation At Risk This 4th of July!

SOURCE: Decline in State/County GPA from Global Warming

The fact that the US is the only developed nation in the world that spends more on Health Care than all other Social Services combined according to a 2015 Commonwealth Fund study is a remarkably regressive achievement. Besides reflecting our distorted financial and ethical priorities, and the natural end point of a profit-driven free enterprise health care system, it also defines our nation’s vulnerability.

There is growing realization that our inability to come to grips with a decision way back in 1947 to throw our weight behind private profiteering health insurance has the potential to soon crowd out all other US priorities and collapse our economy. A simple shift to consolidate back room insurance functions (not the management or delivery of care) could trim 15% off the US health care bill immediately. But more than this, it would allow us to develop for the first time an integrated plan to assure a more healthy America.

Under such a plan, medical schools would integrate social mission into health professional education as Fitzhugh Mullen recently suggested. Also regressive policies such as those proposed by Trump EPA chief Scott Pruit would be exposed for what they are – economically dangerous and ethically disastrous.

As we wait for the US populace to catch up with this administration (in much the same way as 1970 America’s Nixon supporters took 19 months to finally come to grips with the fact that their President was simply not well enough to manage the duties of Presidency), we all need to continue to expose the truth in words and graphics.

Paul Voosen, Earth and Planetary Science journalist for Science magazine does his part in the June 30, 2017 issue of Science. The graphic above depicts the loss in state and county GDP as a result of the predicted impact of global warming under the current regime. It mirrors in part the human carnage of the opioid epidemic, and the supreme irony that Trump’s loyalest supporters are those most at risk as a result of his regressive policies.

As Frank Rich encourages in this week’s New York magazine cover story, “How A Presidency Ends”, it is highly likely that Trump will come to the same end as Nixon. But only if patriotic Americans continue to doggedly and respectfully pursue, display and share the truth in red, white and blue.

Happy July 4th!

The Secret To Making America Healthy – K.I.S.S.

Posted on | June 26, 2017 | 3 Comments

Mike Magee

As the debate over health care in America rages anew this week, the great lie oft repeated but never defended is that our system is too complex to wrestle to the ground. That is the lie, reinforced over half a century, that has left our citizens and now our entire economy at risk. The truth is, the solution is rather clear, the resources available, and the liability of continued inaction of mounting concern.

How do we make America healthy? Before we address this critical baseline question, let’s first tackle another, “Why should we make America healthy?” The answer to this question could go on for pages but the short-hand response is that healthy citizens maximize human productivity and societal stability. If the idea is to make America as great as it can be, then healthy citizens are the starting point.

So, how do we make America (and Americans) healthy? Whatever we decide to create and provide in pursuit of this fundamental goal, it must be universally available to all citizens. This is because we are an inter-dependent species. We are only as well, or as productive, effective and mutually supportive as the weakest link in our chain. Insecurity breeds insecurity. Fear and dislocation breeds fear and dislocation. Despair undermines our collective futures. So whatever we offer to promote and assure a healthy America must be available at the outset, and with certainty and simplicity, to each and every one of our citizens.

Logic dictates that the execution and management of this offering should be designed to consume as few resources as is humanly possible. The more we consume in the offering and financial management of universal basic health coverage the less will remain for actual services. This simple reality is why most nations have centralized the primary back room functionings of health coverage and financial administration. Where most industrial nations (and our own Medicare) consume 5% to 10% of total health resources on this first step, our complex free-enterprise and employer dependent approach to the offering consumes as much as 25% of total resources while failing to ensure universal coverage.

If all must be covered, and the administration of the offering must be a public and centralized responsibility to assure accountability, uniformity, and cost-effectiveness, that leaves the definition of services and the actual delivery of services. These need not, and some would argue should not, be centralized. A basic package of services should be required of all, and not all services are affordable or even desirable. For example, Canadians universal health plan covers on average 70% of the total cost of health care for Canadians. The plan does not cover pharmaceuticals, optical needs or dentistry. Citizens who wish to can purchase private supplemental plans to cover these costs. Furthermore, plans total offerings vary from province to province, as defined by budgets and priorities set by provincial governments year to year. Hospitals are funded by the provinces, and doctors (who on average make more than American doctors) are largely reimbursed fee-for-service. Ample leeway, state to state, as we see with Medicaid, could be offered to allow a reasonable amount of experimentation and choice.

This combination of central control and management of insurance coverage and local responsibility for budgeting, prioritization, and quality assurance has consistently outperformed America’s purposefully complex free-enterprise health sector free-for-all for over a half century. Our approach underperforms by almost every health measure, costs nearly twice as much, and has patient satisfaction ratings of only 25% in the latest polls. We have paid dearly for our complexity in funding an astonishing array of “non-real work”. For example, we support nearly a half million individuals selling and managing health insurance in the US, and and equal number of hospital and physician office coders and billers on the other side working diligently to get payments out of the mostly for-profit insurance companies.

Vannevar Bush

But our fundamental error or conceit dates backs to 1947, as we exited WWII and considered how best to manage an enormous chronic burden of disease. Lead by Vannevar Bush, whose military approach to scientific collaboration had provided new blood products, penicillin, and the atomic bomb, our leaders concluded that a similar unencumbered collaborative free-enterprise approach could defeat disease as it had defeated the Nazis. By omission, their definition of health was the absence of disease. Defeat disease and health would be left in its wake. Fund the effort on the backs of employers and unions as a benefit, and ignite collaboration and a collusive integrated career path with federal dollars and enabling patent legislation and victory was assured.

In contrast, Canada took the time to earnestly ask “How do we make Canada (and all Canadians) healthy?” In response, they created universal coverage and continuously refined their answer to this basic question. By 2010, prevention, not intervention, surfaced as mission central. They stated then that “Health promotion is everyone’s business. While it is clear that health services are a determinant of health, they are just one among many. Others include: environmental, social and economic conditions; access to education; the quality of the places where people live, learn, work and play; and community resilience and capacity.”

It really matters little whether Republicans prevail in their regressive efforts to reinforce over a half century of failed health care policy. The die has been cast. As Warren Buffett recently stated, “Medical costs are the tapeworm of American economic competitiveness.” The cost and inefficiencies have been well documented including: High administrative costs with 850 health insurance companies selling to millions of employers; high costs passed on to employees in rising contributions and lost wages with the burden weighing more heavily on low income employees; employees of small firms and the unemployed/underemployed left out of coverage; employment based insurance the major contributor to bankruptcies and poor labor relations; and finally a coverage system that discourages worker mobility and advancement. Together, these fatal flaws in a single sector of our society are bringing us to our economic knees.

Whether now or in the future, we will be forced to ask that simple question, “How do we make America (and Americans) healthy?” In responding, we will not be limited by resources. More than ample resources, currently misapplied, have already been dedicated to these services. We need only to recognize that health is not the absence of disease, and mirror Canada’s 2005 proclamation: “As a nation, we aspire to a Canada in which every person is as healthy as they can be—physically, mentally, emotionally and spiritually.”

Category: health reform
Tags: aca > AHCA > Canada vs US > health reform > Obamacare > Republican health reform > Trumpcare

Do Majority in My State Support Trumpcare? NO!

Posted on | June 16, 2017 | Comments Off on Do Majority in My State Support Trumpcare? NO!

State Oppose AHCA Support AHCA

DC 70% 16%

MA 59% 22%

HI 59% 23%

WA 59% 25%

VT 57% 23%

CT 57% 24%

MD 56% 24%

OR 56% 29%

IL 55% 25%

CA 54% 26%

NY 54% 28%

RI 54% 23%

WI 54% 29%

CO 53% 24%

NV 53% 28%

IA 53% 27%

VA 52% 30%

MN 52% 27%

KA 51% 31%

NJ 51% 30%

OH 51% 29%

MT 50% 26%

MO 50% 32%

NC 50% 30%

DE 49% 27%

AL 49% 29%

TX 49% 34%

PA 49% 30%

MC 49% 27%

NH 49% 27%

ME 49% 30%

NM 49% 29%

UT 48% 29%

NB 48% 34%

SD 48% 33%

FL 48% 35%

GA 48% 30%

ND 47% 31%

SC 47% 32%

IN 47% 31%

MI 46% 30%

LA 46% 28%

WY 46% 34%

AZ: 45% 31%

OK: 45% 38%

AL: 43% 33%

ID: 43% 30%

KY: 41% 33%

AR: 40% 32%

TN: 40% 35%

WV: 40% 36%

Category: Uncategorized

Warren Buffett and Charlie Munger: Employer Health Care Not Taxes Is the Problem.

Posted on | June 14, 2017 | Comments Off on Warren Buffett and Charlie Munger: Employer Health Care Not Taxes Is the Problem.

Buffett and Munger

Mike Magee

This week the Wall Street Journal editorial page couldn’t help itself. They let loose with a snarky piece titled “California Single-Payer Dreaming” and front-ended their conclusion with the words, “This proves the truism that the liberal solution to every government failure is always more government.” For good measure, they added, “This bill reflects the left’s Platonic ideal, with the promise of free care for everyone for everything.”

The editorial cites a California Senate committee price tag of $400 billion, with a Federal contribution of $200 billion as an offset. But an independent University of Massachusetts/Amherst study released this week pegged the cost at $331 billion and potential Federal offsets of $225 billion. As important the study predicted that moving to single payer simplicity would cut the state’s health care costs by a whopping 18%, and decrease middle class patients cost 9%, and low-income resident costs 5%.

Just about a month ago, the Oracle of Omaha, Democrat Warren Buffett, and his life long sidekick, Republican Charlie Munger, provided a full-throated financial defense of single-payer. Andrew Ross Sorkin who got the scoop summed it up this way when comparing the value of tax reform legislation compared to health care reform: “As Mr. Buffett pointed out, these chief executives are missing the bigger issue — the one that should be their Holy Grail. As a percentage of our gross domestic product, the cost of maintaining our American health care system — hospitals, H.M.O.s, doctor visits, prescription drugs, medical devices, insurance companies, Medicare, Medicaid — is rising at an alarming rate. And Corporate America pays a big (and growing) chunk of the bill.”

Buffett put numbers to his argument. He said, “If you go back to 1960 or thereabouts, corporate taxes were about 4 percent of G.D.P. I mean, they bounced around some. And now, they’re about 2 percent of G.D.P…health care was 5 percent of G.D.P., and now it’s about 17 percent…When American business talks about strangling our competitiveness, or that sort of thing, they’re talking about something that as a percentage of G.D.P. has gone down, while medical costs, which are borne to a great extent by business” are on a steep rise. “Medical costs are the tapeworm of American economic competitiveness.”

His friend Charlie agrees, pointing out that a corporate tax break won’t change operations in any of the Berkshire Hathaway companies. “We’re not going to change anything at the railroad just for some little tax jiggle.” As for health care politics, Charlie says, “On this issue, both parties hate each other so much that neither one can think rationally, and I don’t think that helps, either.”

Easily lost in the debate are the numerous flaws in employer based health care that were laid out in a Health Affairs article over a decade ago. They include:

1. High administrative costs with 850 health insurance companies selling to millions of employers.

2. These high cost are passed on to employees in rising contributions and lost wages. This burden weighs more heavily on low income employees.

3. Many employees of small firms and the unemployed/underemployed are left out of coverage.

4. Employment based insurance is a major contributor to bankruptcies and poor labor relations. Plus, this system discourages worker mobility and advancement.

5. Many CEO’s know nothing about health care and delegate decisions to consultants and favored local agents who are ripping them off.

Way back in 2006, Stanford’s Alain Enthoven and Victor Fuchs wrote, “In the long term, we think that the likely and most desirable outcome is replacement of job-based insurance with some form of universal health insurance that encompasses choice, competition, and technology assessment to revitalize social insurance while making care more cost-effective.”

Back then then noted the lack of political will to address the status-quo, but also said, “But some external traumatic event…could trigger a political upheaval that would increase support for universal health insurance and force a compromise among alternative proposals.”

Trump may be that event.

Category: Uncategorized

How To Defeat Donald Trump in 2018 and 2020.

Posted on | June 7, 2017 | 2 Comments

Mike Magee

It is still early, but I believe Trump may survive immediate impeachment, though a number of his loyal followers may not be so fortunate. This means that those who oppose Trump – both Republicans and Democrats – need to be prepared for elections in 2018 and 2020.

After a recent post on the subject of positive leadership, with Trump as a foil, one of my loyal subscribers commented, “Mike, after many years of active involvement in health policy through my professional organizations, I am preparing to take the next step and run for the legislature in my state. Your essay on leadership has provided me with an excellent framework for my campaign platform. I couldn’t agree more that now more than ever we must each choose to lead in whatever way we can.”

If we were to commit from both sides of the aisle to the bipartisan defeat of Trump and his unwavering supporters, I would suggest that local, state and national leaders embrace and include the following ten points in their election platforms.

1. We have a President who is brazenly and unapologetically regressive.

2. His self-propelled rise advantaged change and magnified fear in a segment of our population.

3. President Trump is a negative leader who embraces fear and uses it as a currency to mobilize and organize populations and achieve short-term regressive goals.

4. Negative leaders retrench and divide; positive leaders connect across the divide. Negative leaders segregate; positive leaders aggregate. Negative leaders build walls. Positive leaders built islands of common stewardship.

5. I am a positive leader. That is why I oppose Donald Trump and his supporters.

6. I believe in pursuing common ground based on openness, inclusiveness, cultural sensitivity, justice, opportunity for all, goodness and fairness.

7. I believe in shared values and a unified vision for the future that includes lifelong learning, new technologies, curiosity, introspection and an active social conscience.

8. As your leader, I will support formative relationships, that is, as I care for you, you will continue to form me as a human being.

9. I am committed to the success of you, your family, your friends and your community thru cooperative productivity. We will help each other succeed.

10. Together, we will combat Trumpian fear. I commit to:

a) advancing positive leaders who lead with vision, not fear.

b) never remaining silent in the face of evil or injustice.

c) persisting and enduring – I will never give up on you, and hope you will never give up on me.

d) pursuing balanced success marked by happiness, relationships, and a stubborn adherence to the highest human values.

e) promoting faith in a higher power, not as a last resort, but as a beacon of goodness, resilience and strength.

Category: leadership
Tags: democrats against trump > Donald Trump > Negative Leadership > positive leadership > prsident trump > republicans against trump > trump opposition

How To Expel Trump From The “Island of Common Stewardship”

Posted on | June 5, 2017 | 8 Comments

Mike Magee

In our lifetime, we have witnessed the emergence of the Internet and HIV, of globalization and overnight delivery, of bubbles and bursts in our stock market, of the genomic revolution and the aging revolution. We have witnessed as well great preparation for war, but little preparation for peace.

But we have never experienced change like this. We have a President who is brazenly and unapologetically regressive. His self-propelled rise advantaged change and magnified fear in a segment of our population.

Three decades ago, while simultaneously studying change and leadership, I first defined the difference between negative and positive leaders based on their approaches to change. Negative leaders embraced fear, using it as a currency to mobilize and organize populations and achieve short-term regressive goals. In contrast, positive leaders were explorers who used a compelling value-centered vision as currency, and through role modeling and the strength of new ideas drew people in as they worked together to shape the environment in the long-term to be consistent with their vision.

Negative leaders retrenched and divided; positive leaders connected across the divide. Negative leaders segregated; positive leaders aggregated. Negative leaders built walls. Positive leaders built “islands of common stewardship.”

On these islands, one consistently found qualities like openness, inclusiveness, cultural sensitivity, justice, opportunity for all, goodness and fairness.

On these islands people spoke a common language grounded in shared values and a unified vision for the future. They shared as well common tools including lifelong learning, new technologies, curiosity, introspection and an active social conscience.

On these island existed formative relationships, that is, as I care for you, you form me as a human being. And on these islands there was a rich supply of renewable capital – human capital, financial capital, and social capital – the equity captured between two individuals committed to each other’s success and to the concept of cooperative productivity.

How do we combat Trumpian fear?

First, we begin by identifying and advancing positive leaders. That means voting for people who lead with vision rather than fear.

Second, never stay silent in the face of evil or injustice. Silence forever entraps you and defines you as passive, vulnerable and insecure. Better to have the courage and take the risk of speaking up and standing out.

Third, persist and endure. We will face many small and large challenges in our personal and professional lives that create anxiety and fear and seem overwhelming at the time. Find strength in character.

Fourth, pursue balance. Our skills, aptitude and ambition assure success but not our happiness. Happiness evolves from a life well spent, from enduring relationships, and from persistent and sometimes stubborn adherence to the highest human values.

Fifth, have faith. When your head hits the pillow, transfer the power to some higher power. Then take a fresh look in the morning. Things always look better in the morning. We are much stronger than we think.

People are basically good, but they are not perfect.

People are basically kind, but when afraid can act unpredictably.

People are basically loving, but when misled can respond with hatred.

People are people.

America calls. Each of us must now chose to lead.

Category: leadership
Tags: change > Donald Trump > Fear > islands of common stewardship > negative leaders > positive leaders

David Brooks: Remarkable Essay on Positive vs. Negative Leadership.

Posted on | June 3, 2017 | 7 Comments

Mike Magee

For over three decades, I’ve been following and contributing to the literature on leadership – most specifically on the traits that separate positive leaders from negative leaders. This past week, David Brooks wrote an editorial in the New York Times focused on Donald Trump’s leadership, and reacting to a Wall Street Journal editorial by Trump cabinet members H.R. McMaster and Gary Cohn, that is truly remarkable.

It reflects everything I believe in, and creates a much needed sense of hope that goodness will prevail. Here are a few of his words, presented in the hope that they will encourage you to read his remarkable essay:

“the Trump project…asserts that selfishness is the sole driver of human affairs. It grows out of a worldview that life is a competitive struggle for gain. It implies that cooperative communities are hypocritical covers for the selfish jockeying underneath…In this worldview, morality has nothing to do with anything. Altruism, trust, cooperation and virtue are unaffordable luxuries in the struggle of all against all. Everything is about self-interest.”

“The error is that it misunderstands what drives human action. Of course people are driven by selfish motivations — for individual status, wealth and power. But they are also motivated by another set of drives — for solidarity, love and moral fulfillment — that are equally and sometimes more powerful.”

Take a moment now to read David Brook’s “Donald Trump Poisons The World”.

Category: leadership
Tags: david brooks > Donald Trump > Gary Cohn > H.R. McMaster > Negative Leadership > positive leadership

« go back — keep looking »