Steve Jobs- A Role Model of What Our Country Needs Today

Our country lost one of the great innovators of our time- perhaps of all time. Steve Jobs was only 56 when he died but fundamentally changed the way we live during the short time he was with us.

Most of us never met Steve Jobs- but we all felt his creativity and passion for excellence every day. We saw the results of what can be accomplished when you dream, you believe, and you persevere. Our lives have been changed by his commitment to dream. Our world was changed by his example of believing and passionately working as a team for the accomplishment of a common good.

Perhaps health care, politics, and our country as a whole should take a break from acting the way it is today to reflect on the legacy of a true innovator and creator. We need more passionate and innovative creators to dig us out of the hole we are in. I’m sure Steve Jobs wouldn’t see the hole- but the opportunities available to dig us out.

We may have lost the dynamic presence of Steve Jobs in the world but we will forever live on with his legacy.

As Facebook creator Mark Zuckerberg wrote in a brief eulogy to Steve Jobs, “Thanks for showing that what you build can change the world.”

We need to continue to dream, create, and work together toward a common goal. It will be the best tribute to one of the most creative innovators of all time.

Armageddon Hypochondria

I attended the monthly meeting of the Association for Strategic Planning the other day. Dr. Jim Paulsen, Chief Investment Strategist for Wells Capital Management was the speaker. He topic was to provide an update on the economic and financial markets and provide some insight into this insanity that seems to be reality today. Dr. Paulsen and I grew up in two small towns about five miles apart in southeast Iowa. We both went to the same church in small rural Iowa and both of us attended Iowa State University. I hadn’t seen him in many years and I primarily went to the meeting just to see him and see if he remembered me (he vaguely remembered). And as if I really needed it, I was also interested in hearing one more perspective of what is going on in the world.

His message was different. He laid out a compelling argument and one that is not nearly as loud as the “gloom and doom” message we’re hearing from the politicians and media. Dr. Paulsen peppered his talk with a portfolio of graphs and charts comparing this recession to those in the past showing how this recovery (and he does believe we are in a recovery) is “normal.” He doesn’t ignore the challenges (housing, credit/lending levels, and health care costs) but believes the positive economic indicators (company profits, investment, and manufacturing) are moving exactly as he would expect and ahead of where we’ve been before. He also presented a clip of a 1991magazine article from Time Magazine describing the economic environment we were dealing with. You could paste the same words used back then into any article today and you wouldn’t know the difference- political paralysis, health care costs, rising debt, etc. etc.

Dr. Paulsen believes our country is a victim of “Armageddon Hypochondria.” While the recovery, from an economic perspective, is proceeding as almost every other recovery has in the past, he believes we have become victims to the politics and the media hype creating the feeling of gloom and doom and extremely low levels of confidence we are experiencing today.

The numbers in his presentation all made sense and it was nice to hear someone believe we are doing ok- not perfect, but ok.

“Armageddon Hypochondria” is a dangerous disease especially in rough economic times. The endless political-cycles in this country and the 2012 elections will very likely make the disease grow in the future- especially to the uninformed or susceptible. We also can’t confuse Armageddon Hypochondria with the Brutal Reality of what is happening in our country and in the world. Health care costs are absolutely unsustainable, unemployment levels are unacceptable, middle-class America is shaken, and the hyper-connected global economy has changed the game for everyone. Doing nothing and letting the market “self-medicate itself” (Dr. Paulsen’s prescription for Armageddon Hypochondria) is a standard free-market solution.

Using the past to predict the future is standard operating procedure and makes perfect sense. I just wonder if the world dynamics have fundamentally changed too much over the past five years to provide any reliable predictions to what will happen in the future.

I’ve concluded (self-diagnosis) I don’t have Armageddon Hypochondria- but I do believe if we continue to address critical economic , healthcare, and policy issues as we have in the recent past, we could bring ourselves closer to the edge.

I may have the symptoms- I just don’t have the disease- yet.

Remembering the Passion of 9-11-01

The clear blue skies and the crisp chill of early fall bring the memories back again. Some call it “9-11 Blue.” These are the mornings when we recall the time when most Americans lost their naivety and innocence to confront the reality of the world we live in today.

Each year we dutifully honor the lives lost in the tragedy of September 11, 2001. The pain of loss will never leave for some. For the rest of America, it pauses, it honors, and then moves on. Unfortunately, we don’t spend enough time reflecting on the magnitude of what happened on that day. There are too many other things to worry about today.

Since 9-11-01, over 6,000 American heroes have given their lives in the wars in Iraq and Afghanistan. Another 45,000 have been wounded. Thousands of families, friends, and loved-ones grieve for the losses and the sacrifices that have come about as a result of this blatant attack on America’s ideals. Countless others struggle to help those who have returned from these wars to somehow become a part of a different kind of America than existed ten years ago when all of this began. Today’s America can seem like it’s paralyzed and confused.

Yes, we have some challenges. We have some big challenges. But, let’s not forget it wasn’t the government, or politicians, or the military, or big business that pulled us together in 2001. It was the will of the American people who established the direction we wanted to follow. We were united in a cause.

As we pause once again to honor all of those who have sacrificed on 9-11 and beyond, let’s not get distracted by the “self-interest politics” that has slowly but surely become part of the fabric of our political process today. Let’s work together to solve our debt problems, support those fighting for our freedom, fix our educational system, grow our economy, create jobs, and finally fix our health care crisis in a way that can only happen in America; a unified nation of individuals with a common purpose and a passion for liberty and democracy for all. We’ve done it before and we can do it again.

Those who have already sacrificed deserve nothing less.

Participation and Engagement Are Not The Same Thing

I gave a talk to a group of businesses on the transactional side of health care the other day. My topic was to provide my perspective of approaching “consumer engagement” for the transactional side of health care from the lessons learned from the health and wellness side.

I spent a lot of time thinking about the topic. The politically correct approach would have been to provide all of the appropriate statistics to show how incentives, benefit designs, and the other “economic” approaches were improving participation in wellness programs (47% participation in completing a Health Risk Questionnaire with an incentive and 26% without) and how innovative communication/marketing strategies improve participation, and all of the other stuff. The politically correct approach would have been to say to just take what we’re doing so well on the health care side and use it in some of the other areas.

But, my topic was engagement, not participation.

Engagement, to me, is deeper. Engagement is commitment, its understanding the context, it’s taking steps beyond the minimum necessary to get by or getting paid to do it; it’s becoming part of the solution.

As I put my thoughts research together I began to realize (actually I had always assumed) that consumers aren’t engaged in health care. Seventy-five percent don’t understand it and many continue to be frustrated by it. Yes, the participation numbers may be improving for some of the wellness/preventive components (25% on average but higher for some program areas and for some organizations in general). However with such a high confusion factor and a health care literacy rate of only around 15% we could do much better. Add to that an industry “trust ranking” of Health Insurance and Managed Care only above Telecommunications, Oil, and Tobacco I concluded we might have a problem with real engagement.

My message to this transactional group ended up being that they need to be aware that they may be “branded by a brand” in health care and the health care brand with consumers right now is not all that hot (except with hospitals and doctors). I told them that they need to be aware that consumers were being asked to play many roles in health care today (Benefit Manager, Financial Manager, Care Navigator, Legal Manager, Information Manager, Personal/Family Wellness Manager) and they need to look at consumers in the total context as they develop products or strategies impacting a single one. I told them they would need to provide the appropriate guidance to consumers to help them fill their role as an Informed Health Care Consumer. And, building trust with the consumer would be a key to building engagement.

Yes, you can certainly improve the participation numbers by paying people and designing benefits to influence what they do. For most, the participation will only be short-term and dependent on continuing to pay them or maintaining the benefit structure directing them what to do. However, if you have them engaged, the participation numbers will be longer-term and the approaches you can use are more flexible. You may not even need to pay people to get them to do the right thing.

This transactional group was only interested in participation- not real engagement. They wanted to hear how incentives and economic structures could drive people to their businesses. They wanted to hear me validate what they were doing today and how participation (how many bodies) was the real indicator- not engagement. I think they wanted to hear the standard stuff. They didn’t want to hear about reality of the consumer perception of health care today.

Well, I still believe building trust in this industry is the real key to engagement. And, building trust starts with confronting the reality of where you are today and what may need to do to change. You build trust with open communication, honesty, integrity, and partnerships. You build trust with collaboration and dialogue. Building trust is more than just a software application, an incentive program, or an HRA. It’s about building a relationship with an individual.

Transactional health care may still be focused on participation. The real solution is engagement- and that’s tougher to earn.

From Minnesota- No Piling On Please!!!

I have to admit, living in Minnesota is never dull.

In addition to being the home of ten thousand lakes, beautiful communities, good people, and some innovative businesses we have created quite a collection of politicians to guide our state to where it is today including: Humphrey, Mondale, Wellstone, Ventura and more recently Pawlenty, and Bachmann. It’s quite the collection of personalities when you think about it. Minnesotan’s have become a pretty versatile people. We’re always looking for the right combination of personalities that can get something done. We’re willing to take some chances.

While historically Democrat, slowly but surely (just like the rest of the country), Minnesota has become ideologically partisan and divided. Last November, we elected a Democratic Governor, and a Republican legislature that work so well together we are now beginning the third week of a government shut-down.

What is the primary issue?; Balancing an “out-of-control” budget combining the right balance of expense reduction with revenue. The right and the left couldn't come to an agreement and is at a stalemate. Now, only the “essential services” in government are funded, the rest of the state is closed.

State parks are shut down (during the 4^th of July holiday), rest areas are closed, renewing your driver’s license or getting a fishing license (almost a requirement to live in Minnesota) is unavailable. Because the politicians could not do their jobs the rest of us are being asked to “suck it up” and live with it. In the meantime, Minnesota’s credit rating was devalued resulting in increased interest costs at a time we don’t need any additional costs.

In Washington we’re now in the midst of heated debate concerning raising the debt limit. What is the primary issue?; Addressing an “out-of-control” budget by combining the right balance of expense reduction with revenue (Sound familiar?) At this point, we’re at a similar stalemate at the federal level and we’re nearing the point that the effects could be worse than what is already being experienced in Minnesota if some resolution isn’t reached.

Since 1962, the debt limit has been increased 74 times. Many times it was increased as a part of some other legislation and never received much attention. Over the past 10 years, however, the debt limit has increased 10 times as the debt of our nation has exploded because of weak economic growth, the 2001 and 2003 tax cuts, funding two wars, and a stimulus package that was intended to prevent us falling into a bigger recession than we already experienced. Both sides need to assume some responsibility for the crisis we now face.

Unfortunately, the debt limit vote this time has become political instead of rational. Politicians are covering their asses as they protect their special interests and are already looking to use the process for leverage in the 2012 Presidential and Congressional elections. As in Minnesota, neither side is budging.

Some argue we aren’t really at any crisis point and can get through by simply juggling how we pay our bills until some resolution is reached. I would ask these people to just take a look at the fragile nature of the global markets. Whether these people want to accept it or not, August 2 is a “real date” to the markets- they will react accordingly.

So, once again (and as predicted when the federal budget was passed to avoid a federal shut-down), we’re going to go down to the wire. Because of the political reality of today, if a deal is reached it will not nearly be what is needed to address the crisis we are facing. If a deal is not reached, we will just have to wait and see what the market reaction will be- and it won’t be pretty.

Either way, once again the American people will be left living with the effects of a partisan political quagmire. We’re already going to have to live with the mess created by shutting down the government in Minnesota- we don’t need the federal government piling on.

Both sides are to blame on this one- so, get to work, put your politics aside, and do what is right for the country.

The Collaboration Health Care Elevator Speech

I’ve been asked many times over the years for the “elevator speech” for Collaboration Health Care. Honestly, I’ve sometimes been at a loss to respond because when I say, “I want to change the way the general population “thinks” about health care,” nobody cares.

Despite the different types of projects we have been involved in over the years, they seem to still boil down to the same thing- we’re still trying to change the way all of the stakeholders look at and think about health care. But still, nobody seems to look at it that way.

It’s still all about ROI, production, diagnosis, measurement, and all of the “transactional” aspects now involved with health care. It’s all about regulations and bureaucracy and following an established set of rules and processes as opposed to looking at the world a little different and trying to have a basic understanding of why all of this is necessary in the first place.

Don’t get me wrong. Measurement and accountability is important. We’re just now going to the extreme and don’t seem to be solving the problem.

Solving our health care cost crisis is not going to be solved in a partisan manner. The Affordable Care Act was a very partisan piece of legislation and needs to be modified. Repealing it is not the answer either. We need to have a basic framework in place we can all work from. We aren’t working from it together today.

And, most of the general population is confused. We’re more knowledgeable than we were before all of this health care talk started- but we’ve been informed from very partisan sources. We really don’t know who to believe.

Despite much of the population still indicating they are relatively satisfied with the way things are, there is a very rapidly growing segment saying they aren’t. More are feeling the affects the rising health care costs are having on their personal finances. And, it’s only going to get worse if something doesn’t change- and change fast.

Our health care costs eat up a substantial portion of our national budget and are a key component of our national debt. The “unfunded” liability (what isn’t paid for) for Medicare over the next several decades will reach $46 trillion. Health care costs have the real potential to be the final straw to bring down our economic foundation if they are not addressed.

So, I suppose the elevator speech should be changed; “Helping stakeholders change the way they think about health care” doesn’t seem to matter much to anyone.

How about, " Protecting our national and personal economic future by changing the way stakeholders think about and interact with the health care system- through education, information, partnerships, and dialogue.”?

It’s a little long, but maybe more folks will get it.

Newt's Comment Is Right- But He Got Creamed For Saying It

Newt Gingrich has been a guest on Meet the Press thirty-five times. He’s covered a lot of territory on the show over the years. During his visit on May 15th, host David Gregory asked Newt his opinion of Paul Ryan’s approach to address the budget deficit and ultimately addressing the unsustainable costs of Medicare. He replied, “I don’t think right-wing social engineering is any more desirable than left-wing social engineering.”

His defection from the party-line quickly reverberated throughout the conservative ranks raising a huge obstacle to his chances of becoming the Republican nomination to challenge President Obama in the 2012 presidential elections.

Despite speaking the truth, and despite being accurate in his assessment- his thirty-fifth visit cost him a lot. The reaction he received from the Republicans illustrated how far apart we are as a country to address the challenges we are facing. Unfortunately, we are being guided by the far-right or far-left politics when the real solutions are somewhere in between.

In the meantime, our health care costs continue to rise. Price Waterhouse Coopers released a new assessment of the medical cost trends for 2012 (Behind the Numbers; Medical Cost Trends for 2012). While medical cost trends increased 7.5% in 2010, they are projected to increase 8% in 2011, and 8.5% in 2012. As the economy struggles along at 2-3% growth (or less) we just continue to lose ground. Any possibilities for relief through initiatives included in the Affordable Care Act will not be felt for several more years- if at all.

The PWC assessment commented, “An interesting blend of reactions to the recession, the slow recovery, health reform, and other variables will affect the medical cost trend in 2012.” The problem is only going to get deeper the longer we wait to take real action beyond the party-lines of the politics and special interests.

Quite simply, the philosophies of the free-market purists will not solve this problem. The theories of the government-control liberals will not solve it either. We need a rational collaboration of both public and private initiatives to eliminate the waste, reduce the inefficiencies, and develop a solution that makes sense for the country.

We need to be able to talk about some of the solutions that are not necessarily “right” or “left.”

Newt’s comment on Meet the Press reflects what we need. Unfortunately he was creamed for saying it.