Regardless of which side of the debate you sit on wrt health care reform, it seems clear that until we attack the endemic ‘Cost Inflation’ of Health Care, we aren’t even anchored on a reality-based discussion.
Nowhere is this topic more paradoxical than in the role health care plays in the process of dying, a topic covered recently in an excellent 60 Minutes segment (click video above).
Some key factoids to noodle on from the show:
- The vast majority of Americans would prefer to die at home, but 75 percent of them end up dying in a hospital or a nursing home;
- Research estimates that 30 percent of hospital stays are unnecessary, and once that Pandora’s Box is opened, an average of 25 specialists individually charge (Medicare in the example) for batteries of tests, x-rays, blood work, opinions, and the like (let alone the risk/cost multiplier associated with hospital-acquired infections);
- Eighty-five percent of the health care bill is paid by government or private insurers, not the end consumer, creating an asymmetry of interest between the recipient of the service and the payee of the service;
- An absence of universal treatment protocols, measurement and commitment to rapidly iterate those protocols translates to patients un-empowered to advocate on their own behalf and a disconnect between results and costs;
- The costs associated with end-of-life care represent the single largest piece of the cost inflation challenge, and while framed as heinously pulling grandma off of the defibrillator, this must be reconciled with the darker truth that 46 million Americans are uninsured.
What’s the right answer in your opinion?
Rickrolling,
Breadcrumbing or Spamming?
In the post
‘Meme Schemes and Attention Seekers,’ I took to task the ‘look at me’ aspect of
the blogosophere; namely, those who sole purpose seems geared towards media
whoredom. (As a note aside, two of
the three people I referenced in the post were gracious enough to acknowledge
the piece and share their perspectives on the topic, which was greatly
appreciated, as the goal of the post was more about discourse than to dig anyone personally.)
With that as a backdrop, and to keep things ‘real,’ I want to share a story about how the tables were turned a week later, and I was painted as the bad guy.
As readers of this blog know, I read, write and comment a ton. The net effect of this is that many of the articles that I write derive from the posts, articles or comments of others that inspire me.
In parallel, as much of what I write is topical, I will often find myself reading articles that are directly relevant to an article that I have previously written. As such, the protocol that I deploy, which I call breadcrumbing (read post HERE), is to write my comment by excerpting a blurb or narrative from a post that I’ve written, reference that post and then link to it in the body of the comment.
In my thinking, I give at least as much as I get relative to extending the conversation, my comments are (hopefully) on topic, and the blogosphere is all about links; i.e., you concisely make your point, if you have deeper thought, you reference it, and the community can decide whether they care enough to delve deeper by clicking (or not).
However, not everyone sees the topic the same way, and upon posting a comment to an article at AppleInsider, a popular Apple-focused blog, a commenter ripped into me, saying the approach violates netiquette, equating it with spam.
Another party in the thread then quipped that “Proper netiquette is that you create an account under a pseudonym such as your name and your favorite cheese and then proceed to post links to your ‘insightful’ posts.” His comment was a total joke, inasmuch as the link provided (http://bit.ly/4kb77v) takes you to a video of Rick Astley singing ‘Never Gonna Give You Up.’
Rickrolling, for the uninitiated, is the process of leading unwitting readers to view the aforementioned video by positing that a presented link is relevant to the topic at hand, when instead, its pure (but harmless) online shenanigans (read the Wikipedia
explanation HERE).
All of this begs the question; Is it okay to reference a post of your own in commenting on someone else's article? I would argue that there is a hierarchy ranging from OK (directly related – nothing to sell) to Depends (loosely related; or directly related – something to sell) to Not Cool (unrelated, rickrolling or malicious links).
What’s your take?
Capitalism 2.0 or Uh-Oh
Talking with a
friend the other day, the topic of economic “recovery” came up, and while I desperately
want to believe a recovery is afoot (but won’t until net job growth begins – not simply a slowdown of job
loss), I found myself chiming out about the risk of a second dip or,
more likely, a Japanese-style 'lost decade' of economic stagnation. The argument for this is pretty simple.
One, we are shifting from a credit-driven society to a cash savings-driven one (proportionally-speaking), and the ripple effect of that will be felt for a long time, both in terms of consumer lifestyle-directed spending patterns and businesses impacted by the contracted spend lifecycle associated with it.
Two, there is so much that we don’t know about what we 'don’t know' about this particular downturn (owing to its global nature, the exoticness of the underlying instruments themselves, and the many, many sectors cross-contaminated by same) that the mechanisms to fix it are likely to be anywhere from imprecise to ineffective to outright damaging, and that creates risk, forces a higher risk premium to fund new efforts, and generally keeps everyone extra cautious, which becomes a self-fulfilling prophecy.
Three, the overhang in commercial real estate is WORSE than the bubble in residential real estate yet it’s not on most people’s radars…YET. It will be soon enough.
Four, while presidential candidate Obama promised to fight entrenched special interests, most notably the finance/banking services sector that, through self-regulation and self-dealing, completely destroyed our economy (while rocking the foundations of our economic system), President Obama has proven unwilling, unable or unclear as to how best to extract ourselves from this 'Octopus' on our economy, best exemplified by the Goldman Sachs Cabal (read an excellent Frank Rich NYT Op-Ed on this topic HERE).
Five, fixing what is broken isn’t free, and while many of us have endured a great deal of financial pain and sacrifice in the past year, the American people as a whole have not be asked to make Real Sacrifice at least 40 years.
Case in point, we outsource our wars; we borrow beyond our means to support a culture of over-consumption; we continue to gut our public education system because it's more expedient than committing to fixing it; we maintain our dependence upon fossil fuels versus ending that dependency, and the wars, pollution and toxic politics that come with it.
When will our leaders ask us to make Real Sacrifice, and give us a mission to make the doing worthwhile?
On this Thanksgiving Eve, I am reminded that we have so much to be thankful for, and that just as the Good Times inevitably come to an end, so will the Bad Times. What I worry about, though, is that relative to the axiom of a 'good crisis being a terrible thing to waste,' that we are indeed wasting THAT opportunity.
