Wednesday, May 10, 2017

Corrine Brown Has Her Day In Court

I have a friend, shocking as it may seem, who once told me that politicians should be limited to two terms, one in office and one in jail.  I could not agree more, especially so, as it pertains to my former opponent, Corrine Brown. 

Ms Brown has been charged with 22 counts attributed to fraud, obstruction and filing false tax returns.   We all await the results of the jury deliberations.  Regardless of the verdict, the case illustrates two sad facts, which are:

  1. It is hard to break free from crime and 
  2. We should expect more from our elected officials, not less as referenced by the aforementioned joke.

In reference to the former stated fact, Ms. Brown, grew up in area known in Jacksonville, FL as the “Northside”, which is an euphemism, code, whatever you want to call it, to paint a  picture that depicts the lives of the residents living in this geographic area as challenging due to a myriad of causes.  The main cause and effect is poverty followed by low literacy rates and higher crime rates that further perpetuates the situation.  Arguably, residents of this community know at least one and possibly many fellow residents that have been affected by crime, whether as a victim or as perpetrator. As a side note, I met many on the campaign trail eight years ago. Regardless, I believe this knowledge of crime and its effects within this community leads to understanding, which leads to tacit acceptance of (& a blind eye to) criminal behavior that I further believe begins in childhood.  Ms. Brown through hard work seemed to have broken free from this cycle of crime, but sadly, she fell back in, which proves the old adage, “you can take a [girl] out of the country, but you cannot take the country out of the [girl].”

In reference to the latter stated fact, I recently saw results of a Gallup survey that showed that the majority of people believe that politicians are corrupt.  Using the same logic in my former argument, if people believe that politicians are corrupt then I contend that these same people expect this behavior whether they acknowledge it or not, which I further contend is tacit acceptance and therefore, it becomes reality as exemplified by the situation in which Corrine Brown finds herself.  I find that unacceptable and so should everyone else.  Moreover, I believe our elected officials should be held accountable for their behavior to at least the same level as ordinary citizens because they are role models. Without the rule of law, anarchy can occur, which is not good for anybody.

Our legacy is what we leave behind when we die is it not? Should we not seek to improve the lives of future generations so that our spirit continues long after we are gone?  Should not every successive generation be the greatest generation? It comes down to what we value is it not?  I value a lot of things such as truth and honest, but germane to this situation, I value the rule of law when someone fails to be honest and commits a crime, how about you?  Hopefully, the jury will see the facts as I see them to convict Corrine Brown on some if not all counts.

Tuesday, March 21, 2017

Cut Soaring Salaries To Reduce Healthcare Costs

Want to cut healthcare costs?  Cut salaries. 

One need not look far to find data pertaining to healthcare costs.  However, discerning the signal from all the noise has been next to impossible as evidenced by myriad of recommendations and government regulations all the while  healthcare costs continue to grow at a rate greater than GDP, 25o bps greater over the last 50 plus years!

The noise is compelling, just look at a few examples:
  1. McKinsey accounts for the cost of healthcare,
  2. History of US healthcare spending,
  3. Truth about medical malpractice,
  4. Harvard Business Review shows how to reduce waste in healthcare spending, and 
  5. Kaiser Family Foundation compiles recent data.
All the above information makes for fascinating reading, but it can make your head spin, especially so if you seek to truly find ways to contain healthcare costs. 

Healthcare costs cannot continue to outpace GDP or eventually it becomes GDP.  At the current pace, healthcare cost would be ~50% of GDP in 45 years and in 75 years, it will comprise all of GDP. So the question becomes when does healthcare cost slow and eventually grow at a rate less than GDP so that healthcare costs are in-line with other industrialized nations? Restricting access to those with money (as Republicans want) is one way.  Taking from those that have money to give to others (as the Democrats did) is another, but neither is the best.

To properly answer that question, we need to find the signal.  The signal is in front of our very eyes and we miss it. I too, started focusing on the noise, but I could not stop thinking about a recent chance meeting with a young neurosurgeon who has 27 classic cars. 

My focus fixation on all those cars allowed me to observe the signal, which is, hold on ---- “salaries”.  It is that simple, yet we miss it, accept it, whatever, but this cannot continue.

The biggest component of any product or service is salaries, especially so in a service industry such as healthcare.  In case you are wondering about information technology (IT) and medical technology spend, together they account for a a whopping $125 billion or less than five percent (5%) of the overall healthcare spend, essentially, this spend is negligible.

Salaries comprise more than those of doctors.  It comprises administrators, salespersons (medical equipment, drugs, insurance, etc…), etc…  In the case of physicians, their salaries have grown at the same rate as healthcare over the last five decades.  Is it correlation or causation?  I believe it is a little of both.

The reason why salaries have been able to increase is because the healthcare industry has become essentially an oligopoly due to electing more lawyers than economists that have passed laws, which have created all the regulations that have led to this mess.  John McCracken, PhD, of UT Dallas, also believes that the healthcare industry is becoming oligopoly, but for different reasons, which he states in his well written blog post here.

If by some miracle our elected officials see the errors of theirs and their predecessors’ ways and fix this mess, sadly, it will take approximately 40 years to contain costs to where the costs are in line with other industrialized nations (assumes GDP growth stays constant and healthcare growth decelerates at a reasonable rate of 95% of the prior year’s growth and essentially goes flat in 20 years).

In short, expect healthcare to remain a topic of discussion for a long time.