Today's Quote: Looking at The (Wo)Man in the Mirror (RIP MJ)

"A loving person lives in a loving world. A hostile person lives in a hostile world. Everyone you meet is your mirror."
-- Ken Keyes

The Cause of High Cost of Health Care in the U.S. and a Solution

According to The Innovator's Prescription, medical services are overly conflated which makes measurement difficult if not impossible to do and leads to the situation we have now. In order to truly understand this position, we need some definitions.

• Solution Shops (SSs): you can think of this as consulting firms. The value SSs bring stem from the people (frequently experts) they hire. These people are usually brought in when the problem is ill-defined and or the solution is ill-defined. For this reason, you must pay an SS for its inputs NOT its outputs. Think lawyers and research firms.


• Value Adding Process (VAP) Businesses: you can think of this as a retalier. The value VAPs bring stem from transforming inputs into output of higher value. A clothing designer's shirt is worthless on her desk. However, it's worth $210.00 on a Nordstrom's rack where people can actually purchase it. VAPs charge for the outputs they produce as there is high confidence in the controllable process used to produce the output. Think McDonalds or your local University.


• Facilitated Networks (FNs): you can think of ebay. The value FNs bring is through efficiently connecting members of a network with other people of the network such that they can share useful things. FNs typically make their money from membership fees or other action based charges.

Now that we have those definitions out of the way, let's start mapping this to the health care arena. SSs are hospitals and private practices. VAPs are eye surgery centers or orthopedic centers or any other specialized medical service oriented place that isn't an SS. FNs would be organizations like dLife or patientslikeme.com. According to The Innovator's Prescription, SSs are trying to do the job of VAPs and FNs. The overhead for doing this is enormous. Imagine if you had to have your highly paid engineer do the janitorial work but you had to continue to pay him his engineering wage--it would hurt your pockets. Beyond that, an economist (Jean Say) seems to have pegged the health care industry when he stated (in so many words), when caregivers make more money by providing more care, supply creates its own demand. A study shows that up to 50% of the health care consumed isn't a patient need or demand.

The overall framework for the solution to reducing health care cost is to have SSs, VAPs, and FNs stick to their jobs (as defined above). SSs will use their expertise to focus on intuitive medicine. Once a definitive diagnosis is made they can send patients to VAPs, who do work at at least half the cost of a hospital or private practice. VAPs can use precision medicine to fix whatever is wrong with the patient. FNs will focus on those patients who have chronic illnesses. More specifically, through the use of a community, FNs will try to ensure that these individuals adhere to appropriate regimens so that they stay healthy.

If you're interested in knowing more about this subject, once again, I suggest you pick up the book.

4 Alarming Reasons Why Health Care in the U.S. is a Problem (aka an Opportunity)

I've read a good part of the Innovator's Prescription, and for anybody interested in finding possible solutions to the Health Care issue in the United States should give it a gander. Below are facts I synthesized form the Innovator's Prescription. You'll have to purchase the book, if you want the citations for where the facts stated below :o).

• Health care spending increases 9.8% annually, whereas spending for the U.S. as whole increases only 7.2%. The upshot? A whole bunch of people can't (and/or will be unable to) afford health care.


• If the cost of Medicare continues to rise as it has in the past, the only item in the U.S. government's budget that will be larger is defense within 20 years.


• Companies that are economically important to the U.S. are becoming uncompetitive on the international stage due to the high cost of health care. *cough* American motor companies.


• If the government were to report the liabilities they have for commitments they have to provide health care for retired employees, every city and town in the U.S. would go bankrupt (unless they took drastic measures such reject funding of schools, roads, public safety).

While these problems are far from simple to solve, they scream for a entrepreneurial fix! In the next post, I'll outline what Clayton Christensen, a co-author of The Innovator's Prescription, thinks are the problems and the high-level solutions.

Is Inaction Really Inaction?

Kevin Kelly in a recent article discussed the "triumph of the default." I'm not going to pretend like I read the post from beginning to end, because I didn't (it's pretty long). I did find the following quote particularly striking from Kevin though:

By definition a default works when we — the user or consumer or citizen — do nothing. But doing nothing is not neutral, since it triggers a default bias. That means that "no choice" is a choice itself. There's is no neutral, even, or especially, in non action.

Kevin's statements ring loud and true. We often believe that we can avoid consequences through inaction (epic fail). However, in reality, we're simply trading one set of a consequences for another set of consequences, namely the default consequences. I touched on this in a previous post. When you choose not to ask for your raise, your inaction is choosing the default consequence of waiting and hoping for your boss to notice how well you work and give you a raise she thinks is reasonable. When you choose not to talk to someone you're attracted to at the grocery store, your inaction is choosing the default consequence probably never seeing or talking to this person ever again. When you choose not to do the important, your inaction on these things causes your inner conscious to shake its head at you in admonishment.

You've probably heard the saying that every action has a reaction. Well, it's also true that every inaction has a reaction! The default reaction. If the default is cool for you, then, by all means, bask in it. But if you're sick to your stomach of being served the same ol' slop, day-in and day-out, choose action over inaction! It's the best shot you have at escaping the default reaction. Godspeed!

Review: How to Get Rich by Felix Dennis

I read a good porition of Felix Dennis's book called "How to Get Rich." I wrote a post on him a while ago here.

There wasn't anything really surprising in the book that I haven't concluded myself. One thing that stood out to me was that he put self-belief before persistence. He claims that self-belief is more important than persistence. He states at the very beginning of the book that the reader probably wouldn't agree with everything he has to say, and he was correct, because I disagree with the assertion that self-belief is more important than persistence. Both qualities are of equal importance. Persistence and self-belief are inextricably tied together. You can't have one without the other and hope to succeed at anything worthwhile.

One phrase that Felix wrote that he repeatedly said to himself, that I thought was cool, was "once I've begun, the job's half done." This stems from the fact that often times the hardest part of any venture is simply starting. I would argue that persisting is harder. I'll concede that few people can start things, but even fewer can actually finish. Nonetheless, Felix's point is well taken.

One of the more powerful points had to do with avoiding taking chances due to a fear failure. It was a point that Steve Jobs made in his commencement speech to a graduating Stanford class. Felix's and Steve's point is that you will one day die. In the words of Steve Jobs, "you're already naked." If you're ultimately going to die, what does it matter if a girl laughs at you when you ask her out? What does it matter if your first business fails miserably? What does it matter if people in your community think you're stupid for changing careers this "late" in the game? Nothing. It doesn't matter.

Last but not least, Felix is a living testament that you don't have to love what you're doing in order to be rich. Everybody wants to have you believe that you have to love what you're doing to be rich, and he is another data point that suggests that, that belief is false. I understand why people go around saying it. They don't want people doing things "for the money." This is a noble aim; but the lie is inexcusable. Now Felix doesn't advocate being crappy at what you do, but he does advocate doing whatever you do well, while keeping your eyes on the (real) prize -- becoming rich. But why become rich you might say? His reasons are consistent with that of Tim Ferriss to some degree. To buy time. With enough wealth, you can spend your time doing, frankly, whatever you want, and this is exactly what Felix does! While I think Tim Ferriss carves out a far more concrete method for attaining more time in 4HWW, the end game is the same. Time is king. Cheers!

Changing Your Attitude Towards Your Job and Happiness

Far too many people believe that the external conditions of a job will make them happy.

If I get a corner office with a view, a six figure salary, my own secretary, 4 weeks vacation, and smart people to work with, then I'll be happy.

The problem with external conditions is that you have little control over them. Ergo, by basing your happiness on external conditions, you are actually leaving your happiness to chance, and your chances of becoming happy this way are similar to that of a typical gambler in Vegas...ridiculously poor.

If you are like me, then you believe that happiness is too important to leave to the type odds you find in the MGM Grand. Fine then, given the importance we place on happiness, what is our recourse? A simple realization: A job doesn't make you happy; a job well done makes you happy. Read the previous sentence again, and make sure you pause at the semicolon; I'll wait.

Think about it. I'm sure you can find plenty of examples in your current primary vocation, but I assure you the realization of where happiness comes from is applicable to a wide array of "jobs." When you've finished fixing up your garden, it's a job well done, you feel happy. When you've washed all the dishes and wiped down the sink, it's a job well done, you feel happy. When you score well on an exam you studied hard for, it's a job well done, you feel happy. When you get all dressed up in your designer clothes to go out, it's a job well done, you feel happy.

Too often we think a job is beneath us and subsequently can be pushed off to some later time. This type of thinking typically leads to pressure situations where you invariably produce inferior output. But then what do we do? We turn around and say things like "this job is stupid", or "I could've done X, Y, and Z if I had more time," or "I work best under pressure" (*cough* bullshit), or "I don't like this job anyways; I don't care," etc. These rational lies actually stem from knowing deep down that you didn't achieve a "job well done." The next time you feel like a job is beneath you, prove it. All-out crush it, demolish it, pulverize it, make it scream your name! You'll be happier for it ;o).

One of the primary benefits of taking the attitude that it's really about a job well done far more than it's about the job itself is that it motivates you to go beyond "just enough." I've personally found that I am much more inclined to go the extra mile to ensure the quality of the work I produce under this mindset. When you fully understand that your emotional state, your happiness, is in some way tied to your achieving a "job well done" you try like hell to reach your version of a "job well done." The manifestation of this attitude is no different in abstraction than the drug addict that has the ability to get his drug high anytime he wants. Similarly, like our fictitious drug addict, you have the have the ability to reach an emotional high anytime you want. All you have to do is achieve a "job well done."

You don't have to leave your happiness for a slot machine to determine. You are the slot machine.

The G-O Method: The No B.S. Way to Productivity Now

One piece of advice most productivity gurus suggest you do to get more done is to focus on things single-mindedly. It's pretty much a wide-held consensus that multi-tasking simply doesn't work (there are still some people out there who believe multi-tasking is more productive, but these folks are simply late adopters). Focusing single-mindedly on something sounds like a good idea, but, the question remains, how the hell do you do that?

By using what I call "The Goal-Oriented Method" or the "G-O method" for short. The G-O method is really simply and you can begin seeing its impact on your life right away. The process is given below.

1. Determine what it is you want to do. I want to write this paper. I want to send out this email and head to the office to pick up some files. I want to finish grading these papers. I want to wash these dishes. I want to dry these clothes. Whatever! Just fix something in your mind you want to accomplish


2. Ask yourself "why am I doing what I'm currently doing? Is what I'm doing working toward that goal?" This might sound too simple to work, but trust me it does. What this question does is refocus you. What kills your productivity are those random thoughts that come out of nowhere and leads you to God knows where. While writing a paper, a business card might catch your eye, the next thing you know, you're thinking about where you got the card from, and wondering if you can find the person on Google or worse Facebook!
   
   These questions not only help you refocus when you're losing it, but it actually helps you focus period. Imagine that you're in bed right now and it's the morning time. If you've already fixed something in your mind, and begin to ask yourself the questions prescribed by the G-O method, you'll find yourself motivated to do what you need to be doing to get your goal accomplished. These questions are powerful because it helps you realize that if you're doing something that isn't germane to the goal you've fixed in your mind, then what you're doing is a relative waste of time. And if you abhor wasting time (or more aptly, your LIFE), you'll find uncanny focus using the G-O method.

So go ahead and give it a spin. What do you have to lose? Focus?