Archive for March, 2017


MSNBC’s Brian Williams opened his Friday’s show with an interesting comment, “… both Trump and Ryan saved the Affordable Care Act.”  To be fair, Williams claimed the quote wasn’t original, that he acquired the verbiage from the Associated Press or another news media organization. Regardless, the statement was perfect.

Regardless of political view, there are many wonderful lessons for all project managers.

First failure was the lack of vision. All projects require vision and the Project Sponsor must be able to effectively communicate that project. Anti-Affordable Care Act (ACA) proponents had nearly seven years to prepare for and repeal the ACA. Estimates vary on the exact number of repeal efforts, but the current count is well over 60. So one would figure the American Health Care Act (TrumpCare) would have a solid foundation, with critical review and bipartisan support across both political and healthcare professions.

Unfortunately, TrumpCare was conceived in weeks, created from a high-level 6 page outline. TrumpCare was hidden, where one could neither read nor contribute to policy discussion. The White House failed to sell TrumpCare and Americans rejected the plan. Various news reports indicated the lead Project Sponsor (i.e.,the President and shelf promoted dealmaker) failed to break through Washington’s gridlock in his first major policy initiative. There was no education as to how TrumpCare was better than the ACA. In the end, not many thought it was better.

Second failure has to be project staff and advisors vacationing during project delivery. Prseident’s Trump’s key advisors, Jared Kushner and Ivanka Trump were vacationing while TrumpCare flopped. I simply can’t fathom key leadership would allow their principle advisors to leave during implementation week. Of course one could speculate Kushner and Ivanka Trump knew TrumpCare was destined to die and said “Screw it babe! Let’s get outta Dodge.” If you’re part of management, you have to be present during both good and bad.

Third failure. Where was Ivanka Trump during TrumpCare’s development. In January, Ivanka Trump professed a wanton desire to push policies benefiting women and girls. Accordingly, she sought the advice of female executives and media stars and the transition team supposedly courted congressional staff on childcare policies. This was an area Ivanka urged President-elect Donald Trump to prioritize. However, did we read of any single contribution from Ms. Trump during TrumpCare’s formation? Did we hear Ms. Trump promoting the positive benefits of TrumpCare for the working poor, single mothers and children? Maybe Ivanka worked behind the scenes. Still, TrumpCare’s key components were never publicly promoted by either Ryan’s team nor the White House.

Fourth failure. Borrowing Stephen Covey’s second principle from “7 Habits of Highly Effective People,”  it’s unclear if anyone began with the end in mind. Did they really understand 20+ million could lose health care as end? Accordingly, TrumpCare would have hit millions of Trump supporters the hardest. And who are those supporters? Older people. People in the west, Midwest, and Appalachia. Technically speaking, political projects are supposed to reward supporters and stick it to enemies — not the other way round.

So what’s the end result? What’s our takeaway?

As someone whose worked in healthcare industry for years, health care policy is extremely complicated. Politicians and project managers over simplifying complexities via grandiose vision fail. There’s always a significant gap between solution and implementation. How well the solution positively impacts your customers is dependent upon the planning. TrumpCare suffered from faulty planning.

Maybe America will benefit in the wake TrumpCare’s failure. Sure the ACA is flawed. Like everything, maintenance is critical. Hopefully leaders from all spectrum of health care will come together and add a little Obama, add smidgen of Ryan, a dab of professional ethics, the heart of clinicians everywhere and the will of all constituents and create something beautiful and wonderful.

We must begin with the end in mind.

As GOP leaders continue marching the American Health Care Act through the legislative process, we are left with bickering pros and cons of affordability and coverage. As one who’s earned a livelihood from the healthcare industry, I view legislative gladiators from the cheap seats and ponder, “If you can’t afford health care, should the state let you die?

The current House plan relies on government tax credits, regulation of the insurance industry, and continued government funding to keep the low-income population insured. Yet in-between weeds, down in the fine print no one ever reads, one can find insurance reforms are positioned so carriers can offer a wider array of policies that pick up less of the tab for getting care. Additionally, Insurance companies can charge the oldest enrollees as much as they want, roll back the Medicaid expansion thereby eliminating approximately 11 million of the nation’s poorest from health care and eliminating healthcare services of poorer via planned parenthood.

In February 2017, Cardinal Burke noted, “Catholic health care, by its constant and careful attention to the perennial moral teaching of the Church, safeguards and promotes the respect for all human life from the moment of conception to the moment of natural death ...”

Sounds wonderful, but there are little safeguards that promote the respect for all human life from the moment of conception to the moment of natural death. Our faith-based nation spends a hell of a lot time upending/defending Roe vs. Wade, but the notion we protect all human life from conception to natural death is bullshit. The back hallways of healthcare facilities are littered with the strewn, discarded and neglected. These hallways are filled with the “let them die” arrogance. We simply do not care about the respect of human life.

Both Bernie Sanders and the Pope have stated similar positions, “…access to health care regardless of income” is a right. Technically speaking, even one without health care can get health care coverage via a hospital emergency room. And in truth, both the Affordable Care Act and the GOP’s American Health Care Act provides opportunities for health care access. Now whether one can afford that access is an entirely different matter.

Health care is not mentioned in our Constitution or the Bill of Rights. Yet our Founding Fathers rightfully focused on life, liberty and justice. Conservatives continue to believe in personal responsibility, limited government, free markets, individual liberty, traditional American values and a strong national defense.

Several years ago, a 17-year-old senior at T.C. Williams High School wrote:

“… it must be noted that the key word in said act is “affordable.” The American people struggle on a daily basis to make ends meet, worrying about groceries, bills, and car payments. For better or for worse, that is capitalism, and as a country the United States has stayed true to its ideals. Nevertheless, the competition of the game of life should never have to be a game of life and death.”

Health care coverage is extremely complex. By nature, medical clinicians, Buddhists, Christians and many others of faith are concerned in their own way in the alleviation, control and ultimately the removal of human suffering. The American psychiatrist M. Scott Peck began his bestselling book The Road Less Travelled with the statement “Life is difficult.” He added, “This is a great truth, one of the greatest truths.”

Borrowing from Peck, the current health care debate is difficult. The disparity between health care and American values is crudely displayed as political views, politicians, managers, and administrators impact who receives what level of proportioned health care. While hospitals are forced to meet sometimes arbitrary measurements of performance, financial incentives are dolled-out on the backside. Lost in all this is what matters. For instance, what may matter more to a patient is the intangible and unquantifiable aspects of care experience. On what measurable performance scale can it be recorded that a dying patient is helped through denial, anger, and resentment to peace and serenity?

Of course, we can mimic Rep. Roger Marshall’s (R-KS) holy view to wash our hands. Marshall used Jesus to justify his opposition to Obamacare by explaining that poor people will reject health care.

“Just like Jesus said, ‘The poor will always be with us.’ There is a group of people that just don’t want health care and aren’t going to take care of themselves. Just, like, homeless people … I think just morally, spiritually, socially, [some people] just don’t want health care. The Medicaid population, which is [on] a free credit card, as a group, do probably the least preventive medicine and taking care of themselves and eating healthy and exercising. And I’m not judging, I’m just saying socially that’s where they are.”

Can we afford to be spiritually ignorant as some politicians? Should society claim that if one can’t afford health care, they die? No. At this point, both societal value and the American Health Care Act are morally unaffordable.

Imbueding

Commentator Jay Busbee wrote of Tiger Woods continuing back dilemmas.

“The clue was right there, buried deep in an otherwise routine Tiger Woods interview last week: ‘I feel good, not great,’ Woods said. ‘I don’t think I’ll ever feel great, because it’s three back surgeries, four knee operations…’

I feel good, not great. For Woods, who has spent an entire career insisting, often in the face of all sane evidence, that he wasn’t just great, he was greater than you could imagine, this was a remarkable concession. This was a man laying down his sword and shield. This was surrender.”

I read no further into Busbee’s article. That’s not to say Busbee’s analysis wasn’t spot-on. Busbee could be right.  Yet, I have no prolonged thoughts of Tiger Woods. Regardless of what’s occurred or hasn’t occurred in Woods’ life, I wish him all the best.

My thoughts are personal. Laying in bed, unable to move due to the Multiple Sclerosis symptoms, disabling neck pain and circulatory problems, I experienced my own personal “remarkable concession.”

I simply want to surrender. I am tried. I want to move on.  


 Fast forward several weeks.

I wrote the above and never posted into the blog, sidetracked by pain management. I thought of changing what I wrote but left the front part of this post intact, as written. I wrote the above in a time of such personal pain.

Anyone living in chronic pain knows, they’ll eventually have to surrender. As life’s end nears the horizon, all query “Surrender to what?

Most Buddhists are taught that if you wish to develop understanding, kindness, and clarity, you must willingly surrender to dukkha, the inevitable pain of life. Suffer? Hmm. I do not necessarily believe my suffering is worse than others. Yet there is a time when I realized I myself must find a way to the spiritual (the other side).

I know one cannot escape death. I do not fear death. When I think of fear, I remember watching the movie Wyatt Earp, when Doc Holiday said “…I wake up every morning looking in the face of Death, and you know what? He ain’t half bad” to which I replied “…damn straight Doc!

What I am amazed me is the weakness and fragility of my human body. In my 20’s, I would laugh at simple walking. At 57, a simple walk exhausts me for days. And as man who has traveled the world, I wonder why I took so much of living for granted.

Still, I continue to reach out to all whom I hurt. I have asked for forgiveness, reached to touch those I have not and sought truce to old lingering wounds. As best as possible, I wish for my death to be calm and peaceful. I simply wish to imbued positive thoughts at the time of death.

Therein lies my message everyone. Imbued! Rather than waiting to reconcile at the end of life, inspire a feeling or quality now. Live in love. Permeate others with a feeling of quality. Honor all around you.

Imbueding” is real living.

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