About Me

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I have worked in health care information management for more than 13 years. I have been a patient of many physicians for much longer. I have found most physicians to be devoted and conscientious but captive to systems and processes that they often don't even think about. We could all benefit from better communication. I'm on LinkedIn (http://www.linkedin.com/in/mpmeier)

Saturday, December 10, 2011

"Job Creators"

If I hear one more Republican official tell me that a tax on citizens with incomes over $1 million is a disincentive for the "job creators" in our society...  If you happen to be in the car next to me at the traffic light you may be entertained by a man beating up his car.  You may even be able to hear me (though it is winter and the windows are up) as I scream my frustration.

The people that our GOP friends are talking about are the same people who have systematically exported jobs for the past 20 years.  Oh, maybe the jobs they're talking about are the au pair, housekeeper, driver, personal assistant, trainer, lawn care positions they've advertised recently.  Probably not though because those are usually filled through the undocumented pipeline.

What really drives me crazy is that apparently We, the People, are simple-minded enough to buy this. There is no other way that they could have received enough votes.

Friends, when someone is telling you that you should be afraid of "illegals" taking your job and that the investment bankers, financiers and CEOs of multinational corporations have your back, you should turn and run.  Give your support and your vote to the other guy.

Sunday, November 13, 2011

Now

We don't value now. We talk about it all the time. We use it for emphasis. We mostly use it to separate the past from the future.

Often when we talk about now we have only the fuzziest of notions, the flimsiest of definitions in mind. "Now is the time for men and women of conscience..." The concept of now in this instance could mean anything from a generation to a session of Congress to a particular crisis. Sometimes we use now to mean very soon or as soon as humanly possible (the future) as in, "I need it now!" Occasionally we use it to bound some time in the past as in, "Now in those days..."

Now has power that, for most people, is unrealized because it is unrecognized. For our purposes now is the moment of decision. If we are able to grasp that moment, that now, and use it, we can change our own life and the lives of those around us. We can use now to create a new future.

In the gap between stimulus and response there is a piece of eternity--now--in which we can decide what the future will look like and decide on the response that will launch that future. Please be aware of now and use it as it is intended to be used.

When we are present in our life we are conscious of each now and we use them to create a future that matches our vision. What is your vision, your ideal? What will you use to direct the decisions you make in each of your nows?

Wednesday, August 17, 2011

Whose Candidate?

The Ames Straw Poll, conducted last week produced a surprising result for many (including me). Since I lived in Minnesota for nearly twenty years, I am familiar with two of the candidates. I have never voted for either of them and have often wondered who did and what their motivations were.

As it happened, one of the candidates (Gov. Tim Pawlenty) made such a poor showing that he withdrew his candidacy immediately after the count was announced. The other, Rep. Michele Bachmann, emerged with the most votes and was immediately included (by various of the talking heads--mostly from FOX) in the "top tier" of candidates.

Yesterday, it was reported that the long lines waiting to get into the Bachmann tent prior to the vote were caused in part by the fact that her campaign had purchased 6000 ballots @ $30 ea and was handing them out.

From this several lessons can be learned:
1. The Ames Straw Poll is, in fact, a fundraiser.
2. The results should be treated much the same as the "best homeroom" contest at the local school. The only part the Iowa GOP missed was the opportunity to cast negative votes. They'll probably include that option next time.
3. I'm sure Tim Pawlenty is kicking himself for allowing Bachmann to jump past him in this way.
4. Someone on the Bachmann campaign is capable of thinking outside the box.
5. Politicians and their campaign staffs think in terms of elections and votes and the reporters seem to follow suit. Bachmann taught everyone a lesson--that votes can be bought. I wonder if it will work again?
6. Fund raisers, straw polls and popularity contests aren't the same as elections (are they?)

She better be able to ride this a long way because she won't have this opportunity again. At the very least other candidates will use the same tactics and cancel each other out. I also have to wonder about the economic smarts of burning your capital to create funds for replacing your capital. There is some kind of natural law that governs these situations. It's the same as cranking a generator to power a light so that you can see your surroundings. Of course you can't leave the generator or the light goes out. At least while the light was on everyone was able to see Rep Bachmann. I hope they got a good look.

Wednesday, July 27, 2011

Mandatory Health Insurance

The State of Ohio has just certified a petition to put a constitutional amendment on the November ballot in Ohio. The amendment would attempt to make Ohio residents exempt from the requirement to have health insurance coverage. The Patient Protection and Affordable Care Act which was signed into law last year has language in it that requires those who are not exempted to have healthcare insurance coverage in effect.

Conservatives have become incensed for reasons that seem impossible to explain. This has become another of those issues where no compromise is possible and in fact civil (meaning with our indoor voices) discussion is impossible. Both sides quickly get to name calling and motive slander. I have heard no one raise the central issue--the elephant in the room so to speak.

There is an expectation in this country that when we are sick or injured we are entitled to medical care. I personally think that the law should have mandated an opt-out for health care rather than healthcare. That is, no one should be forced to buy insurance but the choice would be one of responsibility. I understand that I and not the government (whether Federal, State or Local) am responsible for paying for health (medical) care that may be needed by me or my family.

That is the choice that must be made. The alternative is to agree that we (definition TBD) are entitled to medical care because we are human beings living in the wealthiest nation on the planet. I would have no personal difficulty with that national choice either but the argument would be completely different then.

I've been told that ethics is the study of resource allocation within moral boundaries. The ethical decision in the one case is whether or not to provide medical care to someone who has made a conscious decision not to carry insurance and who will pay for that care. In the other case the ethical choice is about how we as a nation will pay for that care. I think this constitutional amendment is ridiculous because it sweeps the real issues under the rug.

Thursday, July 14, 2011

Behind the Power Curve

"Behind the power curve" is a term that originated with pilots. It represents a situation in which it it may be impossible to apply sufficient power to recover. In other words, a bad situation. Our nation may be behind the power curve with respect to the economy.

The other day I heard a piece on BBC radio (via the Ohio State University-run public radio outlet) regarding the developing financial crises in Europe. Greece, Ireland, Portugal and Spain have each had their bit of fame and it's now the turn of Italy. The commentator/reporter was quite insightful. Each of these countries has borrowed at levels that exceed their ability (in the near term) to repay. Italy is generating particular concern because it is one of the three anchors of the Euro-zone.

What struck me was a statement that Euro-zone politicians are lagging so far behind the unfolding events that they are in danger of becoming part of the problem. They have already become irrelevant but can still do harm. A particular reference to Nero fiddling while Rome burned made me think of what's happening here in the U.S.

There is a feeling today in U.S. political circles that "my" party has the answer if only we could get a majority large enough to have our way. This is perhaps the most dangerous attitude it's possible to have in government. It undermines the very objectives of government.

The purpose of government is to provide a safe and secure place for its citizens to live and work, think and learn.

The only way to achieve this purpose is to collaborate because the greatest good for the greatest number can't be defined by one person, one party or one poll. Further, asking my party colleagues or supporters what should be done produces nothing but agreement. Community is essential for us except that it can also be destructive. When you and I always agree, one of us is unnecessary. We associate only with those who agree. Then we vent our collective anger at everyone else. Often the only outcome is anger but sometimes it's more. The member of the community who takes action by terrorism is a good example.

When does a community become a mob and then a lynch mob or a terrorist organization? The answer is when it ceases to be motivated by the greatest good for the greatest number. A complicating factor is the tendency to rationalize. Rationalizing means creating reasons for doing what we want to do.

The U.S. economy is in crisis. The source of the crisis is the accumulation of debt (both public and private) in excess of our capacity to repay. For private parties the piper shows up with hand outstretched pretty quickly. If we can't pay the piper, foreclosure and/or bankruptcy results. The larger the entity, the longer it takes for the piper to show up and the more drastic the result of non-payment (also known as insolvency)--and the more people who must suffer.

No one knows how Nero rationalized his fiddling by firelight but we see every day in the news how "our representatives" in government rationalize their fiddling. The fire is lit but there may still be time to call the fire department (if they haven't all been laid off).

Friday, July 8, 2011

Governing and the Economy

Regardless of how we got to this point, everyone agrees that the government should be taking some action to get us our of the hole we're in. Great care must be taken to avoid "tinkering" lest we find ourselves even worse off.
In any complex situation (We agree that this is one of the more complex ones, right?), the first thing that comes to mind will virtually never be the way out. If we don't know where we are or how we got there we're most likely to do the thing we're able to do and that thing will hardly ever apply to the situation.
Think lost in the woods. We know how we got to the woods and we may not have even wanted to come along. So now we're lost. Our first problem is that we don't want to believe that we're lost so we keep on going in the direction we're sure will take us back to the car. We all know that when lost, the best thing to do is to avoid panic and stay put until someone comes along. We know that--and still people walk away from their cars, their campsites and become hopelessly lost. Once you're lost, being sure that you know where you are or where you're headed only makes the situation worse.
This pretty much describes the situation we're in now. Sure, we've been through recessions--even depressions--as a nation and emerged whole on the other side. This one may be different though because it involves a complete lack of confidence in institutions in which confidence is essential. Moreover, the lack of confidence is world-wide.
In this situation, the handy "solutions" that are being trotted out are prescriptions for disaster. Market analysts are fond of talking about confidence in the market. When confidence is high it's a growth market. When low it's a preservation market.
What gives confidence to individuals and markets alike is predictability. What we lack most of all right now is predictability. Every last shred of predictability (and therefore confidence) is being eroded away as we listen to the power struggles from Washington. Let's be generous and allow that all the various players really do believe that their approach is the right one for the country and its people. If the solutions are from another era, they should be suspect.
There is no upside to staying lost and quarreling among ourselves when we should be discussing the nature of the situation, the resources at our disposal and the hearts and wills of those affected seems to be a sure way to stay lost. Elected leaders who would rather be right than get their constituents to a place of safety do not deserve to be called leaders and should be disposed of at the earliest opportunity.

Friday, July 1, 2011

Principles and Pragmatism

We are being held hostage by a group of people new to their job (inexperienced) who see principle as the trump card in the deck. The fact that they took a solemn oath to serve the people of the United States and to always act in the best interests of the people seems to have been lost in the shadow of partisan principle.

They have taken to cutting off debate on every issue by redefining the issue in terms of their principle. In another context this would be called obstructionist, bullheaded, stubborn, and (in light of their oath of office) unprincipled.

In order to see just how foolish their principle is we have only to take it literally. If spending on the part of government is evil, let's take away the government's ability to spend. If taxes are evil, let's abolish taxation. Without the ability to spend, taxes are unnecessary anyway.

Imagine what the nation's economy would look like. It would cease to exist. But we don't want to abolish government spending, you say, we just want to reduce it. At this point principle is no longer involved. Deciding how to reduce is a matter of prioritization and negotiation rather than principle.

The irony of the situation is that their principle has so impaired their ability to see that they continue on, digging an ever deeper hole for themselves. Anyone who chooses to see is aware that the nation and its people are not being served by unprincipled adherence to principle. This group's blind service to their principles was the cause of the economic woes we find ourselves in today. All can see that, instead of improving the situation we are being forced in the other direction. When one of these people gets in front of a microphone and insists on deeper cuts, the world wraps it blanket tighter around itself and prepares for the worst.

If one person always had the best idea, we wouldn't need a Congress. I suppose Hitler and Mussolini had principles, too.