Jan 8, 2014

Healthcare 2014: The Untrends List

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One week into the new year, and here I am already probably tearing at the limits of content relevancy, thinking about how to write something meaningful on what to look for in 2014. What are the emerging industry trends and drivers that healthcare executives need to understand and reflect in their 2014 strategic planning? What’s the competitive landscape going to look like? How will diverging synergies of clinical partnerships impact silo management tendencies? How many overused business school concepts can be stuffed into a blog post?

To be candid, I really wanted to write something here that was keen on unique insights and observations. That had a lofty air containing pearls of wisdom. But the more I thought about what to write the more daunting became the effort of where to start, what to include and how to organize my thoughts without losing you to confusion and boredom in the first paragraph.

And being confused myself under the weight of my inability to organize that thinking it dawned upon me that I was tripping over the most common intellectual obstacle: failure to accept that too often our desire to embrace the complex hides our fear of accepting the wisdom of simplicity.  And that reminded me of the scene below between Billy Crystal and Jack Palance in City Slickers. It epitomizes the challenge we have in accepting simplicity.

Curly’s One Thing

So what’s the ONE THING that healthcare providers need to focus on in 2014? Easy answer: the same thing they needed to focus on in 2013. And 2005. And 1919. VALUE. But just as our understanding of life can be both simple and difficult – so too can learning to strategically position a healthcare organization around value.

The concept of providing value is ancient.  Yet the ability to create, deliver and capture value is an increasingly important – and contextual – competitive advantage when resources become constrained at the same time demand is accelerating. Value-based pricing and cost reimbursement models are only a part of the value-driven healthcare paradigm. It’s the small top part of the value delivery pyramid (or perhaps iceberg is a more fitting analogy).

Critically important to understand is what the patient values. And even more important is accepting the processes that patients use for determining and comparing relative value does not easily lend itself to linear thinking or evidence-based protocols. Similarly, the individuals who create and bring value to patients cannot be made to fit into standardized care delivery machines. And understanding how they assess and compare relative value is every bit as important in creating a competitively superior healthcare offering.

Healthcare providers are increasingly being asked to share in the risk of care delivery economics. I know that must sound ironically distasteful to many, since they have already for centuries borne the ultimate risk of patient outcomes. But on the whole, I believe it’s an oddity of our healthcare financing system – not a perverse entrapment designed to reallocate resources away from production – that seeks to align the incentives of multiple participants around value.

If, however, that understanding is ultimately manifested in just measuring and promoting value – without creating and delivering value – value-driven pricing and reimbursement models will necessarily fail, whether that’s payment bundling, ACOs or medical homes. But – those organizations that learn to create and deliver value by strategically positioning themselves in lieu of the industry migration toward integrated care delivery will survive whether those new models succeed or not.

So my list of trends and drivers for 2014 is simple: value, value & value.

Cheers,
  Sparky

Filed Under: Editorials & Opinions, Value Driven Healthcare · Tagged: , , ,
Dec 23, 2013

Republicans, Mandates & Long-Term Care

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Back in October 1989 the conservative Heritage Foundation published Stuart Butler’s seminal work in support of the individual mandate concept. I disagree with the popular media’s characterization that the individual mandate is the lynchpin of the Affordable Care Act, but that is probably because I’m one of the few people who actually read the entire Act.

It is still noteworthy that the IM concept made its way from Butler’s effective argumentation in the Heritage Lectures to 1993 legislation introduced by Republican Sen. John Chafee of Rhode Island: the Health Equity and Access Reform Today (HEART) Act of 1993. The IM provision of the HEART Act was to take effect in January of 2005 (more than a decade after enactment). It was introduced as an option to the Clinton plan, which included a mandate on employers to provide insurance for their workers – a provision that many Republicans found very troubling.

It’s an inaccurate and implausible leap to posit that Republicans introduced and supported the IM before they were against it. You need to have political context to understand the IM concept included in the ACA is not the same as what was contemplated in 1993. Nonetheless, the HEART Act attracted 19 Republican senator sponsors or co-sponsors, including then minority leader Bob Dole. So it is also inaccurate to assert the IM is anathema to Republican thinking, and it is certainly more than a tad ironic that the current lot of Republicans would shut down the government over an issue they were previously willing to include as at least part of the US healthcare financing solution.

So now fast forward to 2013, and those crazy Republicans are at it again. But this time they’re sights are set on a much more difficult challenge: financing long-term care expenditures. At a hearing this past week on the future of long-term care care and how to pay for it, Senator Susan Collins (R-Maine), ranking member of the Special Committee on Aging, stopped well short of endorsing an IM mechanism to fund long-term care. But she sure sounded like it could be a viable alternative (see reference to HEART Act, above).

Senator Collins noted that long-term care is the, “major catastrophic health expense” facing seniors today. She added that, “families can only do so much…” and that, “a viable insurance mechanism” that could be public, private or some combination is needed to address this challenge.  “Even when people are educated about the risks of long-term care and are presented with long-term care insurance policies, we will not truly address financing without requiring everyone to participate,” she said.

Gee, I dunno, but that sure sounds like being in favor of a mandate to me. And it’s probably the only reasonable and pragmatic solution to ultimately addressing the realities of financing a comprehensive and compassionate approach to long-term services and support for those unable to afford such care. I wonder if Collins will be hung in effigy by the Tea Party for thinking about the contingent realities that must be addressed by a caring society when the failure of self sufficiency manifests in a loved one unable to care for themself.

Cheers,
  Sparky

Filed Under: Commission on Long-Term Care, Editorials & Opinions · Tagged: , , ,
Dec 12, 2013

They Did What ?!?!

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Don’t look now, but something remarkable happened in Washington today: both political parties claimed they weren’t happy with a bill but passed it anyway. That’s what used to be known as compromise in Congress. And for House Speaker Boehner the House support he received was a well-deserved reward for having been put through a lot of – well, stuff.

I think he must be either trying to save his political life, discounting the value of it – or being sincerely candid. At a year-end press conference today he was openly critical of conservative organizations that have been the biggest obstacle to bipartisan compromise this country has seen since just before the Civil War, noting they have “lost all credibility” in being critical of a bipartisan budget deal before it was even released.

In obvious anger and frustration he accused – without identifying any groups in particular – those organizations that have hamstrung his speakership as “misleading their followers,” saying that, “I think they’re pushing our members in places where they don’t want to be, and frankly I just think that they’ve lost all credibility.”

On the budget bill, the Speaker noted it wasn’t everything Republicans would have hoped for, but it “takes giant steps in the right direction.” Wait. You mean like making a deal in the interest of your constituents instead of yourselves? Go on. Boehner went on to say that, “I came here to cut the size of government. That’s exactly what this bill does, and why conservatives wouldn’t vote for this, or [would] criticize the bill is beyond any recognition I could come up with.”

I’ve got a potential reason, Mr. Speaker. It’s because in the aspirational views of certain Republican opportunists that have jumped on the Tea Party bandwagon Democrats have the wicked wiles.  Remember this from Snow White?

Grumpy: Angel, ha! She’s a female! And all females is poison! They’re full of wicked wiles!
Bashful: What are wicked wiles?
Grumpy: I don’t know, but I’m agin’ ’em.

Thus the Tea Party and that ilk spent most of 2013 trying mightily to transform the Republican Party from the Party of No to the Party of Anarchy. But alas, with the passage of today’s two-year budget deal it would appear the Republican Party may have broken free of those reactionary shackles. With only 62 Republican defections, the House appeared to brush off criticism and partisan threats from conservative groups like Heritage Action and Club for Growth.

And kudos to Rep. Paul Ryan for saying that,“elections have consequences … to really do what we think needs to be done, we’re going to have to win some elections. And in the meantime, let’s try to make this divided government work.”

Let me attempt to restate that in a different manner: In a democracy, being a minority political party by only a very narrow margin is a frustrating position. There are two approaches to deal with that frustration: obstinate immaturity or constructive pragmatism. The Tea Party has favored the former. Today the Republican Party chose the latter. Without having to change their core beliefs they are a step closer today than they were yesterday to winning the elections Paul Ryan noted.

Cheers,
  Sparky

Filed Under: Editorials & Opinions, Tea Party · Tagged: , , , ,
Death Panels Just Won’t Die
Nov 28, 2013

Death Panels Just Won’t Die

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Death Panels IISince this continues to be the number one searched post of Sparky’s Policy Pub, the timing seemed right for reposting (originally posted on 11/23/12).

I thought this would be a fitting topic for Black Friday. This post was inspired by a conversation I had yesterday with several of my Medicare-eligible family members who are adamant in their conviction that President Obama’s election victory meant the wonderful dinner we enjoyed would most likely be our last Thanksgiving together.  Of course I’m just using hyperbole, right?  Not as much as you might imagine.

Actually, it wasn’t much of a conversation at all.  As the lone Democrat among a group of 12 that feel I am just an unfortunately misguided soul being controlled by the Dark Side, I really do more listening.  And I watch, carefully – for any hidden cues they might send to one another signaling a political intervention that I am sure would include some form of immersion.  But I digress.

At issue here is these intelligent, caring and concerned retirees harbor a genuine fear and loathing of the Affordable Care Act – in ways that I frankly believe are just not supported by reality.  But why? The specific case in point is the promulgation of a piece being circulated around the Internet (enough said?) that apparently is encouraging seniors who may be contemplating knee replacement to have that surgery done soon because the procedure won’t be available in the near future due to rationing under Obamacare.

Now, someone with a working knowledge of healthcare would look at such a story and immediately question what on earth is that all about.  Are the surgeons going on strike? Have hospitals and outpatient surgery centers determined the procedure is too risky? Have the part replacement manufacturers run out of titanium? I wanted to find out for myself, so I went to Google and searched for the news items in question.

And this is what I learned: this is a poignant example on how easy it is to start with a factual piece of evidence-based journalism from a well respected source and pervert it into fodder for conspiracy theorists and those hell bent on advancing a political agenda at the expense of innocent seniors.  It also highlights the incredibly challenging task before us to educate the public on ACA implementation: the easy and the tough – and the realities that future demand on our healthcare system will bring about irrespective of public policy.

In the September 26, 2012 issue of the Journal of the American Medical Association can be found the article, Increasing Use of Total Knee Replacement and Revision Surgery.  The article examines the increase in TKR surgeries (having grown from 93 thousand procedures in 1991 to 226 thousand procedures in 2010).  It discusses several of the key drivers of the increase: e.g., the aging population, knee stress caused by  a growing incidence of obesity, seniors’ desire to lead a more active lifestyle.  It also addresses the rate of hospital readmission after TKR, increase in infection cases for revision cases and shifts in post-discharge care settings.

What the AMJA article doesn’t talk about is care rationing or death panels.

From this journal article, however, the Breitbart News Network’s Dr. Susan Berry created (and I do mean, “created”) a September 29th, 2012 story (note – this was before the election) entitled, Study: Obamacare May Make Knee Replacements Less Available to Seniors.  In that article she referenced the JAMA study above and combined it with a quote from a Wall Street Journal article regarding the same research, entitled, Rise in Knee Replacements Boosts Federal Health Cost. 

In the WSJ article, Dr. Peter Cram, the lead JAMA article contributor and a health-policy researcher and internist at the University of Iowa Carver College of Medicine, is quoted as saying, “Ultimately there’s going to be [only] some number of these we can afford,” The article also attributes the observation to Dr. Cram that, “how to limit the procedure or who should get it will be a ‘really contentious debate,’ .”

Dr. Cram makes a very reasonable point that is certainly worthy of discussion and debate – and has been for a long time before the Affordable Care Act among those who understand demographics and the reality of limited resources.  He doesn’t even intimate, however, what might be the long-term result of that debate.  But from that quote, Dr. Berry made the incredulous leap that such an observation is supportive of the nefarious motivation behind the ACA’s Independent Payment Advisory Board (IPAB) and the completely fabricated notion that the IPAB will be in charge of rationing care.

From Dr. Berry’s article:
Studies of this nature will likely be used to support the “necessity” of the ObamaCare Independent Payment Advisory Board (IPAB), the group of unelected officials who will be responsible for handing down the “rules” to physicians about who gets the knee surgery and who does not. The IPAB will, indeed, be in charge of “rationing” knee replacement surgery and other treatments and procedures, as well.

Apparently Dr. Berry has not read the Affordable Care Act.  I did.  The IPAB was created by the ACA under Sections 3403 and 10320 and is to be comprised of 15 full-time members.  Of the 15, the President is required to solicit suggestions from Congress on 12.  All members have to be confirmed by the Senate and may not hold any other employment.  Each member will serve a term of six years, and only a minority of the 15 may be health care providers.

Beginning in 2015, if the projected rate of increase in Medicare spending (as determined by the Chief Actuary of the Centers for Medicare and Medicaid Services) is above specific targets, then at the beginning of the year the IPAB will make binding recommendations to Congress on how to reduce spending.  If Congress does not agree with those recommendations, it must pass alternative cuts – of the same size – by August of that year.  A supermajority of the Senate (at least two-thirds of those present) can also amend the IPAB recommendations.  If Congress does nothing (its stasis), then the Secretary of Health and Human Services will implement the IPAB’s recommended cuts.

The ACA statutorily prohibits rationing.  Here is directly from ACA, Sec. 3403:
The [IPAB proposal] shall not include any recommendation to ration health care, raise revenues or Medicare beneficiary premiums . . .increase Medicare beneficiary cost sharing . . . or otherwise restrict benefits or modify eligibility criteria.

Now, in the interest of fairness and equal coverage, there have been some good arguments advanced (not by Dr. Berry) that the IPAB’s functioning could lead to indirect rationing by restricting the amount of funding available to Medicare providers – and thus, access to the services and care they provide.  But in lieu of the dramatic increase in demand for those services due to demographics, is it really the IPAB that should be of primary concern?

The real story here is another example where medical technology has created demand for a procedure that wasn’t imaginable when Medicare was started back in 1965.  It’s a wonderfully successful procedure that has made a dramatic difference in the lives of many.  But it’s not free to provide.  And as we continue to run headlong toward the fiscal cliff, it is becoming increasingly obvious that we are not a nation of unlimited resources.  The IPAB was created out of an earnest attempt to recognize that reality and remove the responsibility of addressing it from elected officials.

When there is significantly greater demand than the supply can meet, there will be rationing – the only issue to debate is who does the rationing, and how.  But recognizing that someday not everyone may be able to have on-demand knee replacement surgery fully covered by Medicare is a far cry from all of the misguided rhetoric surrounding the IPAB and its fallacious association with death panels. 

The ACA’s creation of the IPAB does not mandate rationing.  It mandates that we recognize in order to control the growth in Medicare expenditures we will be forced to address certain economic realities.  I believe that was the point Dr. Cram was making, which Dr. Berry took out of context to create a story that then got bastardized into another Internet myth.  Unfortunately,  those myths really scare good people that are trying to understand what is ahead of them – and how to be the best advocates for their own healthcare.  That a physician would play a role in undermining that effort just to score some points on a news site with a particular political bent I find very sad. 

But what do you think?

Cheers,
Sparky

Filed Under: Affordable Care Act, Editorials & Opinions · Tagged: , , ,
Nov 22, 2013

Killing Kennedy’s Spirit

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I am proud to have shared life on this earth with Jack Kennedy: sad to accept that it was but for a much briefer overlap than should have been; yet happy I grew up in a country that was influenced by his wisdom, reflective of his spirit of determination and embedded with his sense of compassion.

I chose this picture because it is the same one I used to have framed and hanging in my room when I was in high school and had with me through college. It was a gift from my parents that – regrettably as with too many other things from my young life – somehow got lost between my ideological youth and responsible adulthood.

Just last month I was in Dallas, and for the first time I looked down upon Dealey Plaza from the Hyatt Regency’s Reunion Tower. Whether because of timing – being as it was so close to today’s 50th anniversary of the assassination – or not, there is no way of knowing, but that image was beyond compelling. I have had the misfortune of having experienced my fair share of blow-to-the-stomach moments of emotional pain, so I am not so easily moved. Yet in that moment I felt a deep sadness that was hard to shake – as if I were witnessing at the same time the tragedy of what was along with the pain of knowing what might have been.

I have written before and hold fast to my belief today that it is never wise to set a human being upon a pedestal. If not their flaws then certainly their death ultimately proves their humanity. Jack Kennedy was human on both scores. But unlike many political heroes before, he carried above him an ideological beacon that alighted upon a generation with renewed hope and energy for what a country might accomplish through collective effort – rather than  individual pursuits.

Sadly, that message from his 1961 inaugural address has been lost. Perhaps it went the way of adult responsibilities too. Or perhaps it has gone the way of greed and avarice – envy, jealousy and spite. Whatever the causes, we only have ourselves to blame for its absence: we have killed that spirit of Jack Kennedy as surely as Oswald killed the man himself.

  ~ Sparky

Filed Under: Editorials & Opinions · Tagged: , , ,
Nov 16, 2013

The Racial Tipping Point?

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This past Friday Rush Limbaugh took marked exception – yes, even for him – to Oprah Winfrey’s comments made during an interview with BBC Arts Editor Will Gompertz discussing a new film she stars in: The Butler. Oprah was responding to a line of questioning that was seeking to understand from her perspective whether and to what extent the race issues addressed in the movie were historic versus contemporary (that’s a bit of context that most of the popular media has left out of this story from what I’ve read).

Within this context, and in response to Gompertz’s question regarding whether or not President Obama has faced race-related challenges, Winfrey made the assertion that the president is disrespected in “many cases” because of his race. She said that, “just the level of disrespect, when the senator <sic> yelled out, ‘You’re a liar!’ Remember that? Yeah, I think that there’s a level of disrespect for the office that occurs, and that occurs in some cases and maybe even many cases because he’s African-American … there’s no question about that. And it’s the kind of thing that nobody ever says but everybody’s thinking it.”

Well, love him or hate him, Mr. Limbaugh has never been in the camp of not saying what he’s thinking. And so he did, rhetorically asking of Oprah on his radio show, “then how the hell did you become who you are?” and, “why hasn’t anybody in your audience, Oprah, ever said, ‘You lie!’? Because you have. It wasn’t a senator, Oprah. It was a congressman by the name of Joe Wilson, and he was right. Obama was lying.”

Limbaugh admitted that he had to be “really careful” because Oprah is seen as a “goddess to a lot of people,” but went on to add that, “these people are not nearly as smart as they think they are, and they don’t know nearly what they think they know,” he continued. “They are embarrassingly ignorant. It wasn’t a senator. It was a congressman. And it’s not because he was black. It’s because he was lying, Oprah! He’s lying now!”

As often happens, Rush Limbaugh seized upon a particular aspect of a news story that he could effectively carve out of and away from a much more complex issue – and in so doing make it appear that his ability to attack that aspect is the same as attacking the broader issue. Of course it is not, but then I think his remarks regarding Oprah’s audience could just as easily be applied to his own.

The underlying point that I think Limbaugh could have made – maybe really wanted to make – is becoming an increasingly relevant and legitimate question: are we nearing, or have we reached, the tipping point where our collective sensibilities to racism are doing more to hinder the advancement of civil rights than help? Let me put it another, more direct way. Is the fear of being called a racist – and everything that entails – becoming an albatross around the neck of society to the point where there is today more concern about being called a racist than being racist?

I imagine Ms. Winfrey would respond that as long as racism exists – which most certainly it still does – the risk of her offending those who are not racist is far outweighed by the need to continue communicating its prevalence. I have no way of knowing whether or not that would be her perspective, but I would find it hard to argue with. I’m not sure Mr. Limbaugh looks at the world that way because if he did, I think he might not have taken such vociferous exception to Oprah’s comments. He might instead have asked the questions that I have above.

What do you think?

Cheers,
  Sparky

 

Filed Under: Editorials & Opinions, Race Relations · Tagged: , , , ,
Nov 8, 2013

People Don’t Come in Boxes . . .

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… so why put them there? In this 21st century age of political correctness we bend over backwards in fear of causing an affront to any group that can call itself a group by virtue of having two or more like-minded people. And yet turn on any major news outlet and the jargon is awash with political stereotypes: the left, the right, the Dem’s, the Pub’s, the moderates, the Tea Party, etc., etc.

It might be more palatable if those were just partial or contributing descriptions, but quite often that’s all the effort that goes into providing someone’s background. They will say, “well, you know, he’s a conservative, so . . .” as if that should embody the sum total of a person’s intellectual existence. I am reminded of a scene from Good Will Hunting. Robin Williams and Matt Damon are seated in front of the Boston Public Park, and Robin Williams’ character, Sean Maguire, takes the young genius Will Hunting (played by Damon) to the intellectual woodshed while helping him understand that both facts and life’s experiences contribute equally to one’s vantage point. Key moment from that script:

Sean: You’re an orphan, right?
Will nods quietly.
Sean: Do you think I know the first thing about how hard your life has been … how you feel … who you are, because I read Oliver Twist!? Does that encapsulate you?

But that’s exactly what we do when we insist on putting people into ideological boxes. We presume to know how they think, their beliefs, their feelings, what motivates them, how they will react in different situations.

I realize that it’s often just innocent and convenient expediency to categorize people as part and parcel of making sense of our chaotic political environment. But if you stop and think about it, that really adds very little to intelligent discourse. To the contrary, it risks the creation of stereotypical dispositions that are manifested as filters of arrogance and ignorance. Recall habit 5 of Steven Covey’s Seven Habits of Highly Successful People (as borrowed from the Prayer of St. Francis):  Seek first to understand – then to be understood.

That’s not a lesson in humility or self deference. It’s a basic tenet of effective communication. Those who take the time and make the effort to understand the views of others are much more effective in communicating their own ideas – and doing so in a way where those ideas can lead to actionable outcomes.

A final point. When we place individuals into ideological boxes – for example as we do with politicians – we should not be surprised when those individuals interpret their station much like an actor on stage: they act to the audience. They perform consistent with the audience’s expectations. So when we as the body politic lament the polarization of Washington perhaps we should stop to consider our role in building the stage upon which those players act.

Cheers,
  Sparky

Filed Under: Editorials & Opinions, Political Ideologies · Tagged: , ,
Nov 2, 2013

NSA ~ “For That Day . . .”

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One of my all-time favorite movies is Three Days of the Condor. Directed by Syndey Pollack, it stars Cliff Robertson as the antagonist Deputy Director of the CIA’s New York division, Robert Redford as the protagonist CIA agent, code name Condor, Faye Dunaway  – and Max von Sydow, who plays the character of Joubert, an international hired assassin whose affable yet cold and calculating indifference to life and politics serves as artistic imagery for the story’s thematic conflict.

Produced almost four decades ago, there is an epic scene at the end of the movie (see below) that, except for changes in fashion design, is as relevant and timely today as it was in the mid 70s. At issue is the value and role that secret intelligence plays in national security. More particularly, it is about the conflicting interests of national security versus individual privacy. Does that sound familiar? Wikileaks . . . Eric Snowden . . . Prism . . . Google . . . Benghazi . . . Angela Merkel . . .

“Ask them”

In an age of electronic media acceleration, knowledge and information that becomes available under the auspices of national security can almost instantaneously be perverted into intellectual weaponry. And once individuals with access to that intelligence who are also seeking positions of political power recognize the value of such weaponry it creates an addiction that goes well beyond the original intent. I think it would be nearly impossible today to determine how much intelligence gathered in the name of national security is primarily used for political security.

For decades we have somehow been able to muddle through a balance between protecting national security and providing the masses at least the illusion their private lives are just that – private. That balance is now in serious peril in a way that it never has been. As Robertson’s character argues in the final scene of Three Days, it’s way too late to discuss the appropriate balance between intelligence gathering and personal privacy when a national threat has been manifested in a way that threatens lives (watch the video).

In lieu of such threats from terrorism and WMD, we discount the value of intelligence protecting our national security at our own peril. But at what point does the cost of gathering that intelligence – in terms of privacy and personal liberty – no longer justify the reduction in risk to our lives? Invoke Patrick Henry here. That is a discussion that we have to have in this country, independent of political interests, and the sooner the better.

Cheers,
  Sparky

Filed Under: Editorials & Opinions, National Security Agency · Tagged: , ,
What’s Next for the Tea Party?
Oct 17, 2013

What’s Next for the Tea Party?

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550px-Remove-a-Stuck-Tongue-from-a-Frozen-Surface-Step-3One might think the graphic accompanying this post was leaked from Sen. Ted Cruz’s political strategy playbook: the next chapter in The Tea Party’s Fight to Repeal the Affordable Care Act. It’s not. Could be though, right? The metaphor holds of doing something foolish to gain popular attention and then suffering the individual consequences of that foolishness.

Of course, Tea Party advocates will no doubt claim I am being foolishly satirical and hypocritical for not recognizing my own ignorance in understanding the dramatic importance of standing up for liberty, fiscal responsibility and apple pie. If they truly believe those were Senator Cruz’s motivations, well then what can I say – they must see a political reality in this country different than the one I see.

Even if we were to believe the efforts of Senator Cruz and other Tea Party congressional enthusiasts – to hold the country fiscally hostage for over two weeks in an effort to defund the ACA – were nonpolitically motivated, the overall reaction of the American public can hardly be what they were hoping for. According to a Pew Research Center poll released yesterday, the Tea Party is less popular than ever, even among many Republicans, with nearly half (49%) of survey respondents having an unfavorable opinion. This is up from 37% in June of this year.

On the other hand, Senator Cruz’s popularity among Tea Party respondents has risen from 47% to 74% since July. I’m not sure how well that bodes for his future political aspirations (at least outside of Texas, if that was of interest), but I am being sincere when I say that I respect the all-in approach of any elected official because it represents a refreshing departure from governing by opinion polls.

My view of the Tea Party, for better or worse, is largely based on the individuals I know personally who are either sympathetic to, intellectually aligned with or proud to be members. I find them to be generally well informed on political issues and passionate about protecting individual liberties. Things go downhill when we start debating who gets to define which liberties should be protected and by whom, which I interpret as the Tea Party being discerningly different than many Libertarian viewpoints.

They are very concerned – and I think rightly so – with the economic future of our country and seem to understand more than most that both political parties are guilty of sustaining special-interest budgeting despite whatever expressions of concern we may hear to the contrary. That’s where a large part of the inherent challenge to the Tea Party’s future lies. As shown in the Pew Research poll, there is a lot of confusion, disagreement and debate over whether and how well the Tea Party “fits” within the Republican Party.

I personally hope it finds its national voice apart from the GOP. If it has something meaningful to offer in the nation’s political discourse – it could hardly do worse – then it should seek to do so through the existing construct of our democracy and not by resorting to Machiavellian tactics whereby it seeks to bend the will of a majority to its beliefs (again, I refer you to the Pew Research poll).

I admit, there is a real attraction to a grass roots political movement in an age where electoral helplessness – whether learned or systemic – has become anathema to a democratic form of government. But waxing nostalgic for the 18th century and expecting that same apathetic electorate to embrace the social and cultural norms of men in wigs and women in hoops is a very tough sell.

And that’s where I find the greatest difficulty in accepting my Tea Party colleagues’ personal political platform. To me it feels like hidden below the surface of, “strike a blow for liberty,” “defend the Constitution” and “balance the budget” is an observable pattern in their logic and debate that belies a commiserate longing for the good old days.

I think all of us over a certain age find ourselves quite often reflecting on a past that was less stressful, less fearful, less threatening and certainly less complicated. Today we live in a world of constant change that just one generation removed couldn’t possibly have imagined. In his book, Managing at the Speed of Change, Daryl Conner talks about the Beast: a metaphor of the challenge each of us faces in adapting to constant change in our environment. It takes incredible resiliency to maintain good mental health in the 21st century.

I do not believe effective public policy – including Healthcare policy – can or should be based on what worked in the good old days. As Don Henley wrote, “those days are gone forever – [we] should just let ‘em go but…” Today we live in a society that is aging at an accelerated rate, that is growing in ethnic and cultural diversity and is inundated on a 24-7 basis with technological advancements that introduce hope and terror in equal measures.

With that understanding of reality, my primary concern with the Tea Party is the perceived sense of moral intransigence and impractical political dogma that transcends their beliefs. We should be focusing our efforts on how best to practically adapt a constitutional style of government to the world we live in today – not expecting today’s society to mirror that of the 1700s. I think I share just as much angst and anxiety over our nation’s future as do my Tea Party colleagues. I just don’t believe that going backwards offers much hope in addressing the problems we face today and tomorrow.

Cheers,
  Sparky

Filed Under: Editorials & Opinions, Tea Party · Tagged: , , ,
We ARE The Media: Entertain US
Oct 8, 2013

We ARE The Media: Entertain US

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Screen-Shot-2017-03-26-at-4.25.06-PMOriginally published in October of 2013
With the already caustic and demoralizing rhetoric that is coming out of Washington being elevated to (hard to believe) new levels via the Shutdown, a short departure from healthcare policy discussion seemed like it could be in order.   I copied the video below off of the Michael Smerconish web site. If you haven’t caught Michael’s program on Sirius/XM’s POTUS channel, it’s definitely worth a listen.

I don’t know who compiled the video, but it’s a short and poignant demonstration of the role media plays today in perverting the exercise of constructive and productive political dialogue and debate in the interest of entertaining us (i.e., the nature of their business model).

We could argue until the cows come home whether election campaigns drove media toward spiteful irreverence or the media has been driven by candidates’ inherent egos and desire for power – but either way the result has been manifested in the most threatening domestic scourge this country has faced since slavery. I know that’s a bold statement, but watch the video and just watch what’s happening right now in Washington – that’s right, nothing!

What makes the media threat especially troubling is that it is like a cancer: you can’t just start hacking away at the parts you don’t like without risking a primary tenet of democracy, that being of course the freedom of speech. But in what I think is a sardonic twist of irony, we seem to have the same culpability empowering the media that we have in empowering stagnant governance: in both cases way too many of us are too damn lazy to exert the personal effort needed to make a difference.  We complain about government but don’t take the time to be informed voters – or don’t vote at all (roughly 4 in 10 eligible voters didn’t vote in the 2012 election).  And we complain about media programming, but somebody must be watching and/or listening to warrant advertising expenditures supporting that business model, right?

So here’s what I would like to offer. Regardless of what side of the aisle your allegiance lies – or wherever your political beliefs may fall along the ideological spectrum – I believe just about all of us are sincerely interested in the truth. And I think most of us agree as well that modern media programming in the name of entertaining us has done more to obfuscate the truth than help us find it.

Part of the blame lies with the media because they seek to package facts in entertaining sound bites. I am reminded of a quote by the late author, Shelby Foote, who once said that, “people make a grievous error thinking that a list of facts is the truth – facts are just the bare bones out of which truth is made.” If you seek the truth, don’t ever assume that it can be given to you even if you ask in the nicest way possible.

A good part of the blame we want to put on the media belongs to us. We need to take ownership for defining the truth and not abdicate that responsibility to broadcast journalism because we prefer to be entertained.  Without wanting to wax metaphysically, truth only exists because of the individual’s desire and willingness to find it – not because someone else has already created it for us.

Cheers,
  Sparky

Extremist Outtakes
Filed Under: Editorials & Opinions, Media · Tagged: , , ,
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