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America! Open the Windows!
By Shlomo Maital
One of the most annoying things about MAGA Make America Great Again is this:
The basic premise of MAGA is, America is NOT great, at present. Understatement. Poor healthcare. Unaffordable housing. Poor schools. Wealth and income inequality. Racism. Antisemitism. Polarized paralyzed politics… just for a start.
So, how to make America great again? Place a Nazi sympathizer in charge of destroying public services. Smash alliances abroad, suck up to dictators, appoint incompetent loyalists to key positions, engage in vengeance, ….
There is another way. It is found in this new book, Another World Is Possible: Lessons for America from Around the Globe. – by Natasha Hakimi Zapata. 2025
The simple, obvious, key point – overlooked by the current Administration. Other countries, far less wealthy, have solutions to America’s problems. Right under our noses. But American exceptionalism means, that is not possible. Because .. well, just because.
Singapore (NOT a leftist socialist liberal country) has extraordinary affordable public housing. I’ve seen it first hand. Check it out, America.
Canada has national health insurance. I was born in Saskatchewan, the first province to implement it, in the 1950’s. Check it out, America. Canadians all have health insurance. So do the British – and most civilized European countries.
Estonia has income tax filing online. Fast, simple, easy. Check it out, America.
Most German public universities (and they are mostly outstanding) charge no tuition. America? Michigan has great state universities – but if you don’t live in the state, you pay $60,000 – $65,000 tuition yearly. Not including room and board.
Schools? America is not among the top scoring countries according to the PISA benchmark. Not even close. Way behind China.
Housing, healthcare, education, public services, ….things that drive our quality of life. America trails, despite high GDP per capita.
Why? Closed windows. Other countries have found wise, pragmatic solutions to key problems. The US refuses to learn from them. Costa Rica? Denmark? Learn from them? Get serious, American politicians spout.
In years of teaching managers, I taught them how to define their key operations (marketing, quality assurance, production, innovation) and benchmark which other companies did these things best, how they did them, and – learn from them, adapt and adopt. Pretty simple idea. Best practice benchmarking. Works for nations too. Yes, even for America.
Learn from others.
The most blatant stupidity is Trump’s desire to annex Canada. Why in the world would any Canadian choose to be part of a nation that is hopelessly divided politically and systematically destroying its public services? A country that blindly asserts its superiority, against all evidence, while refusing to learn from others wiser and smarter?
Natasha Hakimi Zapata’s book is MUST reading for MUSK. But don’t hold your breath.
The REAL American problem:
More Americans Are Dying
By Shlomo Maital
Rising US Morality Rates
What is wrong with America? Most news accounts focus on the US President, now featured on Twitter with the photo-shopped body of Rocky (check it out).
No, that is far from the only problem the US has. According to a new study in the leading medical journal JAMA, “increased death rates in midlife extended to all racial and ethnic groups, and to suburbs and cities.”
Suicides, drug overdoses and alcoholism were the main causes. But other illnesses, like heart disease, strokes, and chronic pulmonary disease, also contributed.
According to the New York Times, “the increase in deaths among people in midlife highlighted the lagging health measures in the US compared withother wealthy nations, even though the US has the highest per capita health spending in the world”.
And note: “fully a third of the ‘excess deaths’ (increased mortality) occurred in just four stats: Indiana, Kentucky, Ohio and Pennsylvania.
It seems that Trump is unavoidable. Those are key swing states that elected him. And his support there is still quite strong and resilient.
The Democrats made a key strategic error, by focusing Congress’s attention on impeachment, while people are dying. Impeachment will end in futility in the Senate. Meanwhile the Democrats’ resounding 2018 win, in gaining a House majority, came about largely because of the healthcare issue.
If Trump wins again in 2020, it will be the Dems’ own fault.
Goal-Driven Innovation: the Case of U.S. Health Care
By Shlomo Maital
U.S. health care expenditures ($billion)
The U.S. spends 18 per cent of its GDP on healthcare. Much of the recent rise in healthcare spending has been driven by higher prices and costs.
In any industry faced with rising costs, innovation must play a role. Harness creativity, ideas, new thinking, to get costs under control. Yet in healthcare the opposite has happened. More and more innovation has created amazing medical technologies that costs astronomical sums – devices, drugs, etc. Innovation became part of the problem, rather than the solution — it’s great to know that you can save lives, but how many people can afford to have their life saved, at those prices?
Writing in today’s Global New York Times, David Brooks notes that healthcare inflation seems to be under control, and partly, as a result of cost-saving innovation:
“ …Recently health care inflation has been at historic lows. As Jason Furman, the chairman of President Obama’s Council of Economic Advisers, put it in a speech to the Hamilton Project last month, “Health care prices have grown at an annual rate of 1.6 percent since the Affordable Care Act was enacted in March 2010, the slowest rate for such a period in five decades, and those prices have grown at an even slower 1.1 percent rate over the 12 months ending in August 2015.”
There is naturally some controversy over why precisely health care prices have stabilized. But here is one theory:
Jonathan Rauch, in a report for the Brookings Institution, argues that the health care market is more open to normal business model innovation than ever before. The quality of health care data and analytics is improving exponentially. Pressures to reduce costs are ratcheting up. Profitable niches are growing for efficiency improving products. In the past, most innovation involved improving quality of care at high cost. Rauch described many entrepreneurs who are providing innovations that maintain current quality of care but at lower cost. We seem to be making at least some incremental progress toward a structural reduction in health care inflation.
Innovation indeed is regarded as a panacea, when the world faces severe problems, as with healthcare provision, and increasingly severe budget and resource constraints.
But the innovation effort has to be focused, with a goal. If health care inflation is the problem, direct your innovation efforts toward controlling and reducing costs, rather than ever-more-expensive gadgets and drugs that make the problem worse.
Like all human activity, innovation needs a clearly defined goal – a precise question to which it is directed. For America, the question should probably be: how can we use our creative thinking to keep healthcare prices stable? So far, it seems to be working.
TIMnovate 