Friday, April 14, 2017


"Sweet Mercy is Nobility's true Badge." - Shakespeare
I swear there is a connection. I mean it is a glaring mental visual, if ever I saw one. Some may not accept this digital pudding but I see it clearly.

What do Oscar Munoz, the CEO of United Airlines and the current breed of healthcare policymakers have in common?

If you said the computer screen, you might be close to an answer. Think about it for a second or as they say on TV, “Let that sink in.”

Detachment from reality is like going to war without a strategy. Always, you lose! The reality is in Munoz’s case a complete dislocation from humanity in the service of his company and its personnel. He didn’t even consider the “boo” in the potential haunting. The “boo” here was the one entity that subscribes to and pats his revenue, net income, earning per share (EPS) and price earning (PE) ratios that govern whether Munoz stays of goes. Munoz, it seems, may have forgotten the supply chain of that effect for the moment in dissing the passenger over the callous remarks at the incipient stage of this debacle. A man for all such seasons, it seems, had lost his way in the catacombs of glass and steel when the rains came. “I am sorry” came a little too late. What he forgot was that “Customer is still King” if the customer pays. The damage had been done to the brand. The wide-eyed competitors jumped on it made new promo advertising to stick it to him and his company. And that is the nature of such a misstep and competition.
Will Oscar Munoz go or stay is for the United Board to decide as this juggernaut of an aisle wreck continues to unfold. But it is a classic tale of caution in business 101 that will be taught by Harvard Business Review in campuses across the country.

The healthcare policymakers have the same blinders on as they go about mixing and matching different pieces of legislations to display their latest greatest version that will bring healthcare into the wonderful blossomed shades of ShangriLa. Truth be told the version we just saw called Obamacare was anything but. Hidden in plain sight was the cost of insuring the high risk placed squarely on everyone. When anyone balked, they were taxed (or penalized) by the government (as a means of revenue to defray the cost of insuring- perhaps too little). And the government found means to kill “the covered” joys with such love that premiums rose and deductibles soared beyond any ordinary middle-class individual means. Such were the travails of the plebeians that they decided to forgo signing up and pay the penalties- the unfolding had begun. On the flip side the government with all good and decent intentions decided to learn what kind of care was being given at what costs and they imposed “Meaningful Use” of computerization on doctor offices and hospitals. The costs of computerization to the offices and hospitals pushed some doctors into closing their doors and hospitals to push out CEOs (MD Anderson). What the government did not get was the “Munoz effect” on the patients. The eyeballs had found favor with the bright glistening computer screen as a detached physician voice asked questions about the patient’s tale of physical woe. The patient felt abandoned facing the back of the computer screen and the doctor felt he or she needed to cross the “T”s and dot the “I:s in a hurry to spend what limited time was available with the patient- to preserve some patient-physician connection. Ah the “Munoz effect” was in full force, imposed and exposed. Total and complete detachment from reality. The bedside manner had emptied its last marbles of empathy. Perhaps as better systems come along the computerization in healthcare will take hold organically and the desired results of better care for the patient rather than billing and cost will be the order of the day. Perhaps. Meanwhile the damage to patient care and overall health is glossed over with Op-Eds and journalism from people who don't understand, until they seek care.

Some time we barricade ourselves in silos that blind us to reality. The policymakers do that all the time, the CEOs some of the time and the results are always disastrous for those that get trapped in this battle of consequences.

Perhaps we can learn. Perhaps we might learn. Perhaps we may never learn. 

"But men and men, the best sometimes forget." -Shakespeare

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