All Life Is Problem Solving

Here’s some counter-testimony to the stories the health industry has been bandying about concerning the supposed problems with the Canadian single payer system. My own view? Stories about Canadian health care being circulated by those who are trying to defend annual CEO compensation running as high as $24 million are just not to be taken at face value, and after the past generation of lying and dissembling on various matters, neither are the claims of Republicans, the party of Karl Rove, the neo-cons, and “the noble lie,” or those Democrats who have received sizable contributions from a health insurance industry that would be out of business if we had the single-payer plan we deserve.

A few blogs ago I wrote about “breaking the pattern.” Mike Lux writes about it too with special reference to the Clinton Administration and what President Obama needs to do now if he wants to avoid its fate on the big questions. Take a look!

In a recent exchange in the Fed KM Google group, one of my correspondents thought that it would be very helpful to a National KM Center to have access to benchmarking-derived “lessons learned,” “best practices,” and “knowledge architecture” from APQC. In reply, I indicated my agreement provided that these ideas were construed appropriately, but then I also expressed doubt about whether APQC excelled in measurement theory and methodology, or whether they had a very good knowledge processing framework on which to base their indicators. And I also expressed doubts about the adequacy of their measures of impact. [Read more →]

Scarecrow provides us a great example of “giving the game away thinking” in a new blog entry. He provides an account of “Democratic Strategist” Steve McMahon’s thinking on what the Democrats ought to do to get a health care reform bill. McMahon’s prescription is perfect for shrinking Democratic majorities in 2010, and for paving the way for making Barack Obama a one-term President. [Read more →]

Occasionally, articles appear comparing health care in the United States with health care in Canada or other wealthy western countries in terms of health outcomes. Yesterday, Nicholas Kristof, in an op-ed piece in the New York Times, compared the two countries’ health care system through the filter of the experience of a 59 year-old American Attorney named Diane Tucker who moved to Vancouver in 2006. I urge you to read Kristof’s article to get the full flavor of her contrasting recent experiences with the two health care systems. But the bottom line is that Ms. Tucker, who’s job in Canada ended, now finds herself constrained to remain there because if she came back to the United States her medical history which includes a stroke would prevent her from getting insurance in the United States at anything but a prohibitive cost. Kristof tells this story to make the larger point that Americans ought not to get scared by current health industry advertising campaigns offering horror stories about Canadian health care, and he also points out that even though America spends nearly twice as much per person on health care as Canada, the “infant mortality rate is 40 percent higher than Canada’s, and American mothers are 57 percent more likely to die in childbirth than Canadian ones.” He also might have added that life expectancy in Canada is now at 81, while it is only 78 for Americans. [Read more →]

If Progressives and Democrats are going to be successful in the future, they have to solve important problems of middle and working class people, such as stagnant real income, declining wealth, terrible and high risk (i.e. easily disappearing) health insurance, high quality education for all, including opportunities for everyone to get a college education, a rapacious financial sector that is impoverishing them, toy and food industries that are delivering increasingly dangerous products, an energy industry that is increasingly incapable of delivering low cost and clean energy, global warming and a deteriorating environment, an economy that needs to re-invented to create new leading industries, and other problems I won’t name here. These problems have been accumulating for a long time, and for at least a couple of reasons. The first is that one of the two American political parties doesn’t believe that Government should solve domestic problems, other than problems of basic security. The second is that the other party has been content to place band-aids on major problems, while cleaning up some of the mess created by the anti-government party. While doing such things however, it has implicitly adopted the posture that most problems have to be left for the future, because of the burden involved in cleaning up messes, and making the few additional advances it decides are feasible to get through a Congress with a severe anti-action bias, and implement with an under-resourced public service. [Read more →]

I’ve always been a Democrat and a pretty progressive one at that. But since the Carter Administration, I’ve been pretty dismayed by the tendency of Democrats who have won the Presidency, or gained control of Congress, to give away their ability to produce solutions to problems that serve the interests of their constituencies by adopting some rule or regulative ideal that makes it impossible to serve those interests. I think this tendency began with Jimmy Carter. The Carter Administration was socially liberal and also idealistic in foreign policy. But in the area of domestic economic policy it adopted the ideal of fiscal responsibility and made various fruitless attempts to “Balance the Budget” by being frugal and refusing to stimulate the economy. President Carter ran the most conservative economic administration since Dwight Eisenhower’s, and his policies seemed to have the effect of persuading the American working class that the Democratic Party was no better friend to them than the Republican Party. When Reagan showed up in 1980, he had a comparatively easy time persuading many industrial workers to vote for him because he reflected their social conservatism and Carter’s tenure had not been particularly good times for them anyway. [Read more →]

I’ve been waiting for universal health care legislation since 1949. But, of course, the opponents of such legislation don’t want us to do anything “hasty,” and “jam” legislation through Congress. They want “careful consideration” of health care reform as if 60 years of proposals, studies, and deliberation were not enough. Representing the opponents of universal health care, Republicans and a few Democrats are offering some principles that they believe should govern health care reform legislation. First, any reform should be the result of a bipartisan process. Second, we need to control costs and be fiscally responsible while we’re doing it. Third, anyone who wants to should have the right to keep their own coverage if they like it. They shouldn’t be forced into a Government Plan. And Fourth, any changes must ensure that all health care decisions are made by patients and their doctors. I’ll comment on these principles. [Read more →]

Perhaps mercifully, if you’re one of my members who like my KM posts but can’t stand my take on political issues, I’ve been pretty quiet lately about the wars, filibusters, the economy, torture, health care, energy policy, political strategy, or any of the other issues I get the urge to comment on. That’s because having delivered myself of my various opinions about how the Obama Administration is falling short in each of these areas, I’ve been waiting to see whether his initiatives are working, or whether some of the misgivings I expressed earlier are becoming reality. From my perspective there’s a little lull in the action right now, in spite of the very successful Obama opening of a US diplomatic offensive. [Read more →]

Yesterday, I offered a high-level case for Federal Knowledge Management. But I did oversimplify things a bit, to keep my post short. The complication I didn’t want to introduce earlier is the idea that Knowledge Management already exists in every locale within the Federal Government, whether we think it does or not, and whether we want it to or not. So, it’s not so much that the Federal Government needs Knowledge Management, as it needs much better and more successful Knowledge Management than now. [Read more →]