Helping people climb a ladder – a perspective

The following is an edited version of a comment on Hugh Curtler’s (a retired college professor of philosophy) post regarding whether we should help people in need or let them fend for themselves. I provide a link below to his post. I am going to cite the work a charity I used to be a part of that builds off the book “Toxic Charity,” written by a minister who lived with the disenfranchised people he sought to help. His name is Robert Lupton.

Lupton’s thesis is simple: true charity should focus on emergency or short term needs. What he argued for to help others long term and we did (and still do) is help people climb a ladder back to self-sufficiency. That should be the goal. An easy example is he would advocate for food and clothing co-ops rather than giving the food and clothes away. People love a bargain, so let them maintain their dignity while they get discounted help. This dignity thing is crucial – people would rather not have to ask for help.

Note, we cannot push people up the ladder. They must climb it.  A social worker I have advocated with used to say “we walk side by side with our clients.” The folks we helped are homeless working families. We had two keys – they received a subsidy for rent based on their ability to pay, but they had to plan, budget, get financially educated working with a social worker and attending required training programs. Our homeless clients had to be responsible for rent and utilities up to 30% of their income, which is threshold for housing risk. Another key is we measured success. Success to us is being housed on their own without help after two  years.

As a community and country, we need to better identify what we mean by success in our help for people in need. Also, are things like healthcare a right? Is food on the table a right? Is a roof over the head a right? What we need is better measurement of what we spend and how it helps. It actually is cheaper to provide housing to chronic homeless and partially-subsidized housing to those who are more acutely homeless (due to loss of job, reduction in hours,  loss of healthcare, problems with car, predatory lending on a car, etc.) than let them go to the ER or commit petty crimes and be jailed. People should know all homeless are not alike, so the remedies to help need to vary.

My former party likes to argue off the extreme anecdotes – the significant majority of people do not cheat the system, but the perceived thinking of such is much higher in Republican ranks. When I have spoken to church groups, chamber groups, rotary clubs, United Way campaigns, etc., I come across this bias which is firmly believed. Just last month, the US president announced curtailing a rule on food stamps which will put 3 million people at risk, as one man was able to purposefully game the system. Yes, there is a small percentage of folks that do that, but the significant majority do not.

What people like David Brooks, a conservative pundit, tout is a dialogue on what kind of country do we wish to be? Our economy is a fettered capitalist model, with socialist underpinnings to help people in need and keep people out of poverty. What is the right balance? Is it better to pay a much higher minimum wage or have a higher earned income tax credit, e.g. Is it better to have a Medicare for All system, subsidize those in need or have a free market system only? A factor in this decision is many employers now employ a larger part-time or contractual workforce (the gig economy) to forego having to provide benefits. This is especially true in retail and restaurant industries.

At the end of the day, Gandhi said it best – a community’s greatness is measured in how it takes care of its less fortunate. With so great a disparity in the haves/ have nots in our country, I can tell you we are out of whack as our middle class has declined and far more of them fell into a paycheck-to-paycheck existence. Ironically, even in the age of Trump promises, we have many people who do not realize they are voting against their economic interests. Doing away with the ACA and not expanding Medicaid are very harmful to rural areas, e.g.

So, I agree with Gandhi, Lupton, and Brooks that we need to help people, but decide what is the best way. We should measure things and adjust them when they get out of whack. It is hard to fix what you do not measure. The group I was involved with would alter its model, if the numbers showed less success than hoped. What I do know is over 80% of the people we helped are still housed on their own after two years of leaving the program. In other words, they live without a subsidy.

Finally, what we need most is for politicians to check their tribal egos at the door when they enter the room. Having been a member of both parties, each party has some good ideas, but both have some bad ones, too. I do not care what a person’s party preference is or if he or she is more conservative or liberal than me  (I am fiscally conservative and socially progressive), we need to use facts and data to make informed choices. And, continue to measure the results making modifications, if needed.

Dilemma

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The Lavender Scare

My wife and I watched an informative documentary on PBS last night called “The Lavender Scare.” This show documents a lengthy period of US government sanctioned discrimination against homosexuals that lasted from the early 1950s to mid 1990s.

The scare evolved directly from the efforts of Senator Joseph McCarthy who led the “red scare” as he carried out communist witch hunts. He turned his eye toward homosexuals saying (without data) those who worked in the government were susceptible to communist blackmailers. Yet, unlike his communist witch hunt publicly dying due to his “lack of decency,” as the Secretary of the Army said, the Lavender Scare gained footing.

To my chagrin, I learned former General Dwight Eisenhower campaigned for President on this issue and signed an executive order in 1953 to identify and expel homosexuals from government positions. This saddens me because of the obvious discrimination, but also because the former General said earlier the UK team led by Alan Turing that broke the Nazi Enigma code saved 750,000 lives and shortened WWII by two years. Turing had to hide that he was gay, so Ike’s executive order in 1953 would have kicked Turing out of employment had he been his boss in WWII – what would have happened if Turing would not have been around to impact the war?

The fact this government sanctioned discrimination lasted until it was ceased by President Bill Clinton is a shame, as well. Multiple tens of thousands of excellent public servants were kicked out of jobs they loved and did well. And, many could not get good employment in the private sector due to their FBI file. One of those was an astronomer named Dr. Frank Kameny.

Yet, Kameny did not sit still. He became an advocate for gay rights pushing a ball uphill. He wrote letters to Congress members, some of which were caustically responded to giving variations of the same harsh response. He organized protests and would help those who lost jobs. And, he was able to save some jobs, one who spoke five languages and was later decorated for service to the NSA. Kameny was awarded the “Medal of Freedom” by President Barack Obama for being the grandfather of the gay advocacy movement.

Sadly, there is a movement today led by some exclusionary religious leaders to condemn gays and foment their discrimination. My thinking is this is a backlash to the US Supreme Court approving same-sex marriage a few years ago. But, it goes deeper than that with a president who has laid the groundwork for divisiveness to occur with impunity. He did not invent divisiveness, but is not preventing it either.

Let me be frank. We are land of freedoms and civil rights. Unless someone is harming you, you have “no standing” to deny the rights of others. I personally am offended by bigotry in the pulpit as I see this a a grievous dereliction of duty. Yet, that person has a right to say what he wants – provided he is not inciting violence or hate crimes. If the latter is true, then that is not a protected right.

Please watch this informative documentary. And, let’s do our best to avoid going back to this dark period. There was one gay postal worker who was to be expelled in the 1950s, but his boss stood up for him saying I know this, it does not bother me and he does a good job. The gay employee kept his job. We need more of that in our country and less of the hate speech.

Don’t be difficult to work with

A lesson I have witnessed often is the more difficult you make it to work with you, people will find other resources. Challenging employees better be good at what they do or they may be shown the door or encouraged to leave. If a company makes it difficult to work with them, buyers from and sellers to the company, will seek other options.

Here are a few real examples:

– A company known for shopping for services annually eventually ran out of bidders because the cost of doing business became too high (one company would just throw their Request For Proposal in the trash can). Sellers and buyers who promote relationships have more fruitful long term experiences.

– When Master Service Agreements became commonplace, the attorneys in our headquarters were as difficult to work with as attorneys at some of our clients. We lost a $1 million sale on an idea we raised and the client loved because of our legal obstinance. The second bidder got the work on our idea. That hurt.

– An employee of ours could never be satisfied and complained often. After she complained in my office for the tenth time about how her last employer did better at something, I said to her “We are obviously not meeting your needs. You are doing good work, but why don’t you look elsewhere.” She did and left. What she did not know is we had a continual growth mindset, so we were always talking with people. Her replacement was one of the best project managers I ever worked and she was a very congenial person and eventually an effective manager.

– A fellow consultant had an arduous client who was always asking for added scope services, which he often refused to pay for. After many months of this, the client called our CEO to complain. My colleague pulled up three competing consultants contact information and provided them to this client. In essence, he fired the client. He said it was one of the best decisions he ever made.

A US farmer noted on PBS Newshour yesterday, we cannot just turn off the tariff spigot and start the pipeline again. His buyers have found other options. As a business person, I have noticed this president fails to appreciate what it takes to get things done. We have witnessed this repeatedly in rash mandates that have people (even his own) scurrying. That is poor leadership and worse management.

Do you have any examples?

A few observations – big and small

Let me offer a few observations trying not to only speak of the man who shall not be named.

– A friend used to have sayings on his voicemail greeting. My favorite one is “always tell the truth as you don’t have to remember as much.”

– The man who shall not be named (MWSNBN) said he did not like “negative and critical” people while referring to a couple of British leaders. Really? Have you read your tweets?

– Another friend said “a man will never be shot while doing the dishes.”

– The MWSNBN failed to get buy-in from his caucus on placing tariffs on Mexico. Apparently, the caucus is not happy, with the Senate leader saying the MWSNBN would use “tariffs to solve HIV and climate change.”

– A person who is accountable and says I am sorry for a mistake is an exemplar for others to follow,

– The MWSNBN once again claimed he did not say something when a released audio recording said he did. What should have been a minor issue with a mea culpa, became a bigger one. This is not an isolated occurrence. “I am sorry” should not be so hard to say.

– A person who awakes and believe it will be a good day stands a better chance to have one than someone who believes the opposite.

– The MWSNBN awakes and tweets in a stream of consciousness. By the time he gets to work by mid-morning (per Bob Woodward’s book “Fear”), he tends to make his day worse not better. His biggest enemy is the one who looks back at him when he shaves.

– Our leaders should help us be better people. They should represent our better angels. Nelson Mandela, Warren Buffett, Paul O’Neill (retired CEO of Alcoa), Bill Russell (who won 14 NBA, NCAA and Olympic championships) are examples of great leaders. They made their organizations better.

– Great leaders do not tell 10,000 lies, do not bully people and think largely of themselves. A great leader deflects credit to others, while a bad one assumes credit even when it is not due, per a lesdership consultant.

Now, I am going to go do the dishes.

 

 

Navigating medical customer service

Before I share a few observations and experiences, let me first note that too many Customer Service Representatives (CSRs) are likely understaffed and undertrained to do the jobs they are asked to do. The healthcare system in the US is complex with a lot of moving parts, including consolidated entities on the provider side and insurer side. In other words, there are plenty of opportunities for the system to fail the customer, provider and insurer.

Through all of this, the patient has to be the navigator of his or her customer service experience. Otherwise, the patients may not realize they are not being treated fairly. As evidence that I am not personalizing this more than I am, let me mention two things.

First, I have a friend who runs a successful business advocating for insured patients. Her firm is hired by companies to help their employees and retirees navigate the healthcare insurance system. In essence, they advocate to get the insurers to pay for what they say they will in plan documents. No more, no less.

Second, as a retired benefits manager and consultant, I am familiar with the complexities, but there are people who know them far better than I. So, what concerns me is people who get maltreated  by the system and don’t know they can push back or don’t feel comfortable in so doing. The various acronyms, footnotes, poor communications, entities and touch points are confusing.

Rather than lament issues, let me offer a few tips to help in the navigation.

– If you need a pre-authorization for a surgery or procedure, start at least a week before or as soon as you can. Ask what they need and make sure they know who to call. An increasing number of providers are putting the burden more on patients to get the process started.

– On any call or reach-out, save emails or notifications, write down notes, names, dates and phone numbers – there are many, especially with centralized functions for smaller doctor offices. Recently, I was given multiple numbers to call (and addresses) from each party.

– Read your EOBs – Explanation of Benefits – including the footnotes as to why something was unpaid or pending. There may be an action needed on your part. If have a non-ACA, non-Medicare or non-employer plan, there may be a need for medical information to confirm this is not a pre-existing conditon.

– If you feel uncomfortable with asking questions of your doctor or insurer, write the questions down or include someone to advocate for you. Don’t be afraid to ask what someone said as it can be confusing or the person may not be the best communicator. And, if it is a major surgery or procedure, it is more than OK to seek a second-opinion.

– Follow-up. This is critical. Hand-offs are made to do things and the receiving entity may not confirm it has the ball. As a result, while you are waiting, nothing is happening. If medical records need to be there in 30 or 60 days, follow-up 10 – 15 days before those deadlines.

– Finally, be as diplomatic and polite as you can, but sometimes it is hard. So, be prepared to say something like, “I am sorry to be a pain, but this is frustrating.” Also, if urgency is needed, please share that need. Some readlng this may note there are websites to facilitate this process, but too often, the website does not do what you think it is doing. It may just be recording a query and not codifying an action. You may be surprised how frequentIy I have to read to the CSR what another part of the company sent me.

Again, there are many fine people in these positions who want to get things right for the patient. It is often said, good people make up for a bad structure.  Yet, it should not be as hard as it is. Until it is made easier, you must be the navigator of your customer service.

Please feel free to share your ideas and reactions.

Freezing executive pay opens up money for workers

An article in The Guardian earlier this week caught my eye. CareCentrix CEO John Driscoll penned an editorial “We froze the salaries of 20 executives – and it improved the lives of 500 employees.” Driscoll took the reins of this struggling healthcare company, whose financial troubles included a significant amount of staff turnover.

Driscoll worked with his leadership team and Human Resources to make a number of changes, but he felt that was insufficient to right the ship. So, he made a decision to find more money to keep workers who were struggling and working multiple jobs.

As Driscoll wrote in The Guardian, “What that meant for our company was that if we just froze the wages of our most senior team – less than 20 executives – we could radically increase the wages and improve the lives of nearly 500 of our teammates.

The conversation with our executives was straightforward. We were in the midst of a turnaround. We were demanding much from every corner of the company. Small financial sacrifices from those at the top could be life changing for those at the bottom of our wage scale. We needed to do it to build a real sense of Team CareCentrix. They agreed. With joy, we announced in January 2015 that our minimum base pay for employees would go up to $34,000, or the equivalent of $15 per hour.

Raising wages in the midst of a business turnaround was not easy. We needed our executive team to buy into a vision of business success where every employee had a fair shot at success. It worked.

Our business has tripled over the past five years. Our minimum wage is now approaching $16.50 per hour and last year we broadened profit sharing to all levels of the company.”

This caught my attention as the US far exceeds other nations in the ratio of CEO pay to average worker pay and has for some time. Having been a former Compensation & Benefits manager, manager of people and consultant, executive pay is much more upwardly elastic than that of average workers. Average worker pay has a lid placed on it through the budget process – which often overemphasizes past, current or expected troubles. Also, downsizing at the time of annual raises facilitates the lowering trend on average pay increases as folks who would have received little or no increase are let go – so folks that remain receive suppressed increases to make the percent increase in the budget work.

What I like about this CareCentrix example is the thought process and solicited buy-in from rhe executives. Yet, it need not take a burning platform to make needed change. There is a productivity cost to turnover that impacts the bottom line due to constant churning, replacement, recruitment and training of staff. Keeping more people longer is accretive to profits.

Some larger national companies have recognized this and raised their floor pay levels – Bank of America, Wells Fargo, and Walmart are in this group. So, thoughtful discussions are needed, in my view, around these issues irrespective of or along with governmental imposition on increased minimum wages.

Competition and collaboration

I am reading a wonderful book on the life of Paul Simon. His story of dedication and diligence to his craft is an amazing read. He is a highly competitive, yet very collaborative professional. And, he notices these qualities in others.

Simon noted after meeting the driving forces of The Beatles, he saw how competitive John Lennon and Paul McCartney were. They made each other better trying to outdo the other. But, they also were highly collaborative with each other and other musicians within the band and recording studio.

Don Henley and Glenn Frey of The Eagles were similar. Like Simon and the lead Beatles, Henley and Frey are highly prolific songwriters. Yet, they worked relentlessly on their harmonies. They were as close to flawless as possible. Regardless of who sang the lead, the others contributed to making the music sound even better.

The Beatles were known for their harmonies as well, with numerous takes and much practice. Like The Eagles, regardless of the lead, they all worked together to get the right sound, either vocally or instrumentally. There is a great documentary on the making of Sgt. Pepper that highlights the competition and collaboration which created the most acclaimed album of its time.

Back to Paul Simon, he and Art Garfunkel would practice their harmonies facing each other to watch the other’s mouth as they sang. They even preferred to record singing in one mike because rhey felt it sounded better. And, like The Beatles, Simon constanty pursued makig the music better collaborating with other musicians who brought different styles of music.

Plus, Simon is competitive due to being told he was not tall enough, he wasn’t good enough, he didn’t have the right birthplace to be a folk singer, he wasn’t rock-n-roll enough, he couldn’t sing as well as Garfunkel, etc. Simon just learned his craft behind the scenes even going to England where he was more accepted for his unique style and songwriting.

Competition is a good thing. Yet, checking egos and working together make the product even better. Collaboration is vital, otherwise the competition can become unproductive through sabotage or rooting for failure. The dysfunction in Congress and White House are obvious examples where the absence of collaboration is stifling progress.

So, it is more than fine to compete, but do collaborate. That added seasoning could make all the difference.