What is News Worthy

  • Malone's Magic shines on Pandora!
  • .
  • Can MSNBC shake the Liberal media under Comcast and take over?
  • .
  • Not another investigation!
  • .
  • Did May deal a good hand to Merkel?
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  • Bill Gross: without German Umbrella just another Economist trying to get attention?
  • .
  • Qatar and $12B in orders after Saudi Mega deals in Defense Spend: A new business Model?

Re-inventing America!

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Silicon Valley Vibes!

  • Elon Musk Line: Car mover underground in Hollywood!
  • .
  • Would you allow Siri to drive you around?
  • .
  • Google Ventures : the hidden gold mine? From curing death to scissoring and splicing genes?
  • .
  • GS Warriors : Is Oakland ready to be part of High Tech bubble?
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  • Did Ford Make a big mistake by changing their tradional CEO?
  • .
  • Killing Uber Management: Is it a Mistake which will burst the bubble?

FANG News:

  • What ever happened to House of Cards: Its not even 7 seasons
  • .
  • Mother of all AI? Lets Fix SIRI before leaping too high!
  • .
  • Under steady Republican policies - will American Advertising spend go down?
  • .
  • If Waymo is $70 Billion should Uber be $200B?

Wednesday, April 22, 2009

AMERICA 2.0! Healthcare

MODERNIZING HEALTHCARE – Mr. President’s Prescription?

Is social healthcare all about providing insurance for 50 plus million American people with no coverage? Is this a mechanism to marginalize the compensation for this high stress high skill precision services industry? Or a way to remove redundancy in a complex mostly underwritten yet very regulated insurance driven industry? Or is it about new means of Healthcare Delivery which brings responsibility to a very complex service driven yet thankless industry at the same time bringing capitalistic innovation for a new and cost effective healthcare to all human beings- bringing services to where it is needed and when it is needed without compromising quality, capability or compensation for the services. It certainly looks like one of those too good to believe strategy.
Healthcare Delivery need not be about reducing patient care or money to every provider in the health care system.

Looking at how the current day participants - patient, doctor, employer, hospitals, governments - state and central, medical device manufacturers and pharmaceutical companies and insurance providers could change to act responsibly without giving up on free market principles – sheds light on the efficiency a change could bring to this industry.In the current setup If a person is insured either through eligible employment or through dependency coverage or through other state or government programs - most likely the following scenario happens.From dental to vision to any doctor’s or hospital visit the concern is not about what the cure is or the cost of service is - it is more about what the out of pocket expenses are. From a providers perspective it is more about what the individual’s eligibility is and not about what the best available service is.

PHARMACEUTICALS:

Statins- 40B in revenue and growing and there is no reason for them to lower the cost for several years. Avastin - has the ability to extend the end of life by a few months in conjunction with other expensive cancer treatments for a total cost of 50K. Every person eventually gets into a lifestyle drug to address some form of age related degeneration or lifestyle induced ailment. As the cost of administering is paid by a third party - insurance which in turn is either provided by the employer or the government in most of the cases( 90% of total healthcare expenses for an individual is towards the last 6 months of life & most of the people at that stage is covered by government policies) - it is very easy to adjust to a cocktail of pills every day without adjusting or making an attempt for a change in lifestyle.
This relieves the individuals from the responsibility of putting pressure for a cure. This kind of lifestyle encourages the pharmaceuticals to create lipitors and avastins which does not attempt to cure the disease but provide life enhancing mechanisms by curing symptoms and incremental solutions. It is the equivalent of Software As A Service- Drugs As A Service?? Imagine having a Tylenol for fixing blood-pressure or diabetes or cholesterol – or on the other end imagine taking a daily pill for the rest of the life for a head ache?
The incentive should be to find medicines to cure ailments and not to address symptoms on an incremental basis- making lifestyle addiction, both physically and psychologically, to a basket of pills.

EQUIPMENT MANUFACTURERS

The next element is equipments and tools that are used in hospitals from MRI to EKGs. Every manufacturing industry from automobiles to semiconductors the common theme is increased capabilities and price compression- in medical GEs and siemens of the world have failed in its responsibility in using the same fundamentals like every other industry - if high tech principle is used today an million plus MRI equipment will be a portable device which will be given away for a couple of bucks.
By keeping costs high it limits the applicability of the device. If you take Intuitive Surgical’s Davinci robotics tool which is million plus - in addition to providing cost effective alternate procedures using minimally invasive operations - it actually increases the odds of survival by a huge factor. The cost makes it very difficult for all hospitals and clinics to afford it and also keeps the skills needed at artificially high levels. By expanding the reach of such equipments and devices we can increase the demand and also provide an inexpensive solution – which will reduce the overall hospital care cost.

HOSPITALS & CLINICS

Either by design or by carefully planned public policies – the states and cities are drawn out to have sparsely populated communities extending to the wide corners of the country- excluding a few major cities. This kind of development makes it economically impossible to have a total healthcare package available in every city and neighborhood. The latest in medical innovation is available to densely populated communities – making it either expensive or untimely to offer services in most of the smaller cities. By adopting a combination of connected clinics with sophisticated tele-medicine we can provide most of the latest development in every corner irrespective of the market size- this will enable the prices of newer innovations to come down dramatically and also have more and more companies entering the market as this will actually address the total population irrespective of the size of individual communities.
Looking at a Wal-Mart’s clinic where most of the day to day medical requirements are available by Telemedicine - it is not just the cost that is important –
- Where it is available
- What it takes to provide services
-increase the productivity of specialist and reach of the specialists to every corner without need for size of area or market
- by easy access to clinics with little cycle time most of the ailments can be detected at a very early stage thus reducing cost both from a productivity standpoint and also from a healthcare point of view.

CORPRATE ADVANTAGES

Moving cost away from the company's structure brings reality to actual pay scale for every position in the company. As the insurance premium is based on average age, size of organization and overall health habits of the employees and their families - the average cost becomes a base wage for every position irrespective of the competitive position of the company's product or service offering. This also gives undue advantage for large companies over smaller rivals as smaller companies end up either paying more or offering less choices to its employees. This movement of cost away from the company enables organizations to focus on products and services and attract talent and contain their costs competitively. From an employee’s perspective - they are able to pick and choose their jobs based on their interest and capability. This indirectly reduces discrimination on prospective candidates based on the individual’s health history. In the long run it pushes the responsibility on the individual which brings more awareness and responsibility to develop healthy habits and eventually bring down cost of patient care. This gives more flexibility for companies to provide different ways to educate and provide a healthy environment for the employees.

INDIVIDUAL & CORPORATE CONTRIBUTIONS

Once the organizations are relieved of the cost overhangs from the insurance subsidies – they have lot of leverage and flexibility to offer better and healthier environment to bring awareness about healthy lifestyles and better medical practices amongst its employees.

Recently Cisco dedicated a huge building for health and exercise with a resident doctor and a full service clinic. At the outset it looks like a PR ploy by the HR Dept. Digging deeper we can see how it can change lifestyle and cost behavior.By offering such a service it enables the employees to use it at the earliest symptoms of any ailments.

This reduces the healthcare costs in several ways-

1- reduces the number of sickness related absenteeism
2- reduces spreading to fellow employees
3- reduces the cure cost as it is found early
4- also reduces the insurance premiums


INSURANCE

Looking at insurance- every person carries insurance from the moment they are conceived. Most of the healthy persons do not start developing any ailments till in their 50s. With a job no issue as the company picks it up. Let us say no job- insurance is impossible to get as the person falls in the high risk category. Now what ever happened to the 50 plus years of low risk period during which the individual carried insurance? Even car insurance offers good driver credit and no accident reduction - doesn't it make sense that if an individual carried a good health for 50 plus years should get something in return?

TECHNOLOGY

As technology is evolving at a rapid clip – from wireless to collaborative innovations – it is very easy to find ways to offer very sophisticated healthcare system that will bring responsibility and accountability to every level of the healthcare supply chain – enabling lowered/affordable yet uncompromising services to everyone without commoditizing and marginalizing the service providers. On an average for every 10 minutes of patient time spent by a doctor 20 plus minutes is spent on non-patient time. BY bringing innovative processes and technology this ratio can be adjusted favorably helping both the patient cost and increasing the productivity of the doctors – without compromising the quality of service or the compensation structure.

GOVERNMENT AGENCIES

Acting as a responsible regulator the government can ensure free market forces to provide a healthy yet capitalistic and creative services driven healthcare. By being a pioneer in implementing a broad base health system this will expand the American corporate global market share significantly as they will innovate and deliver more cost effective yet revolutionary products and services which will be sought after globally. This would bring back market leadership to most of the companies which have been losing market share to either low cost generics or to low cost manufacturing bases.

By bringing new innovation and bring responsibility to every participant of the healthcare system – it will also reduce the cost of insurance both for patient care and malpractice alike.

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Slowing to Smell....!

After going through several blogs I came to the conclusion that it is very difficult to write about your day to day life!

Fascinating to see how creative people are and how so many people around the world are able to choose a variety of topic and pour their heart out and paint something so wonderful- full of life and color!

Need Humor! Need Depth and more than anything need perspective! I found it is easy to write about something substantial in which a person is well versed in. It made me think - I went around the last few days looking around and paying attention to everything from nature to relationships!

Now curiosity started posing a question - what is more important to writing? Chosing a topic or having the patience to research and articulate about the impressions that every day events brings to a person?

I thought I will try this every day! For 30 Days!

Impulsive and spontaneous
!

No research - just type as the feelings flow and as the words can portray! Thanks to the Blackberry - now I can try doing that the moment the urge happens without waiting!

As I was deciding on this I found myself in a shop - decided to pull my Blackberry and type what I saw around me...so begins my first piece.

PS. Since Blog has major restricitons on how many posting and what kind of flexibility one can have using the standard template I will try to find a work around using a couple of gadgets to display a couple of days posting at any given time till I figure out a way to display the history!

To avoid dilution of this site I have moved the experiment to another blog under

http://dailylifesigns.blogspot.com

The following is a sample on content with no photos- the Daily Life Signs posting will be more of a pictorial experience!






Walking around a woman's shop!

Looking at the colors in a woman's shop is like peeking into a kaleidoscope. However, one doesn't have to change to feel the vibrant mood.

Amazing styles and fascinating fashion! Trying to coordinate gives the several option that is needed to meet the day to day lifestyles of varying moods and differing ages.

Age appropriate colors! Shades for fading moods!

Bold red!

Sober red!

Flashy red!

Bland red!

Blood Red!

Romantic Red!

Decisions! Decisions! and Decisions!

Deciding the color at the time of shopping gives the option to choose and refine to the various rainbow moods that a person possibly can go through in a fast paced connected world!

Sizes and fits to match every form and need.

Having a choice helps in refinement!

And helps!

In Decisions! Decisions and Decisions!

Startup Wisdom!

May be there is a reason they want a Money Man to run the venture- but the following tip will save a buck or two! This will list a couple of grey hairs to keep!

  • Success is contageous- start it immediately!
  • Share the Vision but not Leadership!
  • Smart money is great - but Lucky Money is even better. Get some!
  • Being passionate is essential - but only after motivation to make money.
  • Establish the TRUE Pecking Order!
  • Let Sales be part of your core strategy- everything else can be bought!
  • If you havent done Selling START DOING IT NOW!

Building your 2nd Million!

Skip the first million and go straight to the second- as the first one is the most difficult one to bring home! The second one can be as tough as the first one but is never tougher than the first one! You can make money - working - investing in stocks/etc - real-estate - starting a business - others Choose your area of interest first as this will help you identify the opportunity and make you easily motivated to work on the 2nd million!

Not in any particular Order!

  • First lets know the facts: 1) Your work life is 40 something years (even at conservative estimate) so lets make sure we plan that Properly
  • 2) Lets identify opportunity to make money with out too much effort- living for Today is Good but lets not lose today's free money in the process like - benefits, tax breaks, sale,coupons,etc
  • 3) Lets not try to make ALL THE MONEY in the same way! Lets break the objective into smaller chunks and assign different ways to make them individually
  • 4) Put the 1st Million in Auto-pilot and set a 10 Years plus Time table
  • Convince yourself that you need the Money
  • Set a time line to achieve the goal.

Relationships - Learning to enjoy them!

Do we retain relationships? Expectations out of frienships vary from society to society & age group to age group. How long do we carry them? Some of them bring fond memories- and some not so pleasant! Here you can expect to see nuggets from my experiences and analysis!

Family & Friends: We spend less time with family than with friends- yet we feel more comfortable with family than friends- Why? Is it because we dont have expectations with family members but we have some on friends?

Allowing the other person to finish their train of thought builds a very long lasting relationship - as it makes you understand the other persons point of view fully & also to respond being aware making even an opposing point of view reasonable.


  • Cherry Pick your arguments - Left or Right Brained!
  • Make every encounter a transaction - this will make leaving baggages behind easy!
  • Qualify the type of relationship - however strange it might be
  • Chasing friendship is not always helpful as it leads to compromise.
  • Family circles - define it and accept it whether you like it or not!
  • Its ok to do different activities with different people!
Prof Dr Peik A Monie's Corner

  • if being number two is not enough go to a lower market
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  • proceeds from a street dog dont bark
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  • shooting the papparazi dont break cameras

DIGITAL IRIS - An inexcusable view of the photograpic world!

Let me see if I can add a few lines every week highlighting my 2 cents on photography- my experiences and desires

Things that make good photos -

- excellent and expensive set of lenses; in this digital era spend less on the body and keep investing in the high end lenses as the lenses will not lose value and the body is still under construction!

- accessories and the right tripod; never underestimate your advantage with a tripod

- plan & choose the subject and the location

- know your subject well!

- look and follow the calendars; simple things like a night with a Full moon- we dont realise that it does not happen every day - if you narrow it to the summer when the sky is still blue - I guess it becomes a couple of times a year- and if you factor n the location and your availability at that location and time...so Knowing the calendar and season helps for a good but not so common picture

- Take some luck with you!

  • Print and Enlarge Some Too
  • Delete Bad Pictures from Storage
  • Isolate Subject's color
  • Assess various profile
  • Add a subject to the frame
  • Take Nature after rain - they look better
  • Transparent Objects like flowers have creative effect with light behind them
  • If you want to enjoy the trip - leave the camera behind!
  • Define the subject for the shoot out trip
  • Take a survey trip before the real shoot out
  • Learn & Buy the Best Tripod
  • Always take a handy utility camera
  • Use Multiple exposure & shots in action oriented moments- this will help you pick the ideal snap - as even a fraction of a second makes a HUGE difference in photos.
  • Know your camers settings!
  • Understand Shutter Lag
  • Understand the camera shakes

AfterMarket Pulse- The boring Services Industry!

Keeping it inefficient is good for every one- A success story and why it will be restricted to a handful in the services Industry- A serious look at the Service Industry and my views on improving them. As a society we have accepted that everything breaks down and needs periodic maintenance. We are willing to pay both money and time to accomodate such services. What we have not done is define what is the service level that is needed for every such incident. From household appliances to industrial equipments we are forced to accept the cost and quality that the market offers. In such a sellers market room for mediocracy is enormous- giving way for opportunities. Yes predicatability is not always easy when it comes to failure or repair - or for that matter to identify what is wrong once the item is broke as it is not always possible to run the equipment ot see what is going wrong! And there are companies that can afford stupidity & those that cannot- if you want to change choose wisely!

  • Three steps: 1) Localize Failure 2) Response to Events 3) Time to Life
  • Inter-dependency at a higer level accelerates return
  • Resposiveness is rewarding - even if it is just to show on site of event!
  • Failure Prevention is difficult - yet possible
  • Know your Industry problems: Inventory, Turn time, Forecasting Failure, Estimating Cost, Finding Talent, Automation tools
  • Know your industry Practices- Swapping parts, using refurbished items, penalty
  • Define Quality of service
  • Attract talent - as service industry does not attract fresh talents
  • Innovote service packages

About Me

Seen me go through cycles driven by Age, Money, Deception, Affection, Success, Failure, Fear- etc. The current cycle puts me in a middle aged bucket with sculpted bitterness trying to tame it to embrace the sweet crime of success and affection.