Hallowed Ground

I’m a bit late in penning some thoughts on the response to the Islamic community center development plans so close to the site of the Twin Towers, but I came across Lincoln’s Gettysburg Address today and it reminded me of all of the conflict around it. Thought it worth sharing.

Four score and seven years ago our fathers brought forth on this continent, a new nation, conceived in Liberty, and dedicated to the proposition that all men are created equal.

Now we are engaged in a great civil war, testing whether that nation, or any nation so conceived and so dedicated, can long endure. We are met on a great battle-field of that war. We have come to dedicate a portion of that field, as a final resting place for those who here gave their lives that that nation might live. It is altogether fitting and proper that we should do this.

But, in a larger sense, we can not dedicate — we can not consecrate — we can not hallow — this ground. The brave men, living and dead, who struggled here, have consecrated it, far above our poor power to add or detract. The world will little note, nor long remember what we say here, but it can never forget what they did here. It is for us the living, rather, to be dedicated here to the unfinished work which they who fought here have thus far so nobly advanced. It is rather for us to be here dedicated to the great task remaining before us — that from these honored dead we take increased devotion to that cause for which they gave the last full measure of devotion — that we here highly resolve that these dead shall not have died in vain — that this nation, under God, shall have a new birth of freedom — and that government of the people, by the people, for the people, shall not perish from the earth.

It feels like the larger story here is to not only celebrate the lives that existed prior to 9/11, but to remember how before that date, this country worked so hard to be what it was the day of the tragedy…multiple religious, ehtnicities, genders, orientations, working shoulder to shoulder in those very towers.

Whats the diff?

///UPDATE: Apparently, Death Panels are back in the news thanks to our newly minted Republican House. I’m interested to see how consistently they attack this principle across ALL segments. And that was sarcasm, for those of you who couldn’t hear it. For the record, after working in Pharma for years, I don’t find a lot of fault in this kind of system. ////

So let’s recap…

Who remembers the first Facebook Post of our National Laughingstock, Sarah Palin…the one that put Death Panels in urban dictionary? Today, the topic resurfaced when our heroine stated:

“I was about laughed out of town for bringing to light what I called death panels because there’s going to be faceless bureaucrats who will based on cost analysis and some subjective ideas on somebody’s level of  productivity in life—somebody is going to call the shots as to whether your loved one will be able to receive healthcare or not: to me, death panels. I call it like I saw it, and people didn’t like it.”

So here I am today…reading through my new benefits program at work…when to my horror…I learn that the big insurance companies DO THE EXACT SAME THING.

Blue Cross offers a “Presciption Drug Formulary” as part of its plan…as does Anthem. Language is eerily similar to what Sarah Palin referred to as “death panels” in the healthcare bill.

“The Blue Cross of California Generic Prescription Drug Formulary is a list of generic drugs covered under your benefit. These are commonly prescribed Food and Drug Administration (FDA)-approved drugs chosen by Blue Cross of California.”

“This program is designed to encourage appropriate and cost-effective use of medications.”

“If your physician prescribed a medication that does not appear
on this list, the medication may not be covered under your
pharmacy benefit.”

Does that mean that the “insurance companies” = “faceless bureaucrats” that she referred to? It’s all making sense now. Maybe we can agree that it might not be a good idea that insurers can deny medication b/c their board doesn’t think it is cost effective. Or maybe she’s a hypocrite who is paid by Fox who is paid by advertisers who are paid by companies that like to make big profits and thus, pull support if the message is what they consider to be anti-business.

First person to call out the real death panels regardless of their campaign donations gets my undue respect.

Seeing through the Have Not Lens

During my first drive to Sao Paolo from the airport, I noticed a decaying roadside favela…a shantytown…full of shoeless children, raw sewage, crumbling walls and tin roofs. It was not the Brazil I stayed in…beautiful apartments and homes, amazing people, wonderful food, killer shoes. I was mesmerized as you rarely (if ever) see such have nots in close proximity to haves  in America. It made me feel uncomfortable and sad and helpless.

One of the people in the car was looking at the same space, and suddenly she sat up, pointed, and said “Olha! Que flor bonita!” which means roughly, “Look at the beautiful flower.”

I looked at where she was pointing and noticed, barely struggling through a crack in the road, a single, tiny, beautiful flower.

Two things struck me. First, that she picked out the one bright thing, and second, in all of the poverty and decay, that was the only thing she chose to see. Why? Because it was an exception?

I wondered at that moment what they saw looking back at us. Did they just see the watch I forgot to remove for the drive? Or did they see me…someone wondering about their lives and wishing I could do something big in life that could make their daily existence easier and safer…and ultimately all of us stronger.

I’ve gone back to that moment in time during all of the political hullabaloo of the past year.  The name calling, the insults, the hatred, the ugliness, the bricks through windows and the bewilderment I feel watching angry people degrade the very party best intentioned to help them. What really do they see? Is it real, or is it the exceptions highlighted through another lens I could never understand?

The Great Facebook Debate

I was engaged in an interesting Facebook debate about the Massachusetts election yesterday. After some deep, meaningful conversation around why Scott Brown was a great candidate (he was Cosmo’s Sexiest Senator AND his single daughter was on American Idol!!!!) and why Martha Coakley wasn’t (she thought Curt Schilling was a Yankee fan AND she actually supported a healthcare plan in Massachusetts that Scott Brown also supported! The horror). And wait…Martha spelled Massachusetts “Massachusettes” in one of her ads. [Glad the folks that pointed that out are flawless spellers as well]. THAT will teach her to assure every volunteer runs spell check. Although yes, that was pretty dumb. Brought back fond memories of the good ‘ol days…sigh.

But I digress.

I was refreshed to see someone post some questions she had around issues and what these candidates actually stood for.  FINALLY.

In any case, here was the comment that I wanted to respond to:

well.. we have the best healthcare in the world.. why do u think people come here for treatment.. yes we have issues with it.. but we should not demolish all that is good about it .. just so government can control it.. yes it is too expensive.. but why arnt we looking to see why that is and correcting that.. not just saying the gov can do it better… (their track record is not the best .. for instance.. social security was supposed to be saved for only SS but it was used for other things – that is truly why it will not be available when we retire…. Altho we pay into it .. Another one.. I know older people who need help but they cant get it because they are told they make too much pension money or SS and “make to much” for gov help even tho they paid into it all their lives.. and there are others who get it and have not paid in.. at all) – why r prescriptions so expensive.. why do drs practice defensive medicine..why dont we stop all the waste??? I dont know one dr who has said this is a good thing..If we stunt our health care system who will want to be drs.. I certainly want the best dr there is.. Doesnt everyone? I want everyone to have good healthcare but I really dont think either bills that have passed in either the senate or the house will help this country do that…besides all the deals that are being made .. noone truly represents the ave american anymore.. I want our government to stop all the bickering and do the right thing for all of us – it should not matter party affiliation or how much you make or what color you are.. just that we are all Americans.. We should take care of each other .. but it should be fair across the board .. why dont those government officials have the same healthcare we do? .. You know thy get sweet deals and keep it quiet.. right? They wont use the same system they provide to us.. and that is soooo wrong. Maybe if they had to use the system themselves then they might want to do the best thing… I don’t even know Coakley.. but I dont understand why she was telling MA that they should want to support the healthcare bill .. when MA already has it.. and has some budget issues because of it.. maybe they dont think it works that well..

Okay…let’s go one by one…

1. Best Healthcare: I absolutely agree that we have the best MEDICAL care in the world in that our doctors, medicines and facilities are amazing, new, modern, clean, innovative and…accessible to the insured or wealthy. Which leads us to this new phenomenon of medical tourism (seriously…it’s in Wikipedia) which means Americans are going overseas to get medical treatment elsewhere b/c the hoops we need to jump through to access this amazing medical care are too great.
2. Reform: Let’s call it what it is…it’s not about healthcare reform. It’s about insurance reform. Think about it…right now the only source of revenue for either doctors or insurance companies is YOU. So the doctors push through more testing to get more reimbursement and the insurance companies compensate by charging us higher premiums.  Your doctors and your insurance companies are at odds and we are the innocents here. Add lawyers and the threat of malpractice to the mix and phew…you’ve got a real case for reform. I don’t necessarily think the government can do it better but heck, they are the only ones who are coming up with ideas and even admitting it’s a problem, so there ya go.
3. Social Security: There are several reasons one might request social security benefits…either for retirement or disability. Each format has a lot of regulation around it. I have yet to hear of an “old person denied SSI” just because. I’ve heard of folks denied disability for well documented reasons. But I’m with ya. I’d MUCH rather my cash go in to supporting the retired workers who followed the rules over “lending it” to help bail out the banks that caused this mess or support a war that serves no purpose.
4. Prescriptions: That’s a relatively easy one. While I agree they are too expensive, I understand why. The average drug takes 12 to 15 years of hard, non-revenue related effort to come to market. To give you an example, one of the biggest innovations in cancer treatments is based largely on the mass production of Chinese Hamster Ovaries. Seriously. Not kidding. How long do you think it took them to figure that out? In any case, innovation is always the result of a lot of trial and error, usually by incredibly bright, brilliantly educated, focused people. The process is long. It’s frustrating. And it only results in an approved drug coming to market like less than 1% of the time. If we didn’t support this process, cures and innovations would not happen. And without innovation, we wouldn’t be America. That said, there are a gazillion programs pulled together by these drug companies to assure the drugs are more accessible…IF your insurance company lets you.
5. No doctors supporting healthcare reform? The 245,000 members of the American Medical Association actually endorses the more liberal House bill which includes a public option.
6. So the good doctor thing…of COURSE everyone wants a good doctor and I now segment doctors into two categories: doctors who become doctors to get rich and doctors who become doctors to help people. My primary care physician actually won’t deal directly with insurance companies anymore and only takes cash (this happens in South America too) because it’s truly the only way she can “know” her patients. No more :15 appointments. All because over 40% of every $1 spent on primary care traditionally goes toward costs associated with insurance billing and reimbursement. The whole “in or out of network” plus HMO vs. PPO seems much more a barrier to good doctors than not.
7. The Congressional Insurance plan. If they had the plan we have, 15% of them wouldn’t be covered at all. I think the question is why don’t WE have the same plan that THEY DO. Which is essentially what the  House bill was seeking to do. And keep in mind they don’t provide the system to us…which is also what we are trying to fix. I’m all for it. Them providing us with a system that’s good enough for everyone to use.
8. And finally…Coakley. The Massachusetts health plan was SO good that even Brown himself voted it in. I bet he forgot about that. And the resulting budget issues…they are going state to state faster than Swine flu. No vaccine yet.

Sure it’s flawed…but look at my response to drug prices above.

Imagine how much we would learn if no one was willing to take risks and learn from the results. We’d stop progressing. We’d never innovate. We’d learn nothing. Nada. Zilch. And I like learning.

All right…I’m done. Putting my soapbox away. But delighted to finally be discussing issues and not gimmicks. I do say it’s kind of interesting to be having this debate with very people who used to buy me beer when I was underage. Who woulda thunk.

Unintended Accountability

Ho ho ho! Xmas is right around the corner and so are a lot of resolutions. Thought I’d revise an observation I had in an earlier post about human accountability missing from our future b/c of technology. My premise was human…if you make a poor decision based on information you received through technology (a phishing scam, a Yelp review, an Amazon recommendation), are you really accountable for the poor decision or does this set a precedent that bleeds over into our day to day behavior? “Don’t blame me for your crappy meal and resulting food sickness. Yelp told me it was great.” It’s a quandary, but I think I see an unintended consequence to all of this.

Remember in school where you were always threatened with the public record that will follow you around for the rest of your life if you misbehaved? The thought made blood run cold in school children everywhere. NOT the permanent record! Ack! People got it together faster than you could say Win 7.

Nowadays it seems we are signing up willingly for the public record. And it IS following us around. And the results ain’t pretty. Two stories in particular I’ll highlight.

Facebook and Depression: The story is here, but the storyline is that a Canadian woman claimed she had lost her health benefits after her insurance company used her Facebook pictures as evidence that she was no longer depressed. It was interesting to see how it played out in social media. Many people were outraged by what they considered an egregious violation of privacy (a theme for Facebook) yet I tend to err on the other side. I’m no medical professional, not trained in healthcare, etc. but logic tells me that if you are going to post something…anything…on a social platform that visually tells a story the opposite of the one you are telling verbally, you’re guilty until proven innocent. Do I think it’s fair? Nope. Do I think it’s right? No way. But will I be explaining this concept to my children as they start to engage in social? You bet I will. If you claim unhappiness and leave a trail of glee on Facebook, then no. Your right to privacy won’t protect you. And it’s pretty much your own fault. You put it there on a public platform.

Quite a Tiger: The other story is still headlines and they keep coming. Seems Tiger Woods is the media gift that keeps on giving this holiday season. Another victim of the obvious trail technology leaves behind. And through the magic of modern technology, not only is Tiger’s wife pissed, but so are the nearly 12 mistresses as they found out…one by one…that they weren’t the only person he was cheating on his wife with. So they take their anger on the road to…where else? Social media. It’s a social Tiger fest! Tiger’s at the bottom of the food chain. All things Tiger are at the top of CNN’s newspulse, you can’t go anywhere without seeing a new text message or hearing the fateful “my wife has my cell phone” message. Tiger has single handedly launched a dozen careers in classy reality television.

Seriously, Tiger? You went to Stanford for God’s sake.

[Sidenote: You know the Heene family of Balloon Boy fame is thinking "why didn't WE think of that??"]

So you can see I’ve reversed a bit. While too much technology could potentially dumb down society by not making it necessary to think or make cognitive choices based on our own intellect, there are already a lot of stupid people out there. So I suppose I feel better.

Government Intervention isn’t ALL Bad.

It’s been interesting to hear that there is a segment of people who believe that no good can come out of government involvement in our daily lives. I have to laugh (and roll my eyes in disbelief) because these are the same folks who seem to feel that the government has no role in our daily lives today, and to them, I submit this wonderful story below, that was provided to me on Facebook by an unknown author:

This morning I awoke to the sound of my alarm clock powered by electricity generated by the Public Power Monopoly regulated by the US
department of energy. I then took a shower in the clean water provided by the municipal water utility. After that, I turned on the TV to one of the FCC regulated channels to see what the Weather Service of the National Oceanographic and Atmospheric Administration determined the weather would be like today using satellites designed, built and launched by the National Aeronautics and Space Administration. I did this while eating my breakfast of US Department of Agriculture inspected food and taking drugs determined safe by the Federal Drug Administration.

At a time that has been kept accurate by the National Institute of Standards and Technology and the US Naval Observatory, I got into my National Highway Traffic Safety Administration approved automobile and set out to work on roads built and maintained by local, state and federal departments of transportation. I checked my mail delivered by the US Postal Service and dropped the kids of at public school, then stopped for fuel of a quality regulated by the Environmental Protection Agency.

After work I drove my NHTSA car on DOT roads back home, which has not burned down because of state and local building codes and a fire
marshal’s inspection. My house has not been plundered in my absence because of the local police department.

I then log onto the internet which was developed by the Defense Advanced Research Projects Administration and post here about how socialized health care is bad because the government can’t do anything right.

And while we’re here, the “hey government, stay out of my Medicare” sign is…well…stupid.

Something to Back Away From…

Any designer worth his/her salt knows that the clearest path to great design is to provide a big, bodacious, terrifying idea and then slowly back away from that, in partnership with your client. You also know better than to present a design that you don’t truly believe in yourself. Is it a political trick? Sure, but in the end, you get to innovative solutions by deliberately pushing your clients out of their comfort zone. That tension is necessary to drive innovation and start the conversation outside of preconceived restraints.

I have a theory about Obama’s Healthcare Reform and the surrounding firestorm. The guy is obviously no slouch. And he’s innovative. I have a bet that the last few months of Town Hall shout downs, viral videos, Fox News, Sarah Palin hysteria are all part of pushing us all out of our comfort zone, where now, as a society, we will start to come together to define and support the plan that he had in his mind all along.

From Huffington Post

As they say, in the absence of true leadership, true leaders emerge. I believe this is a test. That Obama has deliberately stepped aside from this process to see who would emerge as willing to work and willing to engage at a constructive level (kudos to Olympia Snow – R, for being one of the few).  It’s a risky move, but the potential payoff this early in a presidency could be huge moving forward together.

In the end, we will ALL have compromised but we will ALL have had our say. And we WILL end up with a healthcare plan that will cover every American…public option or not. It WILL be better. And it WILL get done. Just like he said.

Follow Up: UX Process + Healthcare Reform = Universal Understanding

I recently posted an entry on how the healthcare reform issues cropping up in Town Halls could be tamed by simple, illustrative explanation. In light of that, I’ve found a bunch of amazing examples of storytelling that really put the substance of the initiative in new light for me. Thought I’d share two in particular.  The net/net is that a) we will pay anyway and b) we can now decide how we pay.

Healthcare Reform on the back of a napkin:

And a wonderful video that compares government involvement in healthcare to say, government involvement in saving your burning house.

What the bleep is social media?

Love this ethnographic look at where we are today in social.

How the UX process can help healthcare reform.

I often find myself in the position of having to explain the impact of a new system, website or online experience to a group of skeptical stakeholders. It’s part of being a UX designer. It’s noted that you can talk and talk about potential options and review technical specifications until you’re blue in the face, but the minute you show something and telling stories about its use, things start to get interesting.

Recently I have been doing a lot of pitches utilizing user scenarios…showing how a potential user experiences a brand in one way today, and then showing how the experience we are designing will be different for them (and hopefully, better). It’s contemporary storytelling with pictures. For grownups. It re-centers the conversation and gets everyone excited and engaged in helpful dialogue and focused on constructive improvements. Imagine that.

It would also get Sarah Palin to shut the bleep up.

What if Obama’s team…already so tech savvy and forward thinking, could create interactive scenarios that demonstrated, through real before and after stories, how the healthcare policies he is proposing would work for the better? Three that come to mind:

• Middle class family where the breadwinner is laid off (I know 6 families already that could be models).
• Elderly, terminally ill senior who is unable to make decisions. (And sorry, Chuck Grassley. She didn’t do it 20 years earlier either. Sure she should have. But she didn’t. Isn’t hindsight always 20/20?)
• And the illegal alien who injured himself on the job, gardening for peanuts for someone opposed to healthcare reform b/c it’s too expensive. (Apparently so is a legal gardener.)

The set up is simple:

1. Set up the problem (see above).
2. Show step by step problem resolution in today’s system (SOL folks).
3. Illustrate benefits/pain points.
4. Show step by step problem resolution in system you are proposing.
5. Illustrate benefits/pain points.

It’s certainly not rocket science, and it’s time for the amazing people we worked so hard to elect to start offering something (other than impressive rhetoric not being shouted down) in response to the hysteria.

Give us something…relatable.

Scenarios work every time for me. I’d even help you illustrate them.