Monday, July 16, 2007

Updates: Sicko, Wellmark, UIHC, Search, Prisons, Bikes

July 16, 2007, 6:15, 6:45, 7:45 a.m.

Updates: Sicko, Wellmark, UIHC, Search, Prisons, Bikes

Sicko

Marcy and Ed Rolene, "Thank You to Dean, Faculty," Iowa City Press-Citizen, July 16, 2007, p. A9 ("We drove to Cedar Rapids to see 'Sicko.' It confirmed what many Americans already believe. Health insurance companies look out for their bottom line, not for the health of the public.")

"The health of the public?" "Public health?" Hmmm. Could there be a connection here? Has Wellmark been moved to generosity by a Michael Moore movie? Was "The Wellmark College of Public Health" a preemptive strike, designed to associate "health insurance company" with "public health" in a positive way in the public's mind at the same time "Sicko" is being watched by millions of Americans?

"Sicko" very powerfully documents the role of insurance companies in denying Americans health care under our system -- not to mention their lobbying and campaign contributions designed to deny Americans the kind of health care system enjoyed by citizens of countries who are provided the benefits of universal, single-payer systems. Those countries provide their citizens health care for all, free to the recipient, at a lower cost to the society to cover all than we pay to cover some, with better results in terms of public health generally, including longer life expectancy and lower infant mortality rates than we have.

Anyhow, although the Rolenes had to drive to Cedar Rapids to see the film, Iowa City residents -- living as we do in what the Marcus Theaters considers a little, backwater, rural Iowa town -- will actually be able to give the theater chain our money to see "Sicko" locally this Friday, I'm told.

No health care delivery system is perfect -- not ours, not those of other countries. But I challenge anyone to watch that film with an open mind, from start to finish, and then explain to me why they still think the system we have is on balance better than the systems offered the citizens of the rest of the industerialized world. Elected public officials should be forced to watch "Sicko" -- and then report to the world how much money they've taken from the insurance and big pharma industries.

The Wellmark College of Public Health: "Gift" or Shrewd "Advertising Buy"?

Talk about being defensive! The following sounded more like the wild and crazy ranting of a deranged blogger from inside an insurance company board room than something that would come from an editorial board room: "pointless academic principles," "sudden attack of the ethical heebie-jeebies," "drum roll please," "interesting that the college was OK accepting the corporation's lavish gift, but apparently only as long as the outside world was unaware of the source." (Of course, no one ever said "the outside world" should be "unaware of the source" of the gift. Such gifts are always acknowledged with public announcements -- unless the donor wishes for them to be anonymous. That had nothing to do with the issue, which was the possible adverse consequences of an unprecedented naming of a University of Iowa college for a corporation.) I think the "thistle" should have been awarded to the Register, not the University. "Roses & Thistles: Iowa School of Public Hypocrisy," Des Moines Register, July 15, 2007, p. OP 1.

Press-Citizen's Single-Subject Op Ed Page: "Naming Right Draws Passionate Responses," July 14, 2007, p. A 15

Gregs G. Thomopulos, "No Strings Are Attached to Wellmark's UI Gift"
[Thomopulos is a Wellmark board member]

Jim Lewers, "How Much is $15 Million? A Lot, But That Doesn't Matter" [So far as I've been able to discover this column is nowhere available on the Press-Citizen's Web site.]

Letters:

Peter Hansen, "Possible to Sell Out the Entire University"

Garry Kuhl, "Time for Wellmark to Return to Origins"

Kembrew McLeod, "A 'Gift' Should Have No Strings Attached"

Mike Woodhouse, "How Does Wellmark Have All That Cash?"

Wendy Luxenburg, "Faculty Decision Was the Right One"

UI Governance, UIHC, Wellmark, President

Brian Morelli, Dean Says UIHC CEO Role Being Stripped; Documents Show Insiders' Concerns," Iowa City Press-Citizen, July 14, 2007, p. A1

"Gary Fethke E-Mail to James Merchant" [June 5, 2007], Iowa City Press-Citizen, July 14, 2007

"Katen-Bahensky Letter to Gary Fethke"
[December 5, 2006], Iowa City Press-Citizen, July 14, 2007

I have no idea what this is all about -- except that I imagine, as the captain of the Titanic discovered with regard to icebergs, that there is probably a good deal more below the surface than above.

There are some really tough governance and organizational issues here. So I'm left with general observations based on my administrative and managerial experience.

* When everybody is in charge, nobody's in charge. There's a value to having clean lines of responsibility with as few levels of reporting as possible -- up to and including the near-flat organization.

* There's no magic organizational alternative to good rapport among humans who like and respect each other and "play well with others." As much as one would sometimes like to "get the humans out of the loop," as it was phrased in the 1983 movie, War Games, as that film demonstrated we can't do it all with computers -- or with organization charts.

* The devil is in the details -- not in the organization charts. As Maritime Administrator I made a point of interviewing as many of the thousands of employees as possible about the details of their work days. That's the level at which meaningful "re-organization" -- not to mention improvements in morale -- needs to be done. It's a sub-set of MBWA -- management by walking around. When MARAD later became part of a "reorganization" effort the boxes were moved from the Department of Commerce to the Department of Transportation -- by individuals who had never set foot in the agency. The organizational issues I had earlier spotted and resolved -- or not -- were simply moved from one cabinet department to another without ever being addressed in the process. I have no way of knowing, but I would not be stunned to discover that the UIHC and College of Medicine could benefit from the kind of reorganization effort I put in at MARAD -- before addressing the design of the boxes on their organization charts.

UI Presidential Search

Diane Heldt, "Presidential Search to Cost UI $315,000," The Gazette, July 14, 2007, p. A1

Brian Morelli, "Second President Search Cost Over $81 K,"
Iowa City Press-Citizen, July 14, 2007

Prisons for Our Mentally Ill

Jennifer Hemmingsen, "Special Needs Unit Unveiled,"
The Gazette, July 14, 2007, p. B1

Rachel Gallegos, "Oakdale Unit Meets Prison Health Needs," Iowa City Press-Citizen, July 14, 2007, p. A3

Bicycling

Kathryn Fiegen, "Bike Riders Go the Distance and Eat All Along The B-Eat-en Path; Better Bikes Have Cyclists Traveling for a Bite to Eat,"
Iowa City Press-Citizen, July 15, 2007, p. A1

Rachel Galegos, "'Tour de Brew' Rides Across Eastern Iowa; Official Says Event's Attendance has Doubled Over Every Year Held," Iowa City Press-Citizen, July 15, 2007, p. A3

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1 comment:

John Barleykorn said...

Again, you are right about the insurance companies. But, the Single Payer system is not the solution. Just remove the middle men and open the market to competition. If the government wants to provide a standard catastrophic policy, that would be ok. But, we need the cost containment that only the market can bring. Again, a medical service is still an economic good. There is a cost to the doctor's expertise, training, and equipment that they need to cover in addition to making a living for themselves.

As for your challenge...there are plenty of people...many of them union employees for AFSCME, PPME, etc. who insist on putting BCBS health plans as a collective bargaining item contained within contracts. So, yes many people do love their own health plans.