Personal Accountability

This has always been an interesting topic to me. Some of the events of the last few weeks ranging from athletes punching one another out to kids returning to school seems to make it particularly relevant.

A colleague and I were discussing this topic the other day especially as it pertains to health care. Isn't it interesting for all the debate about whether there should be single payer, a public option, how much it will cost, etc. there is little discussion about the individuals role in the whole health care discussion other than as a beneficiary.

I have some pretty strong opinions on this topic. Among them I believe that all Americans should have access to a basic level of health care much like public education and that until we provide that the costs will never really be managed.

I also believe that individuals have a right and responsibility to participate in the management of their own well being and health. We don't talk about that very much. I would venture to say that the majority of Americans who have health insurance are also covered by a group plan- employer, government agency, association, etc. so they have little understanding of how much their health care actually costs and care less until it impacts them in the way of increased co- insurance, higher deductibles, denied claims, or related activities.

I have mentioned a couple of other related concepts regarding health care like our inefficient delivery and focus on the costs of processes rather than paying for outcome based management, but this is a different issue.

I remember years ago when a new employer arrived in town and declared a tobacco free workplace. People were outraged. How interesting? An employer who took the position that if you knowingly contributed to the detriment of your own health they didn't care to subsidize your real or potential higher expenses so they wouldn't hire you.

We tried to pass a law recently requiring all restaurants to post calorie counts for everything on their menu, luckily it failed. Would we want to extend that to homes like the dram shop laws?

Dram shop laws extend liability to private individuals for serving intoxicated people or allowing them to depart your home intoxicated without at least attempting to intervene. Can you see requiring a menu with calorie counts at dinner parties?

I think a big part of the issue is that of personal competency. Personal competency is that "other" right that constitution provides us with in addition to the concept of personal property.

When we began to industrialize and people left the "farm" many went to work for large employers. Large employers responding to both collective bargaining and offering competitive compensation began offering "fringe benefits" including paid time off, retirement and pension plans, and group health insurance benefits. A few years ago it was not atypical for employers to pay all the costs for health insurance for employees and their dependents. Employees had no idea and didn't care what they cost. Add these third party payer systems to advance health care techniques, technology, and a few other things and we created a trillion dollar health insurance industry, and very high expectations.

Very few employers to my knowledge even today talk extensively with their employees about ways they can contribute to lowering health care costs. The idea of "mandated" health screening, enforced wellness, and sliding employer contribution rates based on lifestyle health care costs would probably be seen as some type of corporate fascism. Your employer shouldn't be able to tell you how to manage you lifestyle, right? Even if they pick up the majority of the cost....

I believe until we address the personal accountability issue and employers
actively engage and educate their employees about the root causes of many of the costs we will only be addressing part of the problem. What do you think?

Where Were You When The World Stopped Turning

Alan Jackson, the great country singer included those lyrics in his beautiful song about 9/11. Tomorrow we recognize the eighth anniversary of that event. I remember the shock, disappointment, anger, and horror I experienced that morning and over the next several days.

I also remember that although there was some very real ugliness, I felt like Americans and even the world had come together in a way that I hadn't seen in a very long time.
It is interesting to think about our "journey" over the last eight years. What have we learned from it?

I agreed I think with the majority of Americans that finding the perpetrators and ensuring that this kind of thing would never happen again was a primary objective. I am sad to find us engaged in two wars in some part directly connected to that event and feeling a little like we haven't made much progress understanding Islam or its followers and that in our desire to punish the guilty we have alienated a lot of others.

When I look at some of the angry rhetoric being exchanged over economic policy, health care, and related issues I wish we had some of that bipartisan spirit that we exhibited post 9/11 to addressing some of our current domestic issues. Don't mistake what I am saying, I am not an apologist for terrorism. I still firmly believe that those responsible for 9/11 and other terrorist incidents should be hunted down and prosecuted with a degree of finality that sends a message.

Maybe I am naive in believing that the current economic and health care situations also represent a crisis. Why can't we collaborate on solving those issues. I will admit I don't have a cogent answer.

So I guess what I will have to settle for is gratitude for the thousands of men and women in our armed forces who have served and will continue to serve to allow us to "debate" our differences. They don't get to debate policy, they just protect their country, some of them with their lives.

So amongst others I will fly my flag tomorrow in memory of those who died and those who serve. I will think back about the heroes during those immediately following days. I will also think wistfully about a nation standing together and hope it doesn't take another tragedy to unite us to that level. What will you do?

Whole People

I am a big believer in the concept of whole people. On Thursday evening a football player from the University of Oregon in a state of high emotion made a terrible decision and struck a player from the opposing team. He also had to be restrained from striking others.
The player in question is 22 years old and had up to that point had a promising career even to the point of being mentioned as a potential Heisman candidate.

Within 24 hours his coach announced that his collegiate football career, at least at Oregon, was essentially over. The coach did also announce that the young man would be allowed to remain on scholarship with the team to continue to provide him with the structure he needs to fully develop as a person. Sounds like pretty good thinking to me.

In the heat of emotion a young man made a terrible judgement. His coach decided not to let that singular act define him. In the last 48 hours I have seen the young man and the program vilified. People have screamed for his prosecution and used it as an attack on collegiate athletics. Really? Is this what we have come to? Is it really unreasonable that the program took 12 hours to decide an appropriate course of action?

I have been a practicing human resources executive for over thirty years. In a number of times during the course of my career I have participated in deciding the appropriate corrective action to take when an employee has made a bad decision. I say corrective action, because that is my philosophy. The intent is to correct and to create a learning and a different outcome for the future not to punish.

I have seen occasions in college football and in professional sports where athletes were arrested and then allowed to play. That in my mind is inappropriate. We literally have a situation in my home town where the commissioner of a local utility was arrested on felony drug and weapons charges and is claiming harassment. She has indicated (and her supporters agree) that this should not be cause to request her resignation. I wonder how many of her supporters are baying for the young football players blood?

I applaud the decision on the part of the coach. He took in my mind appropriate action. The behavior was unequivocably unacceptable. He also took into the context the whole person who is this young man and said to throw him away and remove the structure of the team represented actions that were too harsh. College isn't about sports it is about education, educating the whole person. An important statement was made, we look at you in totality. If you make a poor decision you will be sanctioned, you will not be thrown away.

I also hope the media will get bored with replaying the incident over and over again. They aren't playing it as a learning experience, but capitalizing on a tragedy. Shame on them, shame on us.

For those of us that are parents I wonder how we will react when it is our child that makes an error in judgement, and trust me they will. Will we scream for their arrest and banishment, or will we we plead for their whole person to be taken into context? I think in our hearts we know the answer.

I am going to try and keep dealing with whole people, how about you?