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Archive for the ‘Healthcare’ Category

FIGHTING DIABETES

Posted by Tim Bryce on May 1, 2017

BRYCE ON LIFE

– One man’s fight against Type 2 Diabetes.

Click for AUDIO VERSION.
To use this segment in a Radio broadcast or Podcast, send TIM a request.

I recently announced on Facebook I had worked my way off of Diabetes medication, having been able to lower my blood sugar levels over a four month period. This resulted in a landslide of congratulatory messages from friends on achieving this goal, of which I give thanks. In doing so, it made me realize how sensitive people are becoming to Type 2 Diabetes and that maybe my story could benefit others.

Following a physical exam last Fall, I took a blood test which revealed elevated blood sugar levels (333 + 10.5). Frankly, I wasn’t surprised as I knew I had developed an addiction to low-carb sports drinks, apple juice and orange juice. The carbs were low but I wasn’t paying attention to the sugar content. My father also suffered with Diabetes, so when my doctor informed me of the problem, I paid attention. He said I could either address the problem myself or take a pill. At first, I decided to address it myself.

I immediately implemented a cease and desist on all of the drinks I had been consuming, along with alcohol. I was told to also eliminate bread, pasta, and sweets from my diet, which presented no problem to me, and I concentrated on protein. I do not normally enjoy a lot of sweets, but I discovered sugar-free Popsicles satisfied my occasional craving.

As to alcohol, I missed my end of the day beer or glass of wine, but I figured if I could conquer smoking, as I did two years ago, I could also set aside booze. Only once during the next few months did I surrender to a lite beer, but this made me feel physically bad and instinctively realized I couldn’t pursue it any longer. By January, my numbers had dropped to 250 + 9, and by February it was 198 + 8. This didn’t satisfy my doctor who recommended I try a pill to accelerate the reduction, specifically Metformin.

Also around this time, I joined a gym and began to exercise regularly (you may remember my column on “My Trip to the Gym”). In addition, I was taking a fat burning pill available from the drug store, Lipozene. Between the exercise, my new diet, lack of alcohol, and the diet pill, the pounds melted off rather quickly. So much so, I am now faced with having to buy new clothes.

During the two months while I was on Metformin, I began to experience some strange side-effects, such as muscle aches and pains, overly sensitive to cold, nausea, trouble breathing, uneven heart rate, and dizziness. The net result was I experienced difficulty in sleeping, causing me to stay awake as late as 3:00am or 4:00am. This made me feel like a zombie during the day and my family noticed a decline in attitude and well being.

In late March, I complained to my doctor about my situation and he ordered another blood test. Remarkably, my numbers were down to 149 + 7, within normal range. Noting my symptoms, he ordered me off the Metformin, which represented an Independence Day of sorts for me. I want to note here that Metformin may be a good drug for combating Type 2 Diabetes for some people, but it didn’t sit well with me personally. Over the next few days, my symptoms abated and I began to catch up on my sleep.

In researching this article I was alarmed by the number of people affected by Type 2 Diabetes (aka, diabetes mellitus). According to the National Institute of Health, it “is now fast emerging as one of the biggest health catastrophes the world has ever witnessed. Almost 6% of the world’s adult population now live with diabetes (Sicree et al, 2003; International Federation of Diabetes, 2006). It has been predicted that the total number of people with diabetes will rise to 366 million in less than 30 years if preventative action is not taken.” The consciousness of the people is swiftly rising in regards to this, which probably explains why I had so many well wishers send me congratulations.

I wanted to celebrate my achieving “normalcy,” but I realized I am now a man in his sixties who cannot live as he did back in his twenties or thirties. Consequently, I haven’t given up on my exercise, diet, or fat burning pill, at least not until I am confident I am stable. As far as soft drinks go, I primarily enjoy Diet Mountain Dew as it has both zero calories and zero sugar (plus it reminds me of my youth when Pepsi-Cola rolled it out in the mid-1960’s as a Hillbilly drink, e.g, “Yahoo, Mountain Dew; It’ll tickle your innards!”).

Although I won’t go back to beer, wine, or certain other sugar based spirits, I allow myself an occasional glass of Scotch whiskey which uses no sugar. I figure since I can no longer smoke or have a beer (I never indulged in recreational drugs), I needed at least one vice to get me through life. Otherwise, it is time for a Viking funeral where I fire up the Kingsford.

One last note, I am indebted to my doctor and old friend, David Lindberg, for guiding me through this difficult period. He listened patiently to me, diagnosed my problems, and was smart enough to know when to back me off the Metformin.

As the Stones said, “What a drag it is getting old…”

Also published in The Huffington Post.

Keep the Faith!

Note: All trademarks both marked and unmarked belong to their respective companies.

Tim Bryce is a writer and the Managing Director of M&JB Investment Company (M&JB) of Palm Harbor, Florida and has over 40 years of experience in the management consulting field. He can be reached at timb001@phmainstreet.com

For Tim’s columns, see:   timbryce.com

Like the article? TELL A FRIEND.

Copyright © 2017 by Tim Bryce. All rights reserved.

Also read Tim’s columns in the THE HUFFINGTON POST

NEXT UP:  JOB ENTITLEMENTS – Who says you are entitled to it?

LAST TIME:  HOME IS WHERE THE HEART IS  – Be it ever so humble…

Listen to Tim on WZIG-FM (104.1) in Palm Harbor,FL; KIT-AM (1280) in Yakima, Washington “The Morning News” with hosts Dave Ettl & Lance Tormey (weekdays. 6:00-9:00am Pacific). Or tune-in to Tim’s channel on YouTube. Click for TIM’S LIBRARY OF AUDIO CLIPS.

 

Posted in Healthcare, Life | Tagged: , , , , | 3 Comments »

THE AMERICAN HEALTH CARE ACT; HERE WE GO AGAIN

Posted by Tim Bryce on April 10, 2017

BRYCE ON POLITICS

– It looks like history is going to repeat itself.

Click for AUDIO VERSION.
To use this segment in a Radio broadcast or Podcast, send TIM a request.

NOTE: This column was originally published in late March, prior to withdrawing the legislation. The point remains valid.

I have some grave reservations about the pending American Health Care Act, not because of political or health care reasons, but for management. Eight years ago I wrote about the outrage I had in how Mr. Obama’s Affordable Care Act was concocted behind closed doors and written by lawyers. Any company embarking on such a huge undertaking would have first developed a Feasibility Study in order to make a proper business decision. This would have included a Project Scope specifying the limitations of the project, a Current Systems Analysis describing the strengths and weaknesses of the current system, Requirements to define the specifications for the new product, a System Approach to satisfy the requirements (with consideration given to proposed alternatives), a System Evaluation to enumerate the costs, schedule and financing of the System Approach, and finally a Review with participants signing off on the project.

This did not happen back in 2009 and it is not happening in 2017. Despite their best intentions, the Republicans are approaching this in the same manner as the Democrats. Today’s American Health Care Act may be much smaller (123 pages) than what Mr. Obama offered, but it is still written with legal blather. Click to download a PDF version of the document.

I would have liked to have seen a Feasibility Study built in a Congressional Committee with input from both parties, not just one. A frank and open discussion would be one way to de-politicize the bill and build consensus, something we haven’t seen in our nation’s capitol for quite some time. Wouldn’t it be interesting to read an accurate description of the strengths and weaknesses of the current system? In addition, I would have also liked to have seen someone think beyond mere insurance and consider such things as Tort Reform and the nightmare medical systems now in place, but such is not the case.

As I wrote in 2009, “If our Congress went through the motions of building a true Feasibility Study, it would promote cooperation through effective communications, thereby eliminating partisan sniping; it would produce a proper solution for the right set of problems, and; it would go a long way to improving the trust in the government by the American people, simply by assuring them that the “T’s” were crossed and the “I’s” were dotted (that it has been thoroughly thought through).”

Politicians will read this and claim it’s nice, but “We don’t have time to do it right.” Translation: “We have plenty of time to do it wrong.” This is the same excuse I commonly hear from programmers who practice “Fire, Aim, Ready,” as opposed to “Ready, Aim, Fire.”

Consider this, had we performed a proper Feasibility Study back in 2009, we wouldn’t have this discussion now and we would have implemented a system we all are proud of, not a partisan pile of legal gibberish. Regrettably, it appears history is going to repeat itself.

Related article: WHY THE AMERICAN PEOPLE HATE OBAMACARE

Also published in The Huffington Post.

Keep the Faith!

Note: All trademarks both marked and unmarked belong to their respective companies.

Tim Bryce is a writer and the Managing Director of M&JB Investment Company (M&JB) of Palm Harbor, Florida and has over 40 years of experience in the management consulting field. He can be reached at timb001@phmainstreet.com

For Tim’s columns, see:   timbryce.com

Like the article? TELL A FRIEND.

Copyright © 2017 by Tim Bryce. All rights reserved.

Also read Tim’s columns in the THE HUFFINGTON POST

NEXT UP:  THE STATE OF I.T. IN BUSINESS – Have we really made progress?

LAST TIME:  EXPLAINING JACK BENNY  – And his lesson of teamwork.

Listen to Tim on WZIG-FM (104.1) in Palm Harbor,FL; KIT-AM (1280) in Yakima, Washington “The Morning News” with hosts Dave Ettl & Lance Tormey (weekdays. 6:00-9:00am Pacific). Or tune-in to Tim’s channel on YouTube. Click for TIM’S LIBRARY OF AUDIO CLIPS.

 

Posted in Healthcare, Politics | Tagged: , , , , | 2 Comments »

MORE PROBLEMS IN DOCTOR OFFICES

Posted by Tim Bryce on December 9, 2013

BRYCE ON HEALTH CARE

– Poorly designed systems, as dictated by the federal government, are strangling physicians.

(Click for AUDIO VERSION)
To use this segment in a Radio broadcast or Podcast, send TIM a request.

In the past, you have heard me talk about system snafus in Doctor offices, both systems and their inordinate dependence on fax machines. Suffice it to say, doctor offices are perhaps the most barbaric from an administrative point of view, not because they want to run this way, but because the federal government is forcing them to. Now, it appears it is going to go from bad to worse, thereby stretching their patience to the breaking point.

As I’ve written earlier, the government is forcing doctors to prepare extensive electronic records on their patients. This means doctors and nurses are spending more time performing data entry and less time caring for people. I might understand if the data is assembled according to standards, thereby providing the means to easily transfer it from one system to another. Unfortunately, it doesn’t which explains why doctors are so dependent on fax machines to transfer patient data, a horribly primitive approach in this day and age.

According to my doctor friends, more trouble is brewing. On October 1, 2014, all medical diagnosis coding will convert from ICD 9 to ICD 10 codes. The number of codes will increase from 17,000 to 141,000. The codes are supposed to be very specific so that disease processes can be narrowly described with one code number. Here are some examples:

W59.22 Struck by turtle
W59.22XA … initial encounter
W59.22XD … subsequent encounter
W59.22XS … sequela
W59.29 Other contact with turtle
W59.29XA … initial encounter
W59.29XD … subsequent encounter
W59.29XS … sequela

V96.01 Balloon crash injuring occupant
V96.01XA … initial encounter
V96.01XD … subsequent encounter
V96.01XS … sequela
V96.02 Forced landing of balloon injuring occupant
V96.02XA … initial encounter
V96.02XD … subsequent encounter
V96.02XS … sequela
V96.03 Balloon collision injuring occupant
V96.03XA … initial encounter
V96.03XD … subsequent encounter
V96.03XS … sequela
V96.04 Balloon fire injuring occupant
V96.04XA … initial encounter
V96.04XD … subsequent encounter
V96.04XS … sequela
V96.05 Balloon explosion injuring occupant
V96.05XA … initial encounter
V96.05XD … subsequent encounter
V96.05XS … sequela

V91.05 Burn due to canoe or kayak on fire
V91.05XA … initial encounter
V91.05XD … subsequent encounter
V91.05XS … sequela
V91.06 Burn due to (nonpowered) inflatable craft on fire
V91.06XA … initial encounter
V91.06XD … subsequent encounter
V91.06XS … sequela
V91.07 Burn due to water-skis on fire
V91.07XA … initial encounter
V91.07XD … subsequent encounter
V91.07XS … sequela
V91.08 Burn due to other unpowered watercraft on fire
V91.08XA … initial encounter
V91.08XD … subsequent encounter
V91.08XS … sequela
V91.09 Burn due to unspecified watercraft on fire
V91.09XA … initial encounter
V91.09XD … subsequent encounter
V91.09XS … sequela

Seems kind of silly doesn’t it?

For each injury or symptom, the physician will be required to enter one of these codes into the electronic patient records, from a list of 141,000. Hopefully, there will be some on-line help to point doctors in the right direction, but more likely they will have to reference a paper manual in order to look-up the proper entry.

In systems parlance, the code itself is referred to as a “group” data element, meaning it is a concatenation of data elements. We can find examples of “group” data elements in such things as a telephone number (area code-exchange-number), credit card numbers (financial institution-branchID-account-number), check numbers, power company numbers, and many more. It is simply a way to uniquely assign numbers in order to prevent redundancy.

In the example above, the code is probably decomposed accordingly:
First character (alphabetic) – Type of condition
Positions 2+3, Accidents/Conditions by general category
Position 4 – a decimal (presumably to delineate categories from treatment of conditions)
Positions 5+6 – Specific accident/condition
Positions 7+8 – Treatment

In other words, it’s a taxonomy for specifying a specific medical action. The government’s solution though is to force medical personnel to memorize these codes or look them up in a voluminous document or on-line help. A simpler way would be to provide a series of simple prompts to guide people through the taxonomy and assign the proper code.

One doctor friend claims he was told the new coding system will be very difficult to implement, such that insurance claims submitted will not likely be processed because of “computer glitches” in accepting the claims. Errors in uploading and downloading the encrypted codes are likely. So much so, the government is encouraging physicians to secure a six month line of credit to ensure their practices can remain open while the claims fiasco is corrected. He claims this is described by the government and mentioned on Medicare websites in many states.

I have dealt with a lot of information systems over the years, but I’m beginning to think we no longer know how to build them. Obamacare is as glaring an example as I can think of, this is another.

Currently, physicians are spending as much as 2-3 hours each day on meaningless computer work to satisfy government regulations. Time which does not improve the care of patients. Unfortunately, as of next October 1st, it will get worse and we’ll likely see many experienced doctors finally throw in the towel.

Keep the Faith!

Note: All trademarks both marked and unmarked belong to their respective companies.

Tim Bryce is a writer and the Managing Director of M&JB Investment Company (M&JB) of Palm Harbor, Florida and has over 30 years of experience in the management consulting field. He can be reached at timb001@phmainstreet.com

For Tim’s columns, see:
timbryce.com

Like the article? TELL A FRIEND.

Copyright © 2013 by Tim Bryce. All rights reserved.

NEXT UP:  SUPPORT YOUR LOCAL ENTREPRENEUR – How a Mister Sparky franchise is changing things.

LAST TIME:  THE INVASION OF THE MAINTENANCE WORKERS – Does your neighborhood turn into a factory during the day? Mine does.

Listen to Tim on WJTN-AM (News Talk 1240) “The Town Square” with host John Siggins (Mon, Wed, Fri, 12:30-3:00pm Eastern), KGAB-AM 650 “The Morning Zone” with host Dave Chaffin (weekdays, 6:00-10:00am Mountain), and KIT-AM 1280 in Yakima, Washington,  “The Morning News” with hosts Dave Ettl & Lance Tormey (weekdays. 6:00-9:00am Pacific). Or tune-in to Tim’s channel on YouTube.

Posted in Doctors, Government, Healthcare, Systems | Tagged: , , , , | 6 Comments »

WHY THE AMERICAN PEOPLE HATE OBAMACARE

Posted by Tim Bryce on November 6, 2013

BRYCE ON POLITICS

– It certainly wasn’t “transparent,” was it?

(Click for AUDIO VERSION)
To use this segment in a Radio broadcast or Podcast, send TIM a request.

The 2010 Affordable Care Act (aka “Obamacare”) has been the object of our attention for the last three years. It remains controversial to this day as polls show Americans disapprove of it. Of course, this is what led to the ugly standoff between the House of Representatives and the President. Even early supporters of the legislation, such as unions, realize it suffers from deficiencies and needs to be changed.

The bill was voluminous making it doubtful the Congress knew what they were voting for at the time. As Nancy Pelosi said, who was then Speaker of the House, “But we have to pass the bill so that you can find out what is in it.” And herein lies the problem. Since it was signed into law, the details have been slowly emerging much to the consternation of the American public; e.g., exemptions for Congress and big business, that it triggered a flood of companies to turn employees into part-time workers, that companies are laying off workers as they cannot afford it, that young people will be faced with escalating policy costs and elect to pay the penalty instead, that the IRS will enforce it (who has also been granted an exemption), and that it is plain and simply bad for the economy. According to a Gallup Poll, almost half of the American people believe the law will make the healthcare situation in the United States worse.

Bottom-line, the American people do not trust the Affordable Care Act as it represents something concocted in a back-room by one party. It was certainly not something considered “transparent” as promised by the president:

“My Administration is committed to creating an unprecedented level of openness in Government. We will work together to ensure the public trust and establish a system of transparency, public participation, and collaboration. Openness will strengthen our democracy and promote efficiency and effectiveness in Government.”
– President Obama via White House web site

This is hardly what happened with the Affordable Care Act.

This is not how business would devise such a solution. Instead, they would implement a Feasibility Study whereby the current system would be defined, complete with strengths and weaknesses, requirements would be specified, alternatives considered based upon a cost/benefit analysis, and a suitable solution selected. By going through this process, nothing is hidden and everyone understands what is going on. More importantly, it leads to an intelligent business decision. This didn’t happen though, did it?

Some people argue the preparation of a Feasibility Study would have been too laborious and time consuming. Maybe, but when you consider the chaos we are currently embroiled in, a Feasibility Study would have made a lot more sense than the way the Affordable Care Act was drafted and implemented.

The fact remains, we enacted a law that looks like it will do more damage than good. So, what should we do, throw the baby out with the bathwater? Hardly. We have learned a lot from this exercise already, but I would still delay or repeal it until such time as we do a proper Feasibility Study.

Years ago, when I served as a baseball umpire, I learned the importance of getting the call right. As much as I didn’t want to back down from a call, I had to do what was best for the game. Fortunately, I didn’t have to do this too often, but I did have occasion where I had to swallow my pride and reverse my decision. I had to do this for the kids. Now we have to do it for the country.

Keep the Faith!

Note: All trademarks both marked and unmarked belong to their respective companies.

Tim Bryce is a writer and the Managing Director of M&JB Investment Company (M&JB) of Palm Harbor, Florida and has over 30 years of experience in the management consulting field. He can be reached at timb001@phmainstreet.com

For Tim’s columns, see:
timbryce.com

Like the article? TELL A FRIEND.

Copyright © 2013 by Tim Bryce. All rights reserved.

NEXT UP:  THE GOLDEN AGE OF CHILDREN’S TV – What shaped the Baby Boomers?

LAST TIME:  TAKING QUALITY FOR GRANTED – Quality must be built into the product during design, not inspected in afterwards.

Listen to Tim on WJTN-AM (News Talk 1240) “The Town Square” with host John Siggins (Mon, Wed, Fri, 12:30-3:00pm Eastern), KGAB-AM 650 “The Morning Zone” with host Dave Chaffin (weekdays, 6:00-10:00am Mountain), and KIT-AM 1280 in Yakima, Washington “The Morning News” with hosts Lance Tormey & Brian Teegarden (weekdays. 6:00-9:00am Pacific). Or tune-in to Tim’s channel on YouTube.

Posted in Healthcare, Politics | Tagged: , , , , | 7 Comments »

WHAT EVER HAPPENED TO OBAMACARE?

Posted by Tim Bryce on October 11, 2010

Shortly after the Obama Health Insurance Bill (aka “Obamacare”) passed the Congress last March 21st, Democratic spin doctors crowed over its passage and claimed it would be an asset to incumbent Democrats in their bid for reelection in November. This, of course, never happened. Here we are just three weeks away from the mid-term elections on November 2nd and I have yet to hear anyone triumphantly gloat over the passage of Obamacare. Maybe this is because nobody has ever taken the time to read the massive document cover-to-cover, prior to voting for its passage (or afterwards for that matter). All of the signers of the bill (see list below) have basically kept quiet and hoped nobody would notice them, thereby allowing them to quietly slip back into office. The bill is being treated like the plague, Democratic politicians running for re-election refuse to make the slightest mention of it on their web sites.

Obamacare is so politically charged right now that even the state sponsored litigation against it attracts little press as it awaits the outcome of the November elections. Nonetheless, the American public remains overwhelmingly against the bill.

I for one have not forgotten about it. So much so, I wish to remind voters of the people who supported it. Below is the list of the 219 Congressmen who voted for its passage. Is your Congressman represented?

CONGRESSMEN WHO VOTED “YES” TO H.R. BILL 3590
Patient Protection and Affordable Care Act (H.R. 3590) Bill
(passed 219 to 212)

Names Alphabetically (State District)

Gary L. Ackerman (NY 5)

Rick Larsen (WA 2)

Robert E. Andrews (NJ 1)

John B. Larson (CT 1)

Joe Baca (CA 43)

Barbara Lee (CA 9)

Brian Baird (WA 3)

Sander M. Levin (MI 12)

Tammy Baldwin (WI 2)

John Lewis (GA 5)

Melissa Bean (IL 8)

Dave Loebsack (IA 2)

Xavier Becerra (CA 31)

Zoe Lofgren (CA 16)

Shelley Berkley (NV 1)

Nita M. Lowey (NY 18)

Howard L. Berman (CA 28)

Ben Ray Lujan (NM 3)

Timothy H. Bishop (NY 1)

Dan Maffei (NY 25)

Sanford D. Bishop Jr. (GA 2)

Carolyn B. Maloney (NY 14)

Earl Blumenauer (OR 3)

Betsy Markey (CO 4)

John Boccieri (OH 16)

Edward J. Markey (MA 7)

Leonard L. Boswell (IA 3)

Doris Matsui (CA 5)

Allen Boyd (FL 2)

Carolyn McCarthy (NY 4)

Robert A. Brady (PA 1)

Betty McCollum (MN 4)

Bruce Braley (IA 1)

Jim McDermott (WA 7)

Corrine Brown (FL 3)

Jim McGovern (MA 3)

G. K. Butterfield (NC 1)

Jerry McNerney (CA 11)

Lois Capps (CA 23)

Kendrick B. Meek (FL 17)

Michael E. Capuano (MA 8)

Gregory W. Meeks (NY 6)

Dennis Cardoza (CA 18)

Michael H. Michaud (ME 2)

Russ Carnahan (MO 3)

George Miller (CA 7)

Christopher Carney (PA 10)

Brad Miller (NC 13)

André Carson (IN 7)

Harry E. Mitchell (AZ 5)

Kathy Castor (FL 11)

Alan B. Mollohan (WV 1)

Judy Chu (CA 32)

Dennis Moore (KS 3)

Yvette Clarke (NY 11)

Gwen Moore (WI 4)

William Lacy Clay (MO 1)

James P. Moran (VA 8)

Emanuel Cleaver II (MO 5)

Scott Murphy (NY 20)

James E. Clyburn (SC 6)

Christopher S. Murphy (CT 5)

Steve Cohen (TN 9)

Patrick J. Murphy (PA 8)

Gerald E. Connolly (VA 11)

Jerrold Nadler (NY 8)

John Conyers Jr. (MI 14)

Grace F. Napolitano (CA 38)

Jim Cooper (TN 5)

Richard E. Neal (MA 2)

Jim Costa (CA 20)

James L. Oberstar (MN 8)

Jerry F. Costello (IL 12)

David R. Obey (WI 7)

Joe Courtney (CT 2)

John W. Olver (MA 1)

Joseph Crowley (NY 7)

Solomon P. Ortiz (TX 27)

Henry Cuellar (TX 28)

Bill Owens (NY 23)

Elijah E. Cummings (MD 7)

Frank Pallone (NJ 6)

Kathy Dahlkemper (PA 3)

Bill Pascrell Jr. (NJ 8)

Susan A. Davis (CA 53)

Ed Pastor (AZ 4)

Danny K. Davis (IL 7)

Donald M. Payne (NJ 10)

Peter A. DeFazio (OR 4)

Nancy Pelosi (CA 8)

Diana DeGette (CO 1)

Ed Perlmutter (CO 7)

Bill Delahunt (MA 10)

Tom Perriello (VA 5)

Rosa DeLauro (CT 3)

Gary Peters (MI 9)

Norman D. Dicks (WA 6)

Chellie Pingree (ME 1)

John D. Dingell (MI 15)

Jared Polis (CO 2)

Lloyd Doggett (TX 25)

Earl Pomeroy (ND At Large)

Joe Donnelly (IN 2)

David E. Price (NC 4)

Mike Doyle (PA 14)

Mike Quigley (IL 5)

Steve Driehaus (OH 1)

Nick J. Rahall II (WV 3)

Donna Edwards (MD 4)

Charles B. Rangel (NY 15)

Keith Ellison (MN 5)

Silvestre Reyes (TX 16)

Brad Ellsworth (IN 8)

Laura Richardson (CA 37)

Eliot L. Engel (NY 17)

Ciro D. Rodriguez (TX 23)

Anna G. Eshoo (CA 14)

Steven R. Rothman (NJ 9)

Bob Etheridge (NC 2)

Lucille Roybal-Allard (CA 34)

Sam Farr (CA 17)

C.A. Dutch Ruppersberger (MD 2)

Chaka Fattah (PA 2)

Bobby L. Rush (IL 1)

Bob Filner (CA 51)

Tim Ryan (OH 17)

Bill Foster (IL 14)

John Salazar (CO 3)

Barney Frank (MA 4)

Linda T. Sanchez (CA 39)

Marcia L. Fudge (OH 11)

Loretta Sanchez (CA 47)

John Garamendi (CA 10)

John Sarbanes (MD 3)

Gabrielle Giffords (AZ 8)

Jan Schakowsky (IL 9)

Charlie Gonzalez (TX 20)

Mark Schauer (MI 7)

Bart Gordon (TN 6)

Adam B. Schiff (CA 29)

Alan Grayson (FL 8)

Kurt Schrader (OR 5)

Al Green (TX 9)

Allyson Y. Schwartz (PA 13)

Gene Green (TX 29)

David Scott (GA 13)

Raúl M. Grijalva (AZ 7)

Robert C. Scott (VA 3)

Luis V. Gutierrez (IL 4)

José E. Serrano (NY 16)

John Hall (NY 19)

Joe Sestak (PA 7)

Debbie Halvorson (IL 11)

Carol Shea-Porter (NH 1)

Phil Hare (IL 17)

Brad Sherman (CA 27)

Jane Harman (CA 36)

Albio Sires (NJ 13)

Alcee L. Hastings (FL 23)

Louise M. Slaughter (NY 28)

Martin Heinrich (NM 1)

Adam Smith (WA 9)

Brian Higgins (NY 27)

Vic Snyder (AR 2)

Baron P. Hill (IN 9)

Jackie Speier (CA 12)

Jim Himes (CT 4)

John M. Spratt Jr. (SC 5)

Maurice D. Hinchey (NY 22)

Pete Stark (CA 13)

Rubén Hinojosa (TX 15)

Bart Stupak (MI 1)

Mazie K. Hirono (HI 2)

Betty Sutton (OH 13)

Paul W. Hodes (NH 2)

Mike Thompson (CA 1)

Rush Holt (NJ 12)

Bennie Thompson (MS 2)

Michael M. Honda (CA 15)

John F. Tierney (MA 6)

Steny H. Hoyer (MD 5)

Dina Titus (NV 3)

Jay Inslee (WA 1)

Paul Tonko (NY 21)

Steve Israel (NY 2)

Edolphus Towns (NY 10)

Jesse L. Jackson Jr. (IL 2)

Niki Tsongas (MA 5)

Sheila Jackson-Lee (TX 18)

Chris Van Hollen (MD 8)

Hank Johnson (GA 4)

Nydia M. Velázquez (NY 12)

Eddie Bernice Johnson (TX 30)

Peter J. Visclosky (IN 1)

Steve Kagen (WI 8)

Tim Walz (MN 1)

Paul E. Kanjorski (PA 11)

Debbie Wasserman Schultz (FL 20)

Marcy Kaptur (OH 9)

Maxine Waters (CA 35)

Patrick J. Kennedy (RI 1)

Diane Watson (CA 33)

Dale E. Kildee (MI 5)

Melvin Watt (NC 12)

Carolyn Cheeks Kilpatrick (MI 13)

Henry A. Waxman (CA 30)

Mary Jo Kilroy (OH 15)

Anthony Weiner (NY 9)

Ron Kind (WI 3)

Peter Welch (VT)

Ann Kirkpatrick (AZ 1)

Charlie Wilson (OH 6)

Ron Klein (FL 22)

Lynn Woolsey (CA 6)

Suzanne Kosmas (FL 24)

David Wu (OR 1)

Dennis J. Kucinich (OH 10)

John Yarmuth (KY 3)

Jim Langevin (RI 2)

 

I haven’t forgotten. Will you?

Vote November 2nd.

Keep the Faith!

Note: All trademarks both marked and unmarked belong to their respective companies.

Tim Bryce is a writer and the Managing Director of M. Bryce & Associates (MBA) of Palm Harbor, Florida and has over 30 years of experience in the management consulting field. He can be reached at timb001@phmainstreet.com

For Tim’s columns, see:
http://www.phmainstreet.com/timbryce.htm

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Tune into Tim’s THE BRYCE IS RIGHT! podcast Mondays-Fridays, 11:30am (Eastern).

Copyright © 2010 by Tim Bryce. All rights reserved.

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THE HEALTH CARE BILL – HOW I WOULD HAVE DONE IT

Posted by Tim Bryce on September 30, 2009

Like most Americans, I have been watching the wrangling over the Health Care bill carefully. Something that has bothered me from the beginning is how it was developed which, frankly, sounded like it was cooked up in some back room in typical lawyer fashion. I may not have the answer for solving the problem, but I most certainly would have gone about addressing it differently than the politicians did. Here’s what I would have done:

1. Develop a Project Scope – I would have carefully specified the problem to be addressed and identified all of the parties involved. including what parts of the government are affected as well as the populace. In other words, who is directly involved, indirectly involved, and not involved at all. I would also clearly identify the existing system(s) to either be modified or replaced.

2. Study the current system(s) – this would involve interviewing a wide spectrum of people involved with the existing health care systems, such as insurance carriers, hospitals and clinics, physicians and health care workers, malpractice attorneys, etc. Basically, anyone associated with the Project Scope. From this, a “Current Systems Analysis” is produced specifying the strengths and weaknesses of the current mode of operation. This includes what works well, what is deficient, and what is truly broken. Also, consideration would be given to cheating and abuses of the system, not just that it occurs, but why it occurs.

3. Specify Requirements – detailing what is needed from a mandatory, strategic, and tactical perspective. This would include the requirements of the American public, the government, health care providers, etc.

4. Review – “The problem well stated is half-solved.” Before we try to solve the problem, let’s make sure we have the Project Scope, Current Systems Analysis, and Requirements properly and carefully defined. If this is wrong, any solution devised to satisfy it will be wrong.

5. Develop System Approach – to satisfy the requirements, consideration is given to proposed alternatives, including modifying and/or correcting deficiencies in existing systems, devising whole new systems, or both. This would include the sub-systems and infrastructure needed to support them. Because of the enormity and complexity of Health Care, it would be wise to develop multiple solutions in order to propose alternatives with a recommended solution suggested.

6. Prepare System Evaluation – for each approach offered, a cost estimate is prepared (not just development costs, but implementation and on-going support costs as well), along with how it is to be financed, including a cost/benefit analysis (consisting of such things as break even points and return on investment). From this, we can put a price tag on each proposed solution and consider which one we can afford.

7. Review – all of the material thus far is assembled into an organized report with an executive summary highlighting the major points. This would then be presented to lawmakers in Congress for their review and deliberations. The outcome from this would be to accept it as is, ask that it be revised, or discontinued completely.

What I’ve just described is called a “Feasibility Study” as used in corporate America on a daily basis. No, it’s not cheap and can take some time to produce, but business people long ago accepted the fact that you must “look before you leap” into a major project. Yes, it would be tough to prepare, but I know nothing of substance that has ever been done without some sound research and planning, but as far as I can see, this has not been done by anyone, least of all Congress or the President.

Some politicians would argue that we don’t have time for a proper Feasibility Study. Interestingly, I hear this same argument from programmers in the Information Systems world who also don’t believe in the necessity of upfront planning and prefer hacking away at program code instead, leaving an ugly disjointed mess that never gets finished. The fact remains though, no amount of elegant programming or technology will solve a problem if it is improperly specified or understood to begin with. I contend we haven’t got time NOT to do this vital upfront work.

If our Congress went through the motions of building a true Feasibility Study, it would promote cooperation through effective communications, thereby eliminating partisan sniping; it would produce a proper solution for the right set of problems, and; it would go a long way to improving the trust in the government by the American people, simply by assuring them that the “T’s” were crossed and the “I’s” were dotted (that it has been thoroughly thought through).

I guess what concerns me, as well as a lot of Americans, is not so much what is being presented to us as much as the process by which it was developed which, to my way of thinking, was in a vacuum. If Americans don’t trust it, they will not embrace it and may even revolt against it.

Remember, it’s Ready, Aim, Fire; any other sequence is counterproductive. Then again, our attorney/politicians don’t know anything about management.

Keep the faith!

Tim Bryce is the Managing Director of M. Bryce & Associates (MBA) of Palm Harbor, Florida and has over 30 years of experience in the management consulting field. He can be reached at timb001@phmainstreet.com

For Tim’s columns, see:
http://www.phmainstreet.com/timbryce.htm

Tune into Tim’s new podcast, “The Voice of Palm Harbor,” at:http://www.phmainstreet.com/voiceph.htm

Copyright © 2009 by Tim Bryce. All rights reserved.

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