The case for medical insurance changes

I got my health care renewal yesterday. It appears that our insurance is going to increase another 14% this year. We’re getting to the point where we are going to price everyone out of purchasing health care. Or, if not pricing the rest of us out at least making health care such a large part of our personal and corporate budget that we start edging out other important parts of our economy.

Congress continues to debate what’s going to happen with our health care system. The amount of finger pointing that is going on is extraordinary. It seems that no one has any responsibility for causing the problems that exist in our health care system.

On one side we have Republicans who claim we have no problems with our system, we then have the providers who say they aren’t paid enough and then we have patients who want the very latest and most expensive whether they need it or not.

I often wonder whether all of the health care costs we have provide a benefit for our economy. Yes, there are millions of people who are employed by the system and if we didn’t have the system we have, the amount of dislocation in the economy would be huge. So, since everyone else has put their two cents in about our health care issues, I might as add my big five.

First, have real competition between health care payers in the country. We have to get past the evils of a public option and move to having a single payer system. We can’t afford to have 20% or more of our health care costs be higher than normal salaries and high profit margins for health care insurance companies.

Second, we need to have a re-alignment of how people get paid who work in the health care system. We need to re-think about how we educate our doctors and also re-think about how much different types of doctors get paid. Our general practitioners are paid too little and our specialists are paid too much. In addition, we need to move away from doctors providing all services to more responsibility taken by practitioners, physicians assistants and nurses.

Third, we need to have one system for record keeping that is tied into a national data base. There is no way for doctors or to keep up with best practices nor to easily transfer medical records in a readable form from one doctor to another. Along with an electronic medical record system we need to tie in an electronic submission system that automatically sends services and procedures for payment. In many doctors offices I visit I see more administrative staff than health care providers.

Fourth, bring the pharmaceutical companies under control. We can’t afford to nor should we subsidize the rest of the worlds drug costs. If a drug is sold for a particular price anywhere else in the western world, that drug needs to have the same selling price in the United States. There are too many drugs that cost x in a country such as Canada or France and x times ten in the United States. If a drug company can afford to sell a drug for ten percent of it’s US selling price in another country, then we should get the same price.

Finally, we need to get control over procedures that are provided on demand in this country. Whether these procedures are caused by too many law suites or just people who are at the end of life and demanding expensive medical services that are likely to provide little benefit for quality of life and significant life extension. Living longer should not be the only goal, living better should be.

If we adopt the five ideas above, we would go a long ways towards making our health care more humane, cost effective and efficient. If we don’t do something meaningful and not the garbage that we have before Congress, our health care system will continue to remain the dysfunctional system on the planet.

Josh Patrick

Tactical versus Strategic planning

For years I’ve been working with private business owners helping them work through their financial life on a total strategic basis. This process is long and arduous. Most business owners we talk with are not interested in having meetings that last multiple hours and processes that take more than one year to show results.

Because I’ve decided to meet our business owners where they are we’ve introduced a different type of planning process to use with them. We call this process Blueprints for Tomorrow. The purpose is to help business owners work through strategic areas of their business in a tactical way.

We know that business owners like to think strategically and act tactically. This means that owners are good at thinking about the big picture of their business, but when it comes to implementing they often try to do too much at one time. In addition, their advisors are often working on the advisors agenda and not the business owners agenda.

Taking long processes and chunking them down to bite sized bites helps the business owner work on small pieces at a time. There is more satisfaction in getting these tactical activities accomplished. In addition, when the business owner gets to choose what part of the process they want to work on, the owner is able to stay in control of their process.

When we convert strategic processes to tactical activities we have a better chance of both adoption of the process and implementation when planning work is completed. Having our business owner Clients choose what activities are most important keeps the business owners interest high in the projects they commit to.

We as advisors often want our Clients to take on large projects that are complicated. Often our business owner Clients would like to take on the large project but they just don’t have the time. Keeping strategic activities tactical allows us to keep meetings short and the amount of time needed for each part of a larger project small.

When I ran my vending company I always had time for a project that might take 30 minutes a week for a few weeks. If someone wanted me to spend several hours a week for many months, I would have to think long and hard before taking on a project like that. I knew that some of these long-term and time consuming projects were important, but I just didn’t have time and in many instances the interest in pursuing things that required a time investment that was too large.

We’ve been finding as we move towards the role of the architect of the plan and not the implementer we’re having a much higher percentage of business owner participation and ultimately better results for both the business owner and our firm. I strongly encourage you to think about chunking down projects. You might just see a higher percentage of adoption and more importantly completion of projects we bring to our business owner Clients.

Josh Patrick

Marketing = Strategy……Sales = Activity

I’m constantly amazed at the amount of companies that confuse sales activities and marketing activities. Those companies almost always have a mixed message they are sending their Clients. When sales and marketing are combined the message is rarely a coordinated one that helps produce high quality and high profit Customers and Clients.

Instead if we separate the two activities into proper silo’s in our companies we will have a more coordinated sales message that will target the people we really want to do business with.

What this comes down to is sales is an activity. It is the doingness that actually brings Customers into our firms. Marketing is the strategy the sales department uses. The strategy could be as simple as only call on these Customers who live in this area of town. Or, it could be much more sophisticated in not only helping the sales department know who to call on, but what sort of approach should be used with different types of Clients.

If our marketing department can help us understand what our Clients want, we then have a chance of providing the Customer with sales conversations they would be interested in reading or having a discussion about.

When your sales department has a roadmap for where they are supposed to go and what they’re supposed to do once they get there, you have a much better chance of having higher productivity and higher profit Customers produced by your sales team. You MUST manage your sale team to your marketing plan. Remember, many salespeople will move towards the path of least resistance. Often, your best new Customers are hard to find and hard to get infront of. Having your sales people follow a well thought out marketing plan can help with making sure the new Customers that do business with you are the type of Customers you want.

I strongly believe that sales people should not be involved in marketing and marketing people should be involved in the sales process. A good sales person is one who wants to call on Customers and book sales. They often don’t want to think about sales strategies, they just want to go out and sell. On the other hand, marketing people need to go out and make sales calls. If they don’t, they will have no idea whether their marketing strategies will work in the real world.

On a final note, it’s important to remember that advertising is not marketing. Advertising might help build your brand or get name recognition for your company, but it’s not marketing and it certainly is not sales unless you are pulling people to your company and have a measurement system in place to know if your advertising is actually producing new Customers. This understanding of how your sales program works for adding new Customers can’t be a gut feeling. It must be fact based for how many new Customers an advertising program produces and how many dollars the advertising campaign has brought to your company.

Remember, sales does not equal marketing. Having them operate as separate entities within your company will improve the quality of new Clients your company attracts.

Josh Patrick

It’s time to be efficient

Over the past year I’ve had a bout with cancer.  I’m now in remission and getting back to normal.

I’ve found that I don’t have enough energy to work 60 hours a week.  I do get a good forty hours in, but the definition of what a good forty is has changed for me.  A good forty is only when I’m working on projects that provide service for both myself and others at the same time.  It doesn’t work if I’m only providing service for others, nor does it work if I’m only providing service for myself.

I’ve found that providing service in this manner not only makes me more efficient, but allows me to stay in a zone where I’m productive and happy.  This zone allows me true joy in my work and allows time to stand still.

I encourage you to give this a try.  Work on only on projects that keep you in the zone.  You might just find that this zone only happens when the project has a win/win outcome.

Josh Patrick

Back again

It’s almost been a year since my last post.  The cancer treatment is now done and it’s time for healing to begin.  I’m finally feeling strong enough to start posting and sharing thoughts how private business integrates with our personal lives.

During the past year I’ve had personal experience with not being able to work, trying to work and having to take a rest and just plain old starting and stopping.  I keep thinking I have the energy and stamina to get back to only find out another setback is waiting for me.  One would think this would lead to frustration.  Instead I have learned patience and had to become more humble and ask for patience from those who have wanted to work with me.

When our health is good, we don’t think for a second about going the extra mile.  When our health is compromised like mine has been I’ve had to learn to think in a different manner.  I’ve had to learn to say I can’t do that right now and I’ve had to learn to go back and ask for more time and patience.  It’s not something that I’ve enjoyed learning.  I and I think most owners of private businesses don’t like to make excuses and ask for more time.

When one has limited energy and personal resources we have to learn to think about what is really important versus what others would like us to do.  The arbitor of what is really important becomes our own inner thoughts and value systems.

I’m hoping that over the next few months all of my energy returns.  If it doesn’t I’ll have to continue practicing prioritization in my life as well as my business.  I’m sure there will be lessons that will be learned.  Hopefully I’ll have some wisdom that comes which will be useful to share.

I’m happy to be back and have enough energy to start on life once again.

Josh

Two Worlds

So many outcomes in life depend on the way we address the world, the unconscious rules by which we play.  The rules may not be immediately obvious to others, but sooner or later our external actions and attitudes betray the unspoken. 

Online friend Dan Oestreich http://www.unfoldingleadership.com/blog/ offers this description of two radically different worlds:  the world of the strong and the weak and the world of transcendent values. 

  

Dan writes that most organizations have elements of both worlds. 
“In most organizations I’ve known, leaders endeavor to speak from the world of transcendent values. And they believe in them. But they often also find that at some level they must deal with the other world, focused as it is on strength and weakness, on power without any particular moral code. “

This comment seems to me to be right in line with our thread on collaboration and client service.  Each world’s values struggle for dominance in the workplace, in our working relationships with colleagues, and in our client relationships.  I believe that when we operate from a firm stance in the world of transcendent values, we do the best for ourselves and for others.  When we tolerate the opposing values of the world of the strong and the weak, we are all diminished. 
Dan illustrates the difference with this legend.  A Cherokee elder was teaching his children about life. “A fight is going on inside me,” he said to them.

“It is a terrible fight and it is between two wolves. One is evil – he is anger, envy, sorrow, regret, greed, arrogance, self-pity, guilt, resentment, inferiority, lies, false pride, superiority, and ego.” He continued, “The other is good – he is joy, peace, love, hope, serenity, humility, kindness, benevolence, empathy, generosity, truth, compassion, and faith. The same fight is going on inside you – and inside every other person, too.”

The grandchildren thought about it and after a minute one of them asked, “Which wolf will win?”

The elder simply replied, “The one you feed.”

 

 

 

Karen Lynch 

 

 

When collaboration becomes really important

I’m about to head into a vortex where collaboration is going to be really important. Unfortunately, the medical community doesn’t seem to do collaboration even as well as the financial advice industry does. And, this might be a real problem.

I’ve recently been diagnosed with cancer. For years, I’ve been using the medical community as a great example of diagnose before prescribing and for working in a collaborative manner to work with one on managing their health. It appears that the medical community struggles with this process at least as much as we do in the financial services business.

During the diagnosis period for my medical condition we would often tried things to see how they worked out. The diagnosis wasn’t especially thorough and the result was not great. I just happened to get lucky that my particular diagnosis was done relatively quickly. And, that may be how it works for all of us, we just get lucky in our diagnosis in both the medical and personal sense.

This leads me to wonder if that’s how it works with our Clients as well. Do they mostly get lucky that we help them do things that lead towards where they want to go? Or, do we tend to put our Clients in a box and make decisions about what’s important for them?

It seems to me, that we often put our Clients in a box and then decide what’s important for them. I’m not sure this is the most appropriate way for us to help our Clients reach their goals.

Just asking the question, if we were to get together three years from now, what has to happen for you to feel like you’ve been successful is powerful enough to help us all be on the same page. And, it’s all being on the same page that is important.

For example, it’s just as important for me to make sure my affairs are in order as it is to get medical treatment. Both are at a ten in importance and both must be addressed. Otherwise, I’ll not be able to put my full attention on the medical portion of this deal.

The medical community is likely to be only focused on the medical stuff and never find out about the other part of what’s important for me. It will become my responsibility to point this out. We often expect our Clients to tell us what’s important to them. The issue with this is our Clients often don’t know how to tell anyone, much less what’s important. And, isn’t that what our primary job is? We must find out what’s important for our Clients and we must be through in this activity. Doing so will allow us to all focus the appropriate amount of energy in getting the right outcome.

Josh Patrick

Philanthropy and the third generation

I had the opportunity to talk with a TEC group in Michigan last week. During the workshop, we got into a conversation about the role of philanthropy for teaching money values for younger generations.

I found the two companies in the room that were third generation businesses were the most interested in this topic. I suspect this is because these companies are highly successful and the owner/managers are worried about their children not understanding the value of money and the hard work that it takes to produce the money that the family enjoys.

The two companies that were most interested in this topic had a problem that first and second generation companies don’t have. Both businesses had a high level of success the entire time their children were alive. The children of these companies had a world view that money grew on trees and making money was not an especially difficult proposition.

Most business owners we speak with are so focused on keeping their business healthy that they have no time or energy to consider serious philanthropic activities. What I learned from my workshop last week is that third generation owners are more likely to consider philanthropy as a method of helping them achieve several of their goals.

The future will tell us how this theory works out.

Josh Patrick

Even more on collaboration

Collaboration is truly not for the faint of heart.  When we collaborate—even within our own firm—we temporarily hand over the care of our Client to someone else.  We may hold our colleagues in the highest regard, and yet when it comes right down to it, we may not be aware of how little we trust them until it is time to collaborate. 

 

Sometimes dividing up the labor is relatively easy—“You do the lawyer stuff, and I will take care of the financial strategy.”  If I know my attorney colleague is an excellent attorney, I may be happy to collaborate with her.  But if we are all working on various aspects of a complex case, we run the risk that critical pieces may fall through the cracks.  We need to build trust, and we need systems. 

 

It is when we attempt to collaborate with a colleague for the first time that we become aware that effective professionals can have remarkably different work styles.  If I am a person who checks on a Client project every three days no matter whether what, I am going to be uncomfortable working with a person who waits until there is something new to report to communicate with the Client.  Both professionals may be effective in their own practices, but if we are going to work together collaboratively, we need to have some kind of agreement about communicating with the Client.  At least, if we want to derive the real benefit of collaboration we do.

 

When we walk into a Client meeting on our own, we know what we want to accomplish and how to get there.  When two (or more) of us walk into a Client meeting, we need to be on the same page before we get there unless we want to confuse the Client and undermine the value that we are trying to bring. 

 

Collaborating requires an initial leap of faith in our colleagues, but to really harvest the benefit of collaboration we need to conscientiously build trust.  There need to be rules about who does what.  There need to be meetings to plan for meetings.  We have to hash out expectations that we may not be aware we had until they clash, preferably not in front of the Client.  It can be a lot of work at first.  Now that I think about it, maybe that’s why we spent so much time on group projects in the old days in b-school. 

 

It’s easy to lose heart in the first efforts to collaborate.  Those of us who have learned to be effective solo practitioners may legitimately wonder if all this cooperation and collaboration is worth the work it requires.  I am fortunate to have worked many years in a company that had well-established systems for collaboration in place, and I can report that the results for the Client are unsurpassed when you can bring the right professionals to the table and orchestrate the perfect solution.  And isn’t that what this is all about?  Bringing the very best solutions to our Clients.  That goal is probably worth a little discomfort as we learn new ways and build trust. 

 

The good news is that successful collaboration builds greater success.  It does get easier as we learn how to apply each team member’s strengths to the problem at hand. 

Karen Lynch

 

 

 

More thoughts on collaboration

Collaboration is one of those words that we are afraid of saying we are not in favor of. In many respects it’s like apple pie or mom, just one of those things that we all should embrace.

So, the question becomes why is collaboration so rare and why is it so hard to institute in our practices?

I was having a conversation the other day with a friend of mine and we were talking about a group of people where collaboration should be the rule. As it turns out, only about 25% of the people in this group practice collaboration. I have a couple of thoughts about collaboration that might shed light on this issue.

First, we are afraid that if we collaborate then we will lose a certain amount of business. This is a rational fear if you believe and have evidence that there is only so much business. Those who are afraid of losing business tend to live in a world of scarcity. We often believe that if we don’t get ours, then there won’t be enough to go around.

Second, if we collaborate we will be seen as being weak by our Clients. This certainly is a reasonable fear. Our Clients expect us to be “experts”. When we bring in others to work with us, we might not be seen as that expert anymore. I believe that if we set expectations for collaboration from the beginning, we will not have as much an issue with our Clients not seeing us as the expert.

Third, the problem is not big enough to afford collaboration. Collaboration is expensive for the Client. Unless the payoff is large enough, there is not a good reason for the Client to fund a collaborative effort.

Fourth, and probably the most important, we don’t know how to collaborate. I believe that collaboration starts at home. How many of us truly involve everyone in our firm in decision and Client service in a collaborative manner. Most of the time we want our co-workers to do their job and not make too much noise about it.

The more we can build an internal collaborative culture, the better chance we get to practice collaboration. We then have the opportunity to move from collaboration within our firm to collaboration with our Clients. Finally, we are now ready and able to collaborate with the outside world.

I think it makes sense for us to consider practicing internally in a collaborative effort. The more we do this, the better our collaboration will be with others.

Josh Patrick