A Passage to Italy – Part One: Just Don’t Look Down

[Piazza Navona, Rome, Italy] (LOC) (Photo credit: The Library of Congress)

It had been raining for several weeks in Rome – a lingering and inconvenient wet cotton hangover of a hard winter.  As our plane touched the tarmac, the valley of the Tiber shimmered under its first sustained spring sun.  The fields were filled with blood red poppies and yellow mustard.  The April air was honey scented citrus, hyacinth and jasmine. Spring had arrived on a smile from Jupiter and an entire nation now rushed outside like children escaping school at the final bell.

Our trip had become a pilgrimage of sorts – my chance to prolong the adolescence of one of my children by escaping to Europe for one week.  In a time of tangled earphones, bent heads glued to smart phones and castrated dinner conversation; I was gambling that these trips might yield some precious memories and a chance to sew a few seeds of wonder.  The children had almost forgotten what it was like to be lashed to the same mast – an ancient mariner and his apprentice sailing together across a deep strait of water far from the distractions and conveniences of home.

Italy is a brilliant orchestra with no conductor.  It is the perfect place to reconnect with those things that may be missing or not visible in life.  The heart is always dreaming of the beyond and we often neglect our imaginations and our capacity to fill our days with childlike fascination.  Any pilgrimage is about the journey and those you meet along the way.  It is a chronology of life moments in which one travels, clearing the mind of the temporal and seeking the deeper insights only found in other people and in places where our significance is subordinated to a greater purpose that pulses around us.

For a nation whose debt makes the USA’s fiscal cliff appear more like a children’s slide, the Italians seem to shrug off the mounting complexities of their excesses and roll their eyes at the austerity measures that must now reshape public and social policy if Italy wants to remain a part of the euro and the European Union. For many, taxes and debt are a way of life and with a government that has the life expectancy of a housefly, it seems useless to spend a sunny day worrying about the horizon line clouds. In a nation where history and tradition are knotted together like tangled kite string, complications are a fact of life.   In the last few months God’s emissary on earth, a standing Pope, has resigned for the first time in the history of the church. He is now creating complications, as the government has never had to allocate pension payments to a Pope.

To make matters worse, there is no government because the Italian Parliament cannot agree on a coalition that would be legitimate enough to preside over anything other than a food fight. Gas is $11.00 a gallon but the biggest complaint is over the use of a new Autostrada digital camera system designed to photograph and fine the nation’s notorious speeders. This is a huge problem for a country built on its genteel infidelities.  Divorce courts are filling with wives who now have proof that their husbands are cheating on them.  Imagine a wife’s surprise as she opens the mail to spy a ticket and photograph of her husband and an unknown younger woman near Sorrento when he was supposed to be north in Bologna on business.  Mama mia!

Lazio and AC Roma are wallowing in the middle of the pack of the Italian champions league while hated Juventus has moved into first place.  This is of much greater concern than national debt, mounting taxes or the possibility that Silvio Berlusconi who makes Caligula look like a Trappist monk, is still trying to worm his way back as prime minister.

In Rome, we visited new appointed Pope Francis at the Vatican, enduring throngs of genuflecting pilgrims.  Like attending a Notre Dame football game, it just all makes you want to become Catholic.  It’s like being part of a huge dysfunctional royal family with secrets and power. To be a Catholic is dwell at the feet of Popes, Saints, Templars and martyrs.  Rome is a pantheon to rich historical paradoxes – incredible charity and hidden vice, personal sacrifice and hypocritical indulgence, generosity and profligacy. The new pontiff has promised more open leadership. Most like me, are just hoping he might share the remaining secret of Fatima, which might provide a hint as to whether the Jets might make it back to the Super Bowl, or the GOP will take back the White House.

My youngest son and I spend much of our time with my close friend Vincenzo, a Roman native who has been a friend for over fifteen years.  He loves his city and speaks in emphatic broken English as he regales us with legends, embellished facts and scrupulous details of battles from his beloved Punic Wars with Hannibal.  We walk slowly devouring monuments to pagan Gods, organized religion, imperial empires and theocratic republics. Enzo hesitates after regaling us with stories of the great Roman commander Scipio and his Carthaginian nemesis, the genius Hannibal.  He shakes his head and waves a dismissive hand as if to indict the present as a time of profound decline – the nomadic and cynical offspring of a once great civilization.  “Incredible.” He blurts out to no one in particular.  “Our country is like a beautiful woman with dirty feet. If you want to stay married, you just must learn not to look down.”

Enzo concludes this evening’s dinner with a story that relates to his country’s debt crisis. “There was a man who was plagued by his debts to his neighbor and he could not sleep. Every night, tossing and turning.  His wife, annoyed up with her husband’s walking of the floor asks him what is the problem. He looks at her and brings his hands to his face.  ‘I have such a big problem. I owe our neighbor so much money and I cannot repay him.’ The wife listens and calmly walks across the room and opens up the window facing their neighbor’s house.

“Signor. Wake up. My husband can not pay you back your money!”

She turns to her husband and smiles. ‘Go to sleep.  It is no longer your problem.  It is  now his problem.’”

Major Tom Comes Back To Earth

Though I’m past one hundred thousand miles, I’m feeling very still and I think my spaceship knows which way to go. Tell my wife I love her very much (she knows!) Ground Control to Major Tom, your circuit’s dead, there’s something wrong. Can you hear me, Major Tom? Can you hear me, Major Tom? – lyrics by David Bowie

On the opposite arc of three thousand nights is an ivy covered cottage illuminated like a holiday menorah – with motion and brightness coursing through the veins of every room.  A person could find 16 Camelot Close after exiting the Wimbledon Park tube station and walking up a steep, tree lined hill of silent uneven pavement. After a quarter mile, you take a left down a tiny, well manicured cul de sac to the cottage whose energy heat signature was brighter than Chernobyl. “The lights are on in every room of that house every night.  Only Yanks can waste that much electricity!” a British neighbor once joked.

I close my eyes and walk through that door over and over, shouting over a din of activity: “I’m home!”  A thunderous stampeding of bare feet would be followed by the screams, ‘Daaaaaaaady!!!”  I smile as I reminisce about a young family living abroad, balancing moments like spinning plates. Each week, I orbited across countries and continents but my favorite aspect of travel was my homecoming – a hero’s welcome from toddlers who would tumble down stairs like tennis balls sometimes wet and lathered with soap. I was a shining star hanging in a firmament that sparkled with a million possibilities.  After a week of being separated from my family, I would transform into Peter Pan derailing their evening routines, leaving my pirates wide eyed where only an impromptu story of Frog and Toad from the Wind And The Willows might sail my crewman off to the Land of Nigh.  

At times, I would surprise my wife and arrive home early. She would disappear for a moment, returning in running attire, holding a filthy child at arm’s length as if he were a drum of toxic waste –- which he was.  “I’m going out for a run” she chirped.  She would tap on the front door after an hour having found her happy place somewhere along the riding paths lined with horse chestnut trees on Wimbledon Common.  The novelty of my arrival would eventually disintegrate as I was expected to resume my role as an adult and partner assuming my fair share of domestic duties. I preferred to be an accomplice and partner in mischief. Each Monday, I would pack my bags only to return to plunge back into their lives, a father and a husband.

The years moved forward with the determination of a great blue glacier.  We left behind our innocence and our cottage, returning to America.  In time, the tendrils of teenage body snatchers invaded our home turning my adoring confederates into irritable changelings that would chafe at the sound of my breathing.  I went from indispensible deity and story teller to annoying traffic cop and money dispenser.

I now open the front door and fall back into my domestic life with a roller bag pregnant with a week’s worth of travel.  “I’m home!” echoes and falls to the ground of an empty foyer.  As I lament the dying light of my paternal star, I hear a bark of unrestrained joy as the dog sprints around the corner to greet me. He cannot arrest his momentum and comically slides right past me on an area rug and crashes into the wall. 

“He’s home! He’s home!” he announces as he grabs a shoe in his mouth and performs a twisting double axel jump. The family room is occupied by two teen boys hunched over a tangle of electronics and white entrails.  The dog seems incredulous at the indifferent reaction to my homecoming. He barks frantically trying to rouse them from their social media stupors.  “It’s him. He’s back. The silver haired alpha dog — the one that walks on two legs and offers food under the table when the she master is distracted.  Don’t you guys see? He’s here!”

One of my boys reproaches the dog.  “Shut up, Brody!” He glances up and sees me, momentarily breaking away from a text message sent from some slow moving adolescent whose corrupted grammar and syntax, by comparison, could make a village idiot pass for Wallace Stegner. “Oh, hey, Dad. How’s work?” He clearly has not noticed that I have been gone for four days.

My professional life of travel has grayed my temples, herniated an L5 disc and precipitated a predictable transformation where my broad mind and narrow waist have changed places.   But absence also made my heart grow fonder and I came to value every moment I could share with my family. I became keenly aware of the passage of time. I learned to celebrate quality over quantity. I learned personal premeditation to be sure that each minute together had the potential to become a memory. A marriage also benefits from travel. It’s a little known fact that most women marry men for breakfast and dinner but not for lunch.  Familiarity breeds contempt and while our presence is always welcome, we have a way of mucking things up when we are around too much.

My life of travel is now winding down and I am delighted to be waking up in my own bed. Sadly, I have observed with a degree of Harry Chapin irony that I am now coming home to a larger home with fewer people.  Everyone’s lives seem laid out like fiber optic lines. My one-time nuclear family has splintered into a closed social network where I act as a sort of financial server. My teenaged tenants now return home primarily to recharge batteries, ask for money or seek medical attention. I find myself like Brody, the family dog, craving their attention.  I want someone to play catch, go for a jog and rough house. 

Brody senses my restless ambition and watches me, trying to anticipate my next move. My wife seems genuinely excited that I am now entering a phase of my career where I will spend less time on the road.  However, it’s clear, that in my absence, everyone has grown up. I am a mere steward and my job is now to prepare them to forge lives of their own.  It all happened so fast.

As I exit my time capsule, an ancient Major Tom, I am arriving back on earth just in time to watch everyone getting ready to leave – out for the night with friends, away for months to college and into the distant cosmos of adulthood forever.   

At this moment, I just want to be on the ground with those toddlers again wrestling and breaking bedtime curfews. I can’t help but feel like a discarded toy.  I can relate to Brody.  If someone were to hold up a tennis ball and yell “fetch!”, I swear to God, I would chase it.

Black Hats and CAD Stents

 

Top 10 Catholic Health Care Systems (Photo credit: Wikipedia)

When Steve Brill released his recent Time magazine article, Bitter Pill – Why Medical Bills Are Killing Us,, it was an overdue chapter in a critical primer to educate the American public on the perverse incentives plunging our healthcare system and our nation into dysfunction and debt.  The Time piece was the first major media effort in some time to shine a light on the factors beyond the insurance industry that contribute to costs that now eclipse 16% of our GDP. 

Brill’s article clearly touched a clear nerve as the American Hospital Association immediately issued a multiple page press release refuting many of the writer’s observations and complaining that billing practices were an outgrowth of a cat’s cradle of cost shifting and an increasingly Darwinian landscape where only the best equipped, resourced and positioned hospitals will survive. 

Yet, Brill’s facts are hard to refute.  Many not for profit hospitals are paying seven figure executive salaries and posting double digit margins achieved through complex and imbalanced billing practices that rival Egyptian hieroglyphics.  Time’s expose demystifies the complicated calculus of hospital billing and alleges that the system of billing and reimbursement is hopelessly broken leaving the most vulnerable of victims in its wake – those earning too much to qualify for Medicaid but earning far too little to afford coverage.  The stories are gut wrenching and identify a range of misaligned financial and care motives across high margin practices such as oncology, imaging, lab, emergency and pharmacy services. The findings also tie to a June 2009 Harvard study that found that 50% of all US bankruptcies were directly related to medical bills and/or illness.

When I crossed the proverbial River Styx from healthcare consultant to regional CEO of a health plan, I was plunged into a bitter and high stakes battle with large hospital systems demanding and often getting double digit unit cost increases. The result was a zero sum game where in my resolve to try to control double digit trend, I would attempt to extract steeper discounts from smaller providers and community based hospitals – ironically providers who offered lower unit costs and similar quality than bigger systems.  However, consumers demanded big name brands. The daisy chain of cost shifting punished weaker players and slowly drove primary care and small hospitals to the edge of extinction.  Meanwhile, the uninsured paid the most for healthcare – often paying 200%-400% more for care in healthcare’s most expensive setting, the hospital emergency room.

In 2007, I watched two regional hospitals engaged in an arms race for membership through aggressive marketing and sub-specialty expansion. When the hospitals both sought to expand their cardiology programs, the practice of inserting post angioplasty stents increased by 300%.  While the risk of stents outweighed the benefits for certain patients with (CAD) coronary artery disease, cardiac interventionalists routinely placed stents in their patients, not because patients always needed them but rather because they could earn more money. It’s a familiar story: The doctor tells the patient they need a procedure. The patient, fearful and accustomed to the notion that more health care must be better, consents.  To the degree, any payer attempts to disallow a recommended procedure as unnecessary, the payer is accused of bureaucratic meddling or worse, jeopardizing the quality of care for the sake of operating profits.  Years later, we are finally beginning to understand that whoever regulates costs, access and necessity of treatment in the healthcare system – be it a payer or a governmental agency, is automatically fitted with a black hat and labeled the villain.

The Time’s article focusing on certain hospital billing practices are a subset of a nationwide game of cat and mouse as facilities seek to balance highly variable reimbursement from Medicaid, Medicare and commercial insurance.  The fight over the true cost of care is often invisible to those footing the bill – employers.  Many employers have no line of sight into the thorny negotiations between hospitals and their insurer.  To make matters worse, if a large healthcare system threatens to drop out of an insurer’s PPO network, employers often urge their carrier to resolve its contract differences with the hospital to limit disruption for employees.  The insurer, concerned over losing membership if the PPO network loses a flagship provider, quietly caves and the cost of inpatient healthcare trends continue to rise. To make matters worse, employers have consistently resisted implementing narrower PPO networks that might otherwise force billing outliers back toward the mean costs of delivering care. It seems employers want to fly first class but only pay for coach.

The insurance industry has committed its share of financial and public relations misdemeanors during the two decade run up of healthcare costs. Yet, insurers were uniquely singled out during the recent debate leading up to the Affordable Care Act.  Politically, the black hat payers were easier targets than other stakeholders who have abetted the demise of our system: consumers with unrealistic expectations, doctors using malpractice avoidance as air cover to oversubscribe services, drug companies and PBMs engaged in intricate and difficult to understand pricing practices, employers who have remained parochial and disruption averse, the food and agricultural industries for practices that promote products that adversely impact public health, the government for its serial under-reimbursement of providers through Medicaid and Medicare and a range of stakeholders who ineffectively advise and assist the industry in its quest for an optimal balance between quality and affordability.

Steven Brill’s thoughtful rendering is an inch wide and a mile deep as it illuminates the need for hospital payment reform.  However, he stops too soon in his expose, refraining from identifying the other accomplices that drive these billing behaviors — including a Medicare and Medicaid system that enjoys low administrative costs but presides over an estimated annual $100B waste and fraud problem arising out of unmanaged fee for service care.  Medicare is beloved by seniors partially due to the simple fact that it does not manage care.  What Brill also misses is the private sector’s apathy in aggressively punishing high outlier unit costs charges by taking on some of our most sacred players – large teaching hospitals and system oligopolies that now dominate many regional landscapes.  As consultants, we have failed to convince employers of the merits of eliminating open access PPOs, increasing consumer directed health plans, using scheduled reimbursements for elective surgeries and enforcing a bi-lateral social contract around good health by requiring workers to see a primary care doctor and receive age and gender appropriate testing to better manage health status.

As with any stakeholder that feels singled out, the AHA response to the Time’s article was swift and predictable.  I’m sympathetic. Laying our affordability crisis at the feet of any one group misses the entire point of our issues in the US. However, the need for reimbursement reform and billing simplification is irrefutable.  Our system is in crisis. The question remains: will we move towards a delivery model that allows market based reforms and affords consumers a greater role in driving quality and cost effective delivery or will we wake up in a decade to a single payer that rations access and peanut butter spreads reimbursement.  One could argue our entire healthcare system can be best summed up by the average US hospital bill – opaque, misunderstood and bearing little relationship to true cost of the services.

 

A Groundhog Searches for His Winter Shadow

The New England winter doldrums have descended and life has slowed to a twilight drift across denuded woods and frozen ground. It is at this time of year that I revert to the ancient ways of my ancestors – - avoiding the cold weather and socking away calories like a hoarder collects stuffed animals. December through February is a dark turn of a page where prolonged periods of inactivity fuel the need to overeat. I am now disturbed by the man I see in the mirror. He is a strange, lumpy changeling – a human ground hog that hardly resembles the dashing young mammal that used to amble so easily across the green grass of my youth. I prefer not to make eye contact with him and view him only in certain light – preferably a Blanche Dubois 25 watt bulb or even better, complete darkness.

Winter weariness is normal and brought about by deprivation from the sun, the lack of Vitamin D and in my case, resentment of growing up in a land where winter used to mean warm Santa Ana winds heated by high deserts and spectacular days of eighty degree weather. I have yet to join the fraternity of “hearty” New Englanders and routinely mumble rhetorical questions to myself as I scrape ice from my windshield. “Why did I ever leave Los Angeles?” “I could be having my colon cleansed right now. Whose stupid idea was this?”

When I get depressed, I eat. Having given up the traditional vices that often medicate many in Northern latitudes through dreary winters, I turn to food. Each night I engage in mindless foraging and revert to a newborn’s feeding schedule where I awaken hungry every two hours.

My spouse always recognizes when I have overindulged. Perhaps it is the trail of Nature Valley granola bar wrappers or empty wax paper tubes of Ritz crackers. The dog swims under me like a pilot fish hoping for seconds. Any pale morning might reveal a hastily opened bottle of Rolaids or an opaque glass of water with baking soda congealing at its bottom.

I have already betrayed my paper tiger New Year resolutions around weight, diet and food. Each year, I bargain with the cosmos promising extraordinary commitment to health and human service in exchange for modest metabolic change. By mid-winter I am once again a portly Prometheus with my insides devoured by a great eagle of heartburn that attacks each night.

I eventually act on my own disgust and return to the gym. In my latest spasm of fitness, I run four miles and lift weights to feel the reassuring burn of my metabolism. It will be spring time soon and with the first crocus, I may be required to go “skins” by a public pool or at a beach. The ache and perspiration of my work out gives me permission to feel better about myself – so I go to Tony’s Deli and celebrate my improving self esteem with an egg sandwich, potato cones and hot sauce. As I catch a glimpse of myself in the glass door, it appears as if I am hiding two midgets in the rear of my black sweat pants. A woman glances at me and seems suddenly inspired to tell her friend about her recent half stone weight loss. I feel compelled to tell her that I have found her seven pounds and am eager to return them to her.

It is Super Bowl Sunday – the last major winter milestone where food is a centerpiece of the celebration. Tomorrow, I must diet. I will soon be staring at my summer shadow and would prefer not be known as the human eclipse. What I really need is a high school reunion or some vanity based event that compels me back to Jenny Craig and salt less portions no larger than a thimble.

I am soon standing over a buffet offering more fat than an August Sunday on Coney Island. There is something comforting about a family party with its endless conveyor belt of pot-luck food and homemade desserts. I do not discriminate. I eat everything. I challenge the structural integrity of my flimsy paper plate piling it high with a Devil’s Tower of reflux — chili, mozzarella sticks, sushi, chicken wings, jalapeno poppers and of course, carrots to help me see each bite more clearly. I crown this massive culinary surge with a tiara of baked ziti and then skulk toward a dark corner to devour the monstrosity. I put two forks on my plate to give others the illusion that I am sharing with an invisible partner who has only momentarily left me to find a towel to serve as our napkin.

What is it about free food? I notice this same lack of self-possession when I leave leftovers in the office lunchroom. I watch in fascination as people who have just finished lunch eat an entirely new lunch because the sandwiches are without charge. Yet, I am strangely reassured by this behavior. This ravenous herd of unrestrained eaters are part of my tribe.

Yet, as in all of nature, there is another group on my island – The Others, an ensemble of odd aliens who can leave half a dessert on their plate or half the wine in their glass. These unfortunates are cursed with moderation. They chew each bite like a cow and only selectively pick at the bonanza of food found at holiday buffets.

I watch from my private alcove of indulgence as skeletal, thin wristed women with dark form fitting jeans meticulously grab celery and cherry tomatoes from amongst the jalapeno poppers, calzone and Italian sub slices. These cadavers turn sideways and for a moment I cannot see them. They will be the first to die in a famine. Their restraint haunts me.

I return to the dessert table to eat several cookies and sample a brownie that is disappointingly bland and cakey. I eat it anyway. Somewhere someone is starving. It does not matter that I am full. I notice macaroons which have been advertised as “gluten free”. I am uncertain what gluten is but the term troubles me – as if I will be missing something if I eat it. But the coconut puck does have the word “free” in its advertisement, so I stuff it in my mouth. In my haze of sugar and simple carbohydrates, a child cuts in front of me. She looks up at me and smiles. I give her a gentle shove with my knee – the way I lovingly push my dog back when he is crowding me.

I survey the cornucopia of sweets and wait impatiently for more room to form in my stomach. Behind me a kitchen light casts my silhouette across the dessert tray and like Punxsutawney Phil, I look down and suddenly see my shadow. It is a bad omen.

Normally, only four more weeks of winter would be welcome. However, the way I see it, this means there’s only one month of winter before this ground hog may have to remove his hair shirt in public.

Wanted: CEO for Turnaround. Private Jet and Great Benefits

I got a call the other day from a head hunter looking for a new CEO.

“Look, I’m not going to lie to you.  Acirema Incorporated is a blue chip firm but it is in deep doo-doo.  The succession planning is pretty complicated so they are looking now for a CEO that can take over when the current CEO retires in 2016.”

“It seems sort of far off but okay, what’s the deal?”

“It’s a classic turnaround.” He chirped enthusiastically. “The firm is essentially bankrupt and needs a strategy to get back in the black.  The company is spending about a third more than it is generating in revenues.  The line of credit with the bank is strained and getting worse as the firm comes close to violating some of the very liberal banking covenants.  The expenses are running over from two poorly conceived overseas joint ventures and a debt refinancing that went south.  The rest of the money goes to finance active and retiree benefits and pensions, new products, customer services and interest on debt the firm has borrowed.”

His voice got low and he was whispering into the phone.  “ I shouldn’t be telling you this but these guys have about an 8:1 debt to earnings ratio – which is alarming – but the bank that holds the debt has given loose terms and has not raised too much concern about the potential for default.  Acirema has a problem looming with its pension and retiree medical benefits as the CFO made bad assumptions about how much money they would have in the future to pay for commitments to current and retired workers.  Investment yields have been bad and the lower returns mean fewer dollars to pay without dipping into principal.  They now realize they made a massive accounting error when they assumed people would draw only three to four years worth of benefits before dying.  The average worker is now receiving benefits for almost thirteen years – six times what Acirema budgeted.  The new CEO is going to have to fix that.”

“How?” I asked

“That’s why they pay you guys the big bucks, I guess.  I’m just a head hunter on a commission.”

He continued having memorized the entire terms of reference. “So, the firm is underfunded in its medical retirement plan to the tune of almost twenty-five times our annual revenues.  Management can’t honor these commitments with the union and the new CEO is going to have to break the news to the collectively bargained groups who may threaten to strike.  There’s a lot of waste – endless committees and departments.  You can work at the firm twenty years and retire and get 90% of your former salary as a pension.  You can then come out of retirement and get a new salary AND your pension. It’s crazy.”

“Jesus” I said.

The recruiter laughed. “We wanted to offer him the job but could not find his number. Your two predecessors have really messed things up. Revenues are down and many want to raise the price of company services and cut the stock dividends to shareholders but management is not sure if shareholders will go for it.  If they don’t raise revenues, they have to cut dividends deeper and lay off staff.  Acirema is heavily unionized and cutting expenses could create huge problems – even an industrial action.

The board of directors is dysfunctional and divided.  The truth is they have never made money – only made a profit five times in fifty years – but the firm is deeply respected and has done more to influence our industry in the last two hundred years than any other peer.  The board has a low approval rating from our shareholders but they keep reelecting them.  We need a Chairman and CEO that can lead.

Shareholders don’t have a realistic understanding of the economics of the industry in which the firm is now entering.  The next phase is the proverbial “Fourth Turning” – an unraveling phase that precedes a winter crisis that will eventually open up everyone’s eyes to the need to change.  Whoever joins the firm as CEO in 2016 will most likely be grabbing the helm right when the wind is at gale force and the barometer is dropping.”

“Wow, Mrs Lincoln! ” I said sarcastically “Other than that…”

“Here’s the good stuff: The job pays $400k a year plus a $50k expense account. You get to use the corporate house for free and we have a luxurious, multi-acre estate  that is available to you for meetings and weekend getaways.  You get $200k as an annual lifetime retiree benefit.  The firm will give you use of the private jet and helicopter and unlimited vacation – although you will probably never take much.

Now I won’t lie to you.  It’s not for everyone.  You have to be ideologically strong and determined with the unions, employees, shareholders and the board.  Your job is to break up cartels of indecision, pay down the debt, create a blue print for 4% growth and do not let your competitors turn you into a silver medalist role in the industry. It takes guts, charisma and a slightly masochistic personality. What do you say?”

I did not have to think long.  “It sounds like a great opportunity but I am not sure anyone could fix that firm.”

He sighed. “Yeah, that’s what everyone else has said.  You’re the four hundredth guy in the private sector I have called.  No one wants to touch this one.  Could you give me any names?”

“Well”, I said.  ”You need someone who will break eggs and not care about making friends. This requires a benevolent dictator.  A “Fourth Turning “ leader is less of a visionary and prophet and more of a commander and tough guy.  I’m too empathetic and right brain. You need a Lee Iacocca.”

“Hey, not a bad idea.” The recruiter said. “He’s still kicking, isn’t he. Do you have his cell number?”

Okay Dad, Hand Over The Credit Card!

English: Federal Debt Held by the Public by U.S. Presidents and party control of Senate and House, 1901 to 2010; source for debt data is Congressional Budget Office, “Federal Debt and the Risk of a Fiscal Crisis”, July 27 2010, http://www.cbo.gov/ftpdocs/116xx/doc11659/07-27_Debt_FiscalCrisis_Brief.pdf (Photo credit: Wikipedia)

The front door slams and a man with graying hair looks up from his book over rimmed glasses as he sits in an adjacent room. A young woman in her early twenties drops a duffel bag on the wood floor of a well-lit foyer.

Father: You’re home! How’s grad school?

(The girl looks irritated and says nothing)

Father: What’s wrong, baby?

Daughter: (The girl hesitates and then holds her hand out in front of him) Okay. Hand it over!

Father: What are you talking about?

Daughter: The credit card. You and your kick-the-can-down-the-road generation have bankrupted my future. (The girl drops a NY Times on the coffee table and becomes sarcastic) It says in here that the Fiscal Cliff has been averted. Ha! They might as well have announced that the Easter bunny is real. I just finished Michael Lewis’ Boomerang and Strauss and Howe’s The Fourth Turning and I’m depressed.

Father: Haven’t got to those books yet. Since November, I have turned to Merlot and escapism. I’m reading a bestseller about the 16^th century. (Pointing to the newspaper, smirking) Cheer up! The Paper reports that the fiscal cliff is a bunny hill and Paul Krugman says spending our way out of the deficit is the only path back to prosperity. I hear Barney Frank may come out of retirement.

Daughter (looking incredulous): Are you kidding me? They only agreed to delay the debt ceiling discussion for 60 more days. Then they are going to ask Congress to raise my credit card limit. Even if the president got all the taxes he wanted, he’d have raised what, $80B of revenues? Where’s the other $15.92 Trillion going to come from? Government made a bunch of promises back in the 1960s in the form of Medicare that they no longer can keep. We’ve known it for a while, but we are hiding it like Enron. If the US government was a public company, the executives would be in jail for accounting fraud and the country would be in receivership. In the real world, you don’t pay as you go! There is bi-partisan dishonesty about the budgets and how dire our situation is. There is a deficit, all right. It’s a deficit of honesty, vision and courage in our public officials and it’s a deficit of public willingness to accept responsibility for managing a problem that has landed in their laps. Winter has arrived and you jerks keep spending the next few generations’ money to avoid a few cold nights.”

Father: It’s not us. It’s that damn Obama. He has created more debt in the last four years than all the Presidents that preceded him. He passed socialized medicine and now he wants to raid Medicare to pay for it. He’s added at least $7B of public debt and he wants to raise the debt ceiling and spend more money. He’s never worked a day in the private sector and can’t balance a lemonade stand.

Daughter: Dad, get real. The guy inherited a nightmare and a constituency that can’t face reality. This is about facing the fact that our healthcare system is broken and literally sinking the country. At some point, no one will lend you money. Congress and the White House have never shown fiscal discipline. We have recorded a budget surplus just five times in the last fifty years. Four of the surplus years came together from 1998-2001, President Bill Clinton’s last three years in office, and President George W. Bush’s first year in office. By the way, our publicly stated debt counts only current cash obligations. The real debt we are facing is more like $75 trillion dollars because we’re not adding in $45T in underfunding for Medicare. Every politician knows this but it is a radioactive secret. Both sides keep up their “Medi-Scare” rhetoric because they want support from retirees who fear they will lose benefits. Face it, Medicare is the biggest single drain on our budget and we have to deal with it.

Father (getting mad): There’s no damn way I’m going to let them raid Medicare to pay for nationalized Obamacare.

Daughter (smiling condescendingly): Dad, Medicare is unmanaged, fee for service, nationalized healthcare. The government controls Medicare costs by rationing reimbursement to doctors and cost shifting to the private sector. It’s the greatest generational rip-off from young to old in the history of the country. Medicare was established when there were 16 workers for every retiree and the average life expectancy was age 68. In 2030, we will have only two workers for every retiree and will have 80 million retirees, four times as many as today. The math does not work. Social Security is not the problem. We have to cut Medicare and make some tough decisions about how we deliver care in the last few months of life.

Father ( getting angry): Oh, now you want to euthanize me and your mother? This is not about Medicare. It’s about a socialist President who wants to redistribute wealth. We need to elect some fiscal conservatives. The Dems won’t make tough decisions. They are give-away artists who pander to Unions, illegal immigrants and anyone who feels they have gotten a raw deal. The GOP needs to win back the White House.

Daughter: Dad, don’t hold your breath. Try running on a platform of fiscal austerity when the new majority is being told that there was a big party from 1998-2008 that they did not attend but that they must now pay for. The demographics in America are changing and a large enough percentage of the GOP’s base has seen their standard of living decline that they have begun to identify with moderate Democrats joining an increasingly heterogeneous group of pro-Democratic voters. The GOP has not been able to convince non-Caucasian voters that they would benefit under their leadership.

Father: Jesus, you’re depressing. Do you have any good news to share?

Daughter: I’m taking Mandarin and I have a summer internship with an Indian microfinance firm that is trying to expand into China and Africa.

Father (trying to appear encouraged): Well, that’s great. Although it sounds like you are going to have a hard time finding a good cheese burger. (Looking bemused) My kid’s going to have to immigrate to another country to find a decent management job.

Daughter (hugging her father and laughing): Not necessarily. We just have to show the resolve to confront healthcare spending and the weight of our entitlement obligations. If we do that, we can be competitive as a country. The way I see it, we have four choices: default on our debt, raise taxes that only delay the day of reckoning and slow down our economy, create a centralized rationing regime in the form of a single payer healthcare system or migrate to a defined contribution premium support model where people receive help buying public or private insurance. I don’t think we want number one or two. So that leaves three or four. We’ve got to get honest – fast and (looking stern at her father), we have to cut up your credit cards.

Father (grabbing his daughter’s bag): How in the hell did you get so smart?

Daughter (smiling and putting her arm around her father): Four years of economics. I have your ear for BS and Mom’s ability to balance a checkbook.

Father (nudging daughter with shoulder): So, you going to tell me who you voted for in the elections?

Daughter (grinning): Ron Paul, I wrote in

Father (making a face) : That was a wasted vote

Daughter (pretending to look offended): Hey, last time I checked, this was still a Democracy.

Alice in ACA Wonderland

Alice: Cheshire-Puss, would you tell me, please, which way I ought to go from here?

Cheshire Cat: That depends a good deal on where you want to get to.

Alice: I don’t much care where.

Cheshire Cat: Then it doesn’t matter which way you go.

Alice: —So long as I get somewhere.

Cheshire Cat: Oh you’re sure to do that if you only walk long enough.

Lewis Carroll, The Adventures of Alice in Wonderland

2013 has arrived and employers now find themselves on the other side of a looking glass facing the surreal world of healthcare reform and a confusion of regulations promulgated by The Accountable Care Act (ACA) and its Queen of Hearts, HHS Secretary Sebelius. Many HR professionals delayed strategic planning for reform until there was absolute certainty arising out of the SCOTUS constitutionality ruling and the subsequent 2012 Presidential election. They are now waking up in ACA Wonderland with little time remaining to digest and react to the changes being imposed A handful of proactive employers have begun, in earnest, to conduct reform risk assessments and financial modeling to understand the impacts and opportunities presented by reform. Others remain confused on which direction to take – uncertain how coverage and affordability guidelines might impact their costs.

If reform is indeed a thousand mile journey, many remain at the bottom of the rabbit hole – wondering whether 2013 will mark the beginning of the end for employer sponsored healthcare or the dawning of an era of meaningful market based reform in the US. HR and benefit professionals face a confusion of questions from their companions – - CFO’s, CEOs, shareholders and analysts.

How will reform impact our business? Will we take a hit to earnings as a result of penalties or the cost of having to expand coverage? Have we reviewed our strategies for modifying our employment practices to mitigate coverage risks? How will we offer benefits in 2014 and beyond? What financial and coverage considerations should guide our ultimate decisions? Do we think we can manage our healthcare costs to low single digit levels of annual medical inflation? Do we have the right funding strategy? What are our competitors likely to do?

It seems that questions only lead to more questions. For many, the future is less certain and for a few doomsayers, ACA is the final chapter in a narrative about a world of entitlements gone mad. Like Alice, benefits decision makers are asking, “Which way should we go?” – - to which the historical response for employers has been: “follow the path of least disruption”. Yet, ACA has set a new normal in motion and with it, the historical axioms of “do no harm” will no longer work in benefits management. There is no path to achieve the holy grail of affordability that does not carry some risk of delay, disruption, confusion and/or increased administrative complexity. The decisions one makes for 2013 will have an impact on costs and plan participation in 2014. It’s time to get moving but you’ll need some advice to safely cross Wonderland:

1. Think like a risk manager – Any risk management professional has been trained to first review risks, evaluate risk drivers, eliminate or mitigate the identified risks and find the most advantageous way to finance the risks. The roadmap to ACA compliance requires similar planning. Equipped with payroll, coverage and actuarial plan value estimates, any employer can quickly determine what, if any, penalties they may face associated with offering unaffordable or inadequate benefits to eligible employees. Once the risk is assessed, you can explore safe harbor and limited penalty scenarios as well as financing solutions designed to direct participants toward “win-win” scenarios that achieve savings for the employer while helping lower paid workers become eligible for more generous federal subsidies.

2. Strategy first, structure second – Planning for reform means understanding where you want to go. Do you believe providing healthcare is an essential part of the social contract between you and your employees? Are your business conditions changing – causing you to rethink what you offer to employees and how you pay for their benefits? Are higher per capita healthcare costs requiring you to think differently about providing compensation, benefits and retirement? Your total compensation strategy may require you to think differently about the road ahead. You may want to tie annual medical premiums to profits through a defined contribution approach. Strategy is essential. It dictates your direction and enables speed. Without it, you are merely running through the forest, hoping to find a path.

3. The reform roadmap requires you to either “play” or “pay” – While certain industries such as retail, manufacturers, hospitality and agriculture are already calculating the additional costs associated with reform, other employers are finding that they satisfy many of the requirements dictated under reform.

Most firms over 100 employees generally offer medical coverage that meets or exceeds ACA coverage and affordability requirements for the majority of their employees. They have little exposure to penalties. However, these same firms are plotting the coordinates of how reform may change the way they think about financing and offering medical benefits. If the Y axis of reform is “Play” (some version of employer sponsored healthcare) and the X axis is “Pay” (electing to pay a penalty either as a result of failing to meet affordability or coverage requirements), employers have a continuum of choices that range from Maximum Play (Cover All Eligible Employees) to Minimum Pay (Drop Coverage, Pay Penalties, Don’t Gross Up People For Lost Coverage). Each direction requires careful planning and an eye toward discrimination and coverage regulations dictated prior and post reform. One thing is clear: there is more than one way to navigate the Affordable Care Act.

4. Don’t feel guilty about reviewing pay or play scenarios – Reform gives any employer a rare opportunity to reexamine their employee benefits strategy. Management has a fiduciary responsibility to explore all the alternatives presented when business or public policy changes. There are obvious risks to course corrections that may steer you away from traditional employer sponsored insurance. They include the inability to attract and retain talent, effects on employee morale and one’s public image in the community. While over 85% of employers surveyed by the International Foundation of Employee Benefits confirmed their intent to continue to offer coverage, many are privately considering a different future. In the last two decades, employers have simply failed to rein in healthcare costs and have been stuck in a perpetual rut of health plan renewals that start with double digit increases and end with the shifting of costs to employees in the form of higher contribution requirements, reduced benefits or lower wages that arise out of lower profit margins eroded by health spending. The question remains: have you really tried to change? Reform will either happen for you or to you. It is essential that you openly discuss every alternative and that you have a robust multi-year dashboard that holds all stakeholders accountable to achieving low single digit medical trends.

5. Wellness is vital for any employer who desires to continue to offer sponsored plans: ACA offers expanded wellness incentives to employers who aggressively embrace health management improvement. If an employee chooses not to participate in an incentive based wellness plan, it remains unclear whether the act of having to pay a higher premium would make the employee eligible for a public exchange subsidy. Assuming that those who choose not to participate in wellness incentive plans are more likely to be less engaged employees, it stands to reason any employee that opts into a public exchange to avoid the accountabilities of a wellness based incentive plan could help an employer sponsored plan improve its own risk profile.

6. Understand public exchange benefits: Private insurers participating in heavily regulated public exchanges will be under intense political pressure to keep costs down. States and HHS have publically noted that double digit annual premium increases will be viewed as “egregious”. Most open access PPO plans continue to be plagued by double digit medical trends. It is likely that while community rated public exchange plans may actuarially mirror private plans, they will attempt to incorporate more stringent medical management controls such as mandatory primary care gatekeepers, narrower PPO networks and aggressive preauthorization oversight to limit overconsumption, fraud and abuse. Additionally, community rating will shift more premium cost to younger employees as age/sex rate bands limits exchange insurers ability to spread premium burdens to older participants. To the degree an employer is actively pushing employees toward a public exchange, the employer must understand that cost and coverage will not mirror private plans. The rules governing healthcare in the public exchanges may comes as a shock to previously coddled private insured patients while it will be a relief to the uninsured.

7. Defined contribution (DC) plans are a way to redistribute costs, not a path to improved affordability: If you do entertain the notion of migrating to a more defined contribution approach for employees, be certain to understand your options can range from a cafeteria style plan using a single insurer supported by on-line decision and enrollment support tools to a third party private exchange where employees are offered an annual stipend and a range of insurer choices. Cafeteria plans have been available since the early 1980s. Many of these plans failed because of their inability to simplify complicated administration and the natural adverse selection that arose when younger, healthier employees chose lower priced coverage options and redirected premium that might have helped offset claims into the purchase of alternative benefits. Choice will always help reduce employee heartburn when confronted with rising costs. People tend to value those benefits that they can choose for themselves. In the case of a single carrier defined contribution plan, the employer remains active as plan sponsor but has the ability to fix annual contributions while offering employees a greater range of medical and ancillary benefits choices. In the case of multiple carrier private exchange, the employer allows the group to fragment as insurers compete for participants. In these instances, it is more likely that an employer becomes an even more passive financial sponsor, defining annual subsidies but over time becoming less concerned over issues arising from excessive utilization, lack of engagement or rising costs. In a future dominated by DC plans, affordability becomes the employee’s problem.

DC is a cost shifting strategy. If plan costs grow at historical trends, employees will become increasingly disgruntled at the eroding value of the benefit dollars they receive to purchase benefits in the private exchange. Without active efforts to control costs, private exchanges will experience a similar limited life expectancy to the myriad unsuccessful state and private group purchasing based arrangements that have preceded them. Despite the risks, some industry experts view the move toward defined contribution medical plans as inevitable and a logical migration similar to the path taken by defined benefit pension plans toward the 401k savings plan.

Some firms will be intrigued with the notion of private exchanges as they allow management to refocus their energies on other strategic human capital priorities. There is increased recognition that national insurers are engaged in synchronized swimming with similar networks, unit cost contracts, and administrative services pricing. Some analysts believe that offering the choice of multiple insurers in a private exchange reduces employer leverage, undermines the ability to self insure and leads to the inevitable deconstruction of employer sponsored healthcare.The path through ACA Wonderland will invariably require crossing the bridge separating defined benefit and defined contribution plans.

8. Self-insurance is 20/20 vision– Health reform includes assessments that stakeholders will pass on to commercially insured and self funded plans. The preservation of group fully insured policies are essential to insurers profit models. The opaque practice of pooling fully insured risk often lead to the overcharging of employers. Many fully insured plans already contain inflated margin, administration and reserve charges as well as hide inflated broker remuneration. For employers under 300 lives, many insurers do not divulge paid claim data that might help an employer better direct their health management strategies. Despite ACA capping an insurer’s overall allowed loss ratio at 85% for their entire block of 50+ life insured accounts, any individual client can still run well below an 85% loss ratio and they may never know it. Self-insurance remains the most efficient method of financing healthcare – provided an employer understands its risk tolerance. Self-insurance, if structured correctly, can limit financial risk while maximizing transparency. Transparency leads to increased competition leading to lower costs. We estimate that post reform, an employer that chooses to self fund may avoid as much as 4% to 8% of additional expenses arising out of ACA insured plan fees, state premium taxes, margin loads for increased risk arising from compliance, the cost of complying with state mandated benefits and the lost opportunity cost arising out of one’s inability to understand what one’s true loss ratio is when negotiating a renewal.

Which way? The road through Wonderland will be serpentine and fraught with blind corners, misinformation, and strange characters. The future of employer sponsored healthcare and market based reform hinges on which direction employers choose to move. Those that understand where they are today and move with a blend of caution and resolve have a higher probability for making it through the looking glass. For those who remain behind, irritated by the hassles imposed by reform, the future will be considerably more complex. Will we eventually navigate this upside down world of regulation and change? Oh yes! But you have to first decide if you are looking for a way forward or a way out. How long will it take to arrive?

That will depend on whether you know where you are going…

Once Upon a Hurricane or How I Learned To Love My Generator

Storm clouds over swifts creek (Photo credit: Wikipedia)

I am slowly crossing off items on my “I Shouldn’t Be Alive” list. I have had a brush with a nurse shark in Hawaii, and run around like a headless chicken during Southern California earthquakes. I’ve fled falling ash from suburban fires and narrowly missed the eruption of Mt Etna. This does not even take into account my numerous acts of self sabotage during college. I still have several boxes that remain unchecked: being chased in New Guinea by cannibals, being stuck in an elevator with a Jehovah’s Witness or watching a Presidential election with my father. But as of last week, we could attest to surviving our first hurricane

Riding out Sandy seemed exciting. We were miles from the coast and nestled in between the shoulders of two wooded hillsides. While a storm meant certain disruption, Mother Nature was also grounding our two teenage sons – forcing our nuclear family back into a week of close-quarter, analog evenings of card games and trash talk.

As the Monday evening barometer dropped, the tri-state was silently cut from its moorings and we floated helplessly out to sea. Above Connecticut’s Merritt Parkway, most were cut off and clueless to the insanity raging outside our darkened windows. The wind began to rake across a century of trees – accelerating like a freight train passing across a narrow gauge track. Our electricity suddenly cut-out followed by the reassuring thrum of our generator. The lights flickered reminding us of our fragile tether to life’s basic amenities. Our cable, phone and internet communications provider, heretofore known as (Sub)Optimum, collapsed quicker than the French along the Maginot line. True to their regular advertising, we had once again become victims of (Sub) Optimum’s “triple play” — one hit leading to three outs.

Sandy howled and scratched at our patio door daring us to gaze upon her savage face. Peering through paned windows, I could see the eerie Aurora Borealis glow of transformers exploding in the distance. I acquiesced to Sandy’s taunts and opened the door to bellowing wind, swirling debris and deep, obsidian night. Like so many of the stupid people we see on television, I did not understand that the hurricane had launched a thousand sharpened arrows in the form of branches and sticks — any of which could have skewered this suburban pumpkin faster than you can say “he had it coming”. Our resident risk manager informed me to shut the door and retreat into the house. As I closed one door, the garage door mysteriously started to open on its own, a victim of a confusing electrical surge.

Dawn brought wreckage. The lawn was riddled with angled punji sticks, silently launched from the wild archers of the prior night. A massive oak was uprooted in my neighbor Charlie’s yard – its seven foot circumference trunk proving no match for the invisible hand that randomly harvested it like a troublesome dandelion. A hemlock lay on its side leaving a massive headstone of dirt and roots that reached eight feet into the air. Electrical wires dangled like twisted entrails – a cat’s cradle of broken conveniences – reminding me that my tiny generator and its 150 gallons of propane was the only thing standing between me and the movie The Village.

Over the next few days, an entire region would be reminded of property lines, introduced to tree wardens, forced to read the fine print of their homeowner’s policies and come to grips with terms like: “acts of God”, “proximate causes” and “business interruption”. A presidential election would pass the tri-state unceremoniously like a distant clipper ship. We finally accessed newspapers and televisions and learned of tragic deaths, overwhelmed neighborhoods and homes swept out to sea. Lower Manhattan was flooded and plunged into darkness. Transportation was ground to a halt and the NYSE closed for a historic two days.

I became irritable and discontent. I decided to focus my rage on my cable provider, (Sub)Optimum – ordering them to restore my cable, phone and internet – this very minute. I punctuated my temper tantrum with a firm “or else.”

“Or else what?” inquired the calm therapist who had been hired to mollify abusive customers until their arms tired. I was stumped and hung up.

School was cancelled. The kids ditched us like a bad neighborhood and headed for families with heat, cable and full refrigerators. Every few hours, the generator wheezed like a fat man climbing a flight of stairs and our lights would fade to brown. A yellow warning light began to blink on the generator indicating a low level of oil.

It was indeed a fortnight of strange days. Lines began to form at Steve’s local Gulf station as a rumor circulated that bandits from Wilton had hijacked a gasoline truck and rerouted it to Orem’s diner. I saw six people chasing a propane truck offering money. Someone told me that a woman in New Jersey woke up and found a six foot shark swimming in a salt water filled depression on her front lawn. A teenager was rumored to have thanked his parents for a ride to a friend’s house. My man, Mitt Romney, lost his bid for the White House. To cap a week of indignities, Old Man Winter did an early autumn drive by and hit us in the face with a pie of slush and snow.

The absence of electricity and mass media created a vacuum giving people way too much time to think. Many ruminated over the election and declared the results tantamount to the opening of Revelations’ Seventh Seal. Others quietly smiled in darkened houses and apartments feeling their first flicker of power in a week. I admit I was depressed over the election results. I descended into my usual abyss of self pity with my biggest concern that I would not be able to fit into the cardboard box that I expected to be living in by 2016. My butt was getting too big.

In my darkest moment, the lights suddenly flickered on. The computer router lights grinned green and the television pinged on. If it is true God only gives us what we can handle then it seemed he had determined that I had a low threshold for pain. The good news is we’re all still together. Yes, it’s gonna be a bumpy ride. We have to dig out of a mess of trees, wires, budget deficits, mounting debt, partisan politics and disturbing fractures along racial and social fault lines. Closer to home, I will still suffer the periodic indignities of Sub-Optimum and I will keep asking our local officials how much it costs to bury all our electrical wires (according to newly minted State Congressman Tom O’Dea, it’s about $1m a mile). Personally, I will miss my emergency telephone updates. I would gladly pay higher taxes just to have someone walk by my house each night reassuringly yelling “one o’clock and all is well.”

One thing is certain: our ability to gracefully navigate environmental, political, social and climate changes will define us as a generation. Frankly, I’m over my depression. I’m getting energized and am ready for a good fight. You can take away my electricity — but I’ll be damned if you’re going to take away my power.

See My Thumb, Gee I’m Dumb

Image via CrunchBase

I received an email this week from Tim Cook, CEO of Apple, congratulating me as the 7^th Billionth customer to purchase an iPhone.  Apparently, there were only two people left on earth –some nomadic Mongolian named Davaa and myself – who had yet to convert.  In my case, I had been resisting Apple’s 21^st century phone due to a deep addiction to my Blackberry. In Davaa’s case, he simply preferred texting using smoke signals from horse dung fires.

For years, I have been a power Crackberry user.  Having mastered the ability to type without actually looking at the keys, I sent memos while sitting in dark theatres and dimly lit taxis.  My ability to write a missive under the table at dinner while maintaining eye contact with my spouse placed me in a rare pantheon of Research in Motion uber-texters.  I could bang out three page memos in a matter of minutes.  To the chagrin of my colleagues, I was effectively Twittering with unlimited characters – sharing my frequent inspirations and authoring Pulitzer Prize winning memorandums.

I could compose documents while working out on the elliptical at the gym.  I wrote several chapters of a book as well as numerous columns for the paper while jogging through the air on my metal lectern.  I debated entering the “50 and Over” age bracket for the national texting competition. I was beyond productive.  I was a prodigious, verbally incontinent cyber God.

Yet, my prolific emailing had a darker side and eventually led to several attempts on my Blackberry’s life.  Someone was going to great lengths to incapacitate my hand held device.  At first, it was innocently “misplaced” for a week between the cushions of the sofa.  It was run over in the driveway by a car. Each assault was well coordinated and clearly intended to discourage me from my manic memo writing.  Yet, My plucky hand held partner would not die.

About this time, I became increasingly aware of people using iPhones with Face Time video chat and those glued to Apples and Hulu Plus watching lost episodes of Lost.  My plain Jane Blackberry clearly had her limitations but I had promised to remain with her in sickness and in health. It finally took a very bad day – a depleted battery and a Blackberry server outage followed by the inability to download an important attachment – to force me to defect from RIM and join the Apple Army.

I had been the subject of ridicule by my three teens for failing to keep up with technology.  I countered that this was a productivity tool and that I was a very productive tool.  When I finally relented and upgraded to an iPhone, their reaction would have made you think that I had received a donor kidney.  The phone was immediately ripped from my hands and loaded up with a million useless applications including one that would allow me to successfully sign with a deaf Croatian dwarf should I ever encounter one.

They introduced me to Siri, the fickle female genie and purported personal valet that would manage my cyber universe.  When no one was looking, I attempted to communicate to Siri.

“Hi, Siri”

“I don’t understand you.”

“I just said, hello”

“Whatever.”

Apparently, Siri is a teenager.  My first attempt to send an email did not go well.  I felt like I was typing while wearing two catcher’s gloves.  With the Blackberry, my digits felt slimmer than Eubie Blake’s fingers.  After switching to the iPhone, my hands suddenly transformed into bloated zeppelins.  I became a human thumb.  The phone presumptuously corrected every word for me resulting in my first gaffe as I responded to a colleague’s email to please review a report he had written before the end of the evening.

I quickly tapped out, “I’ll peek at it when I get home.”

Within a minute, I received an email that simply read, “TMI. It’s not that bad.”

Glancing back at the castrated message, Siri had mischievously corrected my note to read, “ I’ll pee on it when I get home.”

My next multi-paragraph email took one hour and I finally deleted it out frustration due to typos and castrated syntax. Somewhere in the cosmos my colleagues were declaring this day a national holiday from the tyranny of my Blackberry memos.

That night, I dreamed that a giant Isotoner glove was chasing me.   I awoke the next day and went to get my morning Zumbach’s coffee.  My nose was running and my hand was shaking. I was clearly having withdrawals from my Blackberry.  Everyone around me was happily swiping and tapping on iPhones.  I just wanted my old Blackberry – who was now home, drained of his battery and staring up at me with a blank screen saying, “why, Mike, why?”

I sat at the small table tucked in between a bustle of morning java Junkies, reassured by the smell of roasted beans and the caffeine now coursing through my veins.

“I can do this.” I declared as I typed another memo to staff.

After two sentences, the phone kept self-correcting to pronouns and verbs that I did not understand. My blood pressure began to rise and I squeezed the phone – which caused Siri to wake up.

“What can I help you with?”

“I want you to die, Siri!”

“I am sorry. I can’t do that.  Self euthanization is illegal.”

Just then I got a text message from my son.

“How’s the phone?”

“Not good.  It is messing up and writing weird notes.”

“I programmed it to self correct in Dutch. hahaha”

I give up. Anyone know where I can buy some horse dung?

Get a copy of Michael Turpin’s new book, “T-Rex By The Tail” at Elm Street Books and Zumbach’s Coffee. 

Protected: T-Rex: Red, White, Black and Blue Chapter I

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Back To School

Reblogged from Michael A Turpin's Blog:

Back to The School

It’s the week after school has started and I am already having those yips like a war veteran as I watch my soldiers leave each morning at 6:45am with field backpacks, educational essentials and new clothes to be sent into the " bush " of high school.  It is a time of great anticipation and angst.  We are on a slow conveyor belt to an empty nest with one in college and two in high school. 

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They're back - in school and once again exploring the perimeters of our green grass worlds. Keep your hands and feet in the car. It moves fast.

Ask Jack

Reblogged from Michael A Turpin's Blog:

Ask Jack

“Fashion is a form of ugliness so intolerable that we have to alter it every six months.” Oscar Wilde

It was a cloudless September Saturday full of Indian summer promises. I had emerged from my closet ready to pace the sidelines of two football fields.  I had my usual ensemble - white cargo pants, black tee shirt, flip flops, backward facing baseball cap and retro Ray Bans.

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It's as apropos as it was in 1975. Dress properly and prosper !

The Great Air Conditioning Wars

Reblogged from Michael A Turpin's Blog:

“It was luxuries like air conditioning that brought down the Roman Empire. With air conditioning their windows were shut, they couldn't hear the barbarians coming.”

Garrison Keillor

We recently received a letter from CL & P that provided normative data from our immediate neighborhood on our electrical consumption.  If the letter was to be believed, we were consuming enough power to light several small Midwestern towns. 

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One of my favorites. Sorry that I have been remiss on blogging as of late, but I have just finished a manuscript for the second T-Rex Book - completed over my recent trip to the Islands. Now to the editors ! I will post a few chapters for those fans of Karl Patton. The Allosaurus is alive and kicking in this novel set in 1976!

E-Book Review: T-Rex by the Tail

Reblogged from Musings and Marvels:

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T-Rex by the Tail by Michael Turpin

"When 81 year old neo-conservative Karl Patton dies, his four sons must gather up his bones and dredge the river of their own lives lived in the shadow of their father—the T-Rex.

'The T-Rex father possessed an abnormally large mouth from which he would chew out loud, belch, curse, and devour any weaker form of life.

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A nice review from an on-line reviewer.

Latest Column for Leaders Edge Magazine on Technology and T-Rexes

Latest Column for Leaders Edge Magazine on Technology and T-RexesWill the insurance broker survive in a digital age ?  Can the last of the service dinosaurs adapt?