~synthesis~

awakening

The recent uprising in Tunisia was sparked (sorry) by the act of one person, it (very) rapidly expanded into a national uprising that resulted in the ousting of a long time President whose resounding electoral victories (he won his fifth election in 2009 with his lowest mandate - 89%) were always suspicious. Despite his close call in 2009, it was not until January 13 of this year that he announced that he would not seek reelection in 2014, and then realizing this was not enough, fled the country the next day. I'm willing to bet that in the 29 days following Bouazizi's immolation, former President Ben Ali had NO idea that that one seemingly inconsequential event would so quickly evaporate his once-powerful stranglehold on Tunisia.

That one man's desperate act would have gone unnoticed without the amazing communication capabilities, which even the poorest among us now enjoy, is a powerful testament to the world we now live in.

President Hosni Mubarak is reeling from roughly the same kick in the groin, and wondering, "what the hell just happened?" Emboldened by these acts, the oppressed from Morocco to Pakistan are rising against their leaders; leaders who until very recently lived under a wonderful shelter of power, wealth, and comfort without accountability. These regimes (even the faux-democracies) have wielded power over their citizens (many of whom live in poverty) for generations without repercussions. How will things change?

I think there are three lessons to be learned - first, politics or leadership is a delicate balance between the application of power and serving the citizens. Second, the right (and ability) for people to assemble may not be pervasive, but it is unstoppable. Third, be careful what you wish for, lest it come true.

Politics - citizens expect that leaders will be somewhat heavy-handed; they also expect public safety, employment, the opportunity to feed, clothe and shelter their families, and in most places, education and health care. We are all willing to suffer, but there is a breaking point. The Middle East reached it recently; we saw it in Sudan with their referendum; it affected the dissolution of the Soviet Union; and caused America to declare her independence from Britain.

Are Western states immune? Nope - the Wars on Terror + the Patriot Act combined with severe domestic belt-tightening have created unrest across America and Western Europe. The difference in the West is that politicians give away more than they should to win, where in the East, they suppress the populace more than they should to remain in power. But either way, in the end, the people suffer.

I think sustainable leadership requires adherence to three absolutes - Integrity, Transparency, and Accountability. There can be no compromise. Once you cross this delicate line, you are either perceived as insipid (President Jimmy Carter) and lose respect, or as despotic (almost every other example of government gone bad) and subject to revolt. Most governments will use misdirection (Wars, etc.) to keep their citizens in line and resistance at bay, until they get found out.

Assembly - the Communication Revolution is upon us and there is no turning back. Anyone has the capacity to create and share and associate, though its implications are not fully grasped by all. Even the American government was caught off guard by the speed with which things progressed in Tunisia and then spread to other countries. Birds of a feather are able to find like-minded people, convene and create movements in ways that were not possible even five years ago. Once tightly-held secrets (Wikileaks) are also fair game. Governments simply can't keep up.

Wishes - the Egyptians want Mubarak ousted - he is why they live in poverty, suffer high unemployment, and a high cost of living, etc. They want free and fair elections to choose their next government, believing that once Mubarak is gone, Egypt will once again flourish and all will be better. I feel sorry for the eventual winner of the elections - the world markets are in crisis, oil and grain (and hence most food) will be more expensive due weather, this turmoil and the economy; and let's face it - the situation in Egypt (or anywhere else) is not caused solely by its leader - most of the contributing factors that caused these problems still remain, and are very difficult to fix. The next leader may not fare any better.

The world is holding its breath to see what happens in the Middle East - from economics to diplomacy to war, changes of this magnitude to the status quo will have gigantic repercussions. Bouazizi may have ended up doing a huge favor to the Ben Alis and Mubaraks of the world - they will leave (with $$ tucked away in offshore accounts), their successors will inherit the messes they presided over, and the citizens will need to start over.

But there is something to celebrate - rising against despotism is a good thing. Self-determination is a good thing. I hope the citizens of these countries will look inwardly to realize that they are now responsible for their destinies, that they can no longer blame "the man," and that they alone have the ability to create viable economies, and ensure the health, safety and well-being of their families.

a notre sante

In the face of the Republican onslaught against the Health Care Reform Bill, here's a speech I'd consider if I were President Obama.

[The Oval Office]

My fellow Americans, good evening. Almost 30 years ago, President Reagan delivered his first speech to the nation from this very desk in the Oval Office. His speech was about the economy, and the tough times ahead. I wish I could report that tough times are coming to an end, but I can't. Turning our economy around is my highest priority, and today I wish to focus on our health and how it affects the economy. To paraphrase President Reagan, I regret to say that Americans have never been more unhealthy than they are today - there is no comparison in our history; this despite the fact that we spend more on health care than almost every nation in the world.

I recently asked for a health care report card, and here are some high (or low) lights. You won't like it. I didn't like it. But we have to face the truth and then go to work to turn things around. And make no mistake, we can and will turn it around.

The incidence of obesity, diabetes, cancer, heart disease, and others is highest our history. Today more American children are at risk of chronic health issues than ever before; we spend more per person on health care than ever before; and we waste more per person on health care than we can afford. Focusing on our children, 14.5 million (over 20%) live in poverty; over 16.7 million live with anxiety and depression and do worse in reading and math because there isn't enough food to eat. More than 1.5 million American children are homeless, resulting in a lack of safety, comfort, privacy, reassuring routines, adequate health care, uninterrupted schooling, sustaining relationships, and a sense of community. And things are not improving; two million children will be affected by the housing crisis and resulting foreclosures; and in 2000, 39% of children lived in low-income housing, by 2009, it was 42%.

These are shocking numbers, as are their consequences.

Children who begin life in difficult circumstances are most likely to end up struggling throughout their lives, most likely to run afoul of the law, and most likely to become a burden to society to the tune of about $500 billion per year. It breaks down to $160 billion in increased health care costs, and $170 billion each in increased law enforcement costs and lost economic productivity.

Setting aside the moral obligation to ensure that every child in this country has shelter above their heads, is well-fed, healthy, and well-educated, can we afford the economic impact of sick and impoverished children? I know the incoming Congress pledged to cut our budgets by $100 billion, and I'm very interested to see where they propose to make these cuts. But I'd like to up the ante - let's find a way to save $500 billion/year! With deficits ballooning and rising defense and social services costs, I challenge our Congress to make a real and sustainable dent in our budgets, with an impact that will last for generations.

Many will claim that America has the best hospitals, doctors, and nurses; the best technology; the most innovative researchers and the best treatment options available in the world. I agree. There is no better place to be than the United States if you need any kind of medical help, provided you can afford it. But as we've seen, millions of our children can't.

The definition of health care is the prevention, treatment, and management of illness and the preservation of mental and physical well-being through the services offered by the medical and allied health professions. I believe we have the best management and treatment system in the world, but we fail when it comes to prevention and preservation.

Why? As with many things, it comes down to money. The current health care system from pharmacology to treatment to long-term care gets paid when you get treatment. Their success is dependent on your ill-health. Let's think about that for a minute - if you don't go to the doctor, he or she doesn't get paid. If you don't need any medicine, the pharmacist and the pharmaceutical companies don't get paid. For them to be successful, you have to be sick.

Now you might say that being healthy favors the insurance companies, and I thought so as well, but it's not the case. People who are healthy don't buy as much insurance, and don't contribute to rising costs, which help justify premium increases; people who are unhealthy buy more. Insurance companies might prefer not to pay claims, but they realize that they have to keep the machine running - the more people visit doctors, go to hospitals, and seek treatment, the more they can keep raising premiums and growing profits.

Last year, we passed the Health Care Reform Bill, which aimed the state of our - your health care. While it does help, we must do more to address our children's struggles, and to improve the overall state of our economy.

So I challenge us all to find ways to save $500 billion a year, every year by investing in prevention and preservation for our children. From pre-natal to early childhood to young adults, by providing every child with free health care and a great education, we can not only save $500 billion/year, but also lower unemployment, decrease crime, and increase income taxes; all of which will help accelerate our path towards a stronger, healthier and wealthier country.

To close, once again in the words of President Reagan, my fellow citizens, let us join in a new determination to rebuild the foundation of our society, to work together, to act responsibly. Let us do so with the most profound respect for that which must be preserved as well as with sensitive understanding and compassion for those who must be protected.

We can leave our children in poverty, with an un-repayable massive debt and a shattered economy, or we can leave them liberty in a land where every individual has the opportunity to achieve their greatest potential. All it takes is a little common sense and recognition of our own ability. Together we can forge a new beginning for America.

Thank you and good night.

real service

During elections, candidates will tell you that their primary motivation for entering politics is to serve. They are called to a higher purpose, and wish to devote their time and energy to public service. Hmmm... I'm thinking "No..."

Paul Krugman's latest OpEd suggests that the only motivation Republicans have is to benefit wealthy people at the expense of the poor. Krugman thinks the new Republican House is bending their own rules to repeal the Health Care Reform Bill "because it would cover the uninsured — and that’s something they just don’t want to do."

In the wake of the killing spree in Arizona, Democrats also feasted on the militaristic attitude of Republican campaign tactics aimed at stirring their base into a frenzy of fear and anger and frenetic action at the thought of a Democratic leadership. This story was almost as big as the actual shooting - "political rhetoric caused that idiot to arm himself and shoot people." Of course the Dems sought to mark the Republicans as the instigators. For shame!

Both sides are seeking to paint their opponents as evil, misguided fools, ostensibly in the hopes of getting them to see the truth, and come around.

But I think we're being naive - Democrats and Republicans exist neither to create a gay loving, baby-killing Socialist state, nor to create a redneck, gun-toting military state. They simply wish to win; to beat the other party and win.

It turns out governing is almost like the tax they have to pay for winning. I used to wonder how politicians ever work together following campaigns that have so much vitriol. Imagine for a minute that Sarah Palin had run for Congress in 2010, and been voted Speaker of the House -- how might she have "partnered" with Nancy Pelosi to create a bi-partisan Congress? To steal a quote from one of the best movies of all time, "Inconceivable!"

Hence the benignly-titled "H.R. 2: Repealing the Job-Killing Health Care Law Act." It aims to paint the opponent as "job killers" in the lead up to the 2012 election. It isn't about governing or improving health care, or even about creating jobs, it serves only to position one side as job creators and rescuers of the American worker, and the other side as misguided wrong-doers. A good marketing strategy at least.

Surely not all politicians are bereft of the desire to truly serve? Will voters ever prefer a genuine commitment to representing the electorate? Will there come a point in our future when people look back on idiots like Palin and Pelosi and wonder what the hell we were thinking?

Survival (or getting reelected) is the basest of motivations - the system requires politicians to be in constant campaign mode or they die. We live in a very connected world; to rise above the noise and become the preferred candidate, you need to raise and then spend a ton of money promoting yourself and de-positioning your opponent. The economics make actual governing an afterthought.

Can we fix this? What if we limit the President, Senate and Congress to only ONE term, and also ban private campaign spending. Each candidate gets a fixed amount of public money to spend on their election. This might make a difference, but it doesn't eliminate the D vs. R vitriol.

What does? The real problem is not the candidates, it is the electorate. They choose not to engage, hold their representatives accountable, or take the act of voting seriously. Until the right to vote is not given but earned, it will be squandered, and the voters will continue to suffer.

deFUDdle

Back when I worked at IBM, if we didn't have the "winning" solution, our strategy was simple - we used FUD. It was brilliant, and worked more often than you might think. FUD = Fear, Uncertainty and Doubt. The idea was to push the customer's emotional buttons, poke holes, create scary what-ifs, do whatever it took to force a delay, redefine the problem, or whatever so that we were in a more favorable position.

The Republicans FUD skills are renowned. They are able to create a sense of tension in the electorate in ways that routinely befuddle Democrats. Take health care - they did a brilliant job of associating the reform bill with "bad for the economy" and "a perilous step towards socialism" - fantastic! First, I'm willing to bet that most of us don't even know the definition - according to Webster, socialism is a: a system of society or group living in which there is no private property; b: a system or condition of society in which the means of production are owned and controlled by the state.

Is there any real risk that America turns into a socialist country through health care reform? Hardly. There is no correlation between the government providing a service and the elimination of all private ownership, but it's a fabulous way to create FUD. The first people to oppose socialism are our much-vaunted Congress, who let's face it, enjoy private ownership of a lot of stuff, some of which was funded by special interests and the tax payers(!); they will do everything in their power to preserve the fruits of their avarice. So - socialism is an absurdity.

What about "bad for the economy"? Again - there are many ways to make numbers mean what you want. You only have to look at this NY Times article about law schools using misleading data to shore up their performance numbers (graduate employment rates, etc.) to help improve their rankings, and you can see how universities ("reputable" universities) will lie.

When it comes to the economy, there are two things that matter most - I want a good job, and I want to take home more money than I am now. But then here's one pretty diabolical piece of FUD: taxes are bad. Well... I don't think it's that simple. How much tax do you want to pay? As little as possible - right? Me too. Thus the resonance with the Republican push on lower taxes. It makes total sense - or does it?

Do my taxes really matter or is there more to this?? Put another way, the real question in my mind is: how do I maximize my net earnings? What I really care about is how much I take home at the end of the day, the nature of the deductions from my earnings are less important than the value I get for those deductions and whether the net amount I'm taking home is going up. <-- Does that make sense?

If it does, then it's not really about taxes is it? Why not make it about personal profitability? Profits being what you get to keep in your wallet after all your expenses are paid. So if there is a change to our economic system that costs me more in tax but lowers or eliminates another (bigger) salary deduction, and after all that I end up ahead, why should I care?

According to this (well worth a read), the American health care system is the most expensive in the world; in 2006, we spent more than $6,700 per person on health care, compared ~$3,500 for most Western nations. The cost is actually higher since every other Western country has universal health care, and about 10% of Americans don't have any coverage at all, so the $6,700 is actually closer to $7,500 per person.

Digging a bit deeper, 70% of Canadian health care costs are borne by the government vs. 46% in the US; the Canadian system costs about $3,700 per person (just about half of the US cost), and yet Canadians live longer and have a lower infant mortality rate - these are the two primary measures of national health care effectiveness.

Bottom line: Canadians spend $3,800 less per person for better health care. If you're American, you might think - yeah but my employer pays my share - what do I care? Well - if personal profitability is your goal, then you will know that you are paying EVERY penny of your medical insurance costs, whether it is in taxes, payroll deductions, a lower salary, or lower prices at the store. No matter how you cut it, the $3,800 difference DOES come from your wallet, and means those of us who live in the USA earn that much less every year, and die earlier to boot.

Even if the US decided to spend $4,500 per person (for every person), that's still a savings of $2,200 for each of us plus the knowledge that no-one gets left behind. Every person in this country gets access. Every person also gets to pad their wallets a bit, and rarely is that a bad thing!

But how to communicate this? It's a pretty complex analysis, and given the state of education in America, I'm not convinced that every voter is going to understand it. Think back to the last person that had a tough economic message to share with the populace - President Ronald Reagan in is first address to the nation from the Oval Office in 1981 - a brilliant speech.

If President Obama had addressed the nation in just this way - not talking to politicians and special interests as he did in his attempts, but talking to the American people, sitting in his office, and not standing in the House; if he had applied simple metaphors as Reagan did, perhaps each of us might have been able to look forward to an extra $2-3,000 in our wallets in 2011.

anger

Does it feel like the world is angrier today than ever before? Perhaps it's just that communication is so easy, that every action (more often every bad action) in the world is made more visible. But I think it's more than that.

A 22-year-old man shot a Congresswoman in Arizona. There are violent clashes in the Sudan during a referendum that will decide whether the country should be split in half. A few days ago, Salman Taseer, the Governor of Punjab, Pakistan was assassinated; his death was celebrated by a segment of the country that decried his moderate views. The assassin was showered with rose petals and garlands during his appearance before the court. What provokes all this anger?

Extremism exists in every community - that's reality. The "edges" have historically not been as visible to the middle, but the media in their relentless quest for shock-journalism are changing that. Once they become visible, it's much easier for the edges to collect fellow extremists, and wannabe extremists with the tools the Internet makes available.

What were scattered, random, disconnected micro-freaks are finally able to coalesce into much larger, more coherent, better funded, and very real threats to the mainstream. Of course the media will now shower ever more attention on these now macro-freaks, and in doing so, legitimize them (can you say, "Joe the Plumber"???). This is when things get scary.

Being legitimized means that you are accepted as part of the zeitgeist - you are now acculturated, and scarily you are a "respected" force. Look at Moktada al-Sadr who recently returned to Iraq from exile - originally a cleric in a small town, he became political by weaponizing his community, and inciting them to resist. He became a force when CNN and the US Army began to pay attention to him, and this enabled him to recruit more micro-freaks to the point where he went macro.

The scariest part is when a mainstream player decides that to become even more "main," they must incite the fervent and freakish edges to their cause, thus expanding their base with people more driven to act (donate, vote, rock the vote, etc.). Frenzy is currency is politics - the ability to drive your constituents into a frenzy is considered a good thing (for any party); it is defined as:A state of violent mental agitation or wild excitement; temporary madness or delirium; a mania; a craze. Is it hard to picture violent acts resulting from this? If you can drive your constituents into a frenzy against your opponent, your chances of winning have gone up significantly. Honor and being honorable are seen as weakness.

Going back to the Arizona case, the same NY Times article talks about how Sarah Palin's Facebook page contained a map where every "enemy of Palindom" was identified with cross hairs. It's interesting that she just chose to take this down now, in the wake of the Arizona shooting (the Congresswoman is one of the "targets" she identified). Is that an admission of guilt?

I wrote a post after the US Midterm elections last November questioning whether Democracy is simply the lesser evil, and that there must be a better form of government that is at once both pluralistic and of integrity.

No doubt there are horrific examples of wanton violence in non-democratic states around the world, and when they occur, the "voting" countries all rise up to condemn them. And yet more and more we see horrible acts of violence in the name of winning elections in democratic countries, yet no-one rises up to question that.

Campaigning and then governing based on anger is no different than despotism and fascism when it comes to the price exacted on humanity and integrity. In fact, the advantage with despots and fascists is at least you know what's coming and can, to an extent, steel yourself. With democracy acts of anger are random and spurious, and always catch you by surprise and unprepared.

Until politicians (and voters) can agree that winning with integrity is preferred to winning at all costs, acts of anger will occur even more frequently - this isn't the last time a 9 year old girl will be killed by politics.

curativity

Being charitable is an essential part of humanity. The definition of society is a community formed to (among other things) help those who can't help themselves. Humans are inherently giving beings.

According to the National Center for Charitable Statistics, as of August 2010, there are 980,000 nonprofits (that filed IRS returns; there are 1.6 million registered .orgs) in the United States alone; they earned $1.74 TRILLION, and have $3.89 TRILLION in assets. That's an average of $1.78 million in annual revenue, and $3.98 million in assets per organization.

Obviously the "big" foundations skew these numbers with their $multi-billion endowments, but still - $5,637 per American resident was donated in this last (economically tough) year. Impressive.

About a year ago, I received an email from Paul about giving - what's the motivation, why do people do it, etc.? Most people give money to relieve guilt or to (as Paul put it) "make a spectacle of themselves." You only have to look at how philanthropic organizations solicit money - guilt is the essential ingredient in .org marketing. Almost every advertisement or solicitation you see will in some way make you think, "there but for the grace of God go I."

In good times, this works well - those who have respond, and help those that don't. Tough times are often (sadly) also marked with major disasters (earthquakes, tsunamis, hurricanes, etc.), and in these times, people will rally in support of these causes, taking money away from their normal nonprofits, and their beneficiaries can be left with nothing.

Back to the numbers, I'm most shocked by the almost one million nonprofit organizations - surely there aren't this many societal issues that Americans alone wish to address? Surely there aren't a million Americans who are skilled at managing philanthropic organizations? And ...surely there aren't a million+ people/potential employees skilled at eliminating societal problems??

Most nonprofit founders have either personally experienced, or observed a "problem" first hand, and are now compelled to do something about it. This is a great thing - the motivation to help others not suffer as much as you did or saw is truly heartwarming.

But as an old friend once said, in business as in life, you must put the right tool in the hands of the right person. The wrong tool in the hands of the wrong person creates unwanted results: if you give a dentist a jackhammer, dentistry will not occur (!).

We give because we care; we give because we feel guilty; we give because we can. But how do we know the ones to whom we are giving "can"??? What's the assurance that these 980,000 nonprofits have the ability to not just make a symptomatic difference in the moment (palliative care), but actually do work that creates real and sustainable improvement, that eventually eliminates the need for that nonprofit altogether?

There is no assurance - this is the problem. Rarely do the people that form nonprofits have the skills and experience to solve the problem. They may not even have the skills or aptitude to effectively operate a nonprofit. More often than not, their core skills are empathy and fund raising. These are both important, but not enough to get the job done. This is where the whole point of giving is at risk.

You might be asking yourself "what's wrong with hiring the people that can do the job?" Nothing! Except - most people who have the expertise/talent/experience to contribute to the solution and can afford to work for a pittance are already trying to set up their own .orgs! Hence the almost one million separate organizations! Irony abounds.

To Paul's question, I think this is why people make their giving visible - they recognize that motivating others to give is the only real difference they can make.

To the question of how you fix it - how to make giving curative and not palliative? I suggest two acts - first - raise the bar so that actually setting up a nonprofit is incredibly difficult. Second - the big foundations should use their marketing muscle to showcase successful interventions (ones that create sustainable improvement); and then show givers how they can contribute their time and money to helping proven interventions scale through the existing channels vs. setting up their own .orgs. "This is working - here's proof - help make this work in more places!"

Happy New Year everyone - here's to a curative 2011!