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Saturday, June 27, 2009

Government Run Healthcare Makes Sense

As a young man I was a Reagan Republican raised in a family of Goldwater Republicans. My views have moderated significantly during the ensuing years but the one thing that hasn't is my belief that each individual is responsible for their own outcomes in life and should pursue them without outside interference or restriction.

With this type of outlook it might then surprise you to know that I favor a national health care plan, either a public "option" or the conversion of the current system into a single payer program similar to the Canadian system.

Why in the world would I feel that way? Simple; for the last 20 years I have had the responsibility over group health plans and have had to deal with insurance carriers.

In the last 10 years the health insurance industry has grown more profitable, has consolidated to just a handful of carriers, and makes literally life-and-death decisions about your health care based upon profit-and-loss considerations. In years past we as corporate Plan Sponsors have been able to influence some coverage decisions by using the leverage of taking our business elsewhere. That influence erodes more each year and has never been less than it is now. That's because there's almost nowhere else to go and the carriers know it.

Our last health care negotiations were hurt by the fact that only four multi-state fully-insured carriers remain: United Healthcare, Blue Cross/Blue Shield, Aetna, and Cigna. No matter which of these is your carrier, that means you're only marketing to the other three. As a rule, Blue Cross has the highest quotes by about 30% as they focus on margin rather than volume: if you want a better price than your current carrier that means you're marketing to only two others. During our recent re-marketing effort (to see if we could get a better deal than we got at our April renewal) we had UHC as our incumbent and Blue Cross was immediately out of the running due to price. The Aetna and Cigna representatives' main questions during our negotiations was "what's the other guy's quote?"

In this scenario its no wonder that the insurance industry is howling about the prospect of a government "option". Entry into this monopolistic and recalcitrant marketplace by a strong competitor would change the landscape to favor people rather than carriers.

Personal liberty would also be increased through a government plan because I believe many people with serious health conditions stay with their employers because our health care system is employer based. To change jobs and risk losing yours, or to start you own business and become self-employed means risking becoming uninsured. According to Dave Ramsey, even though foreclosures have been the highest on record this year personal bankruptcies due to unpaid medical bills are four times that of bankruptcies due to home foreclosure.

I'm loathe to depend on government for anything. But with government I have an elected representative that I can call if my government health plan isn't working. Who do I call if my carrier cheats me on coverage or overcharges me? The current health care system is dictating who can and cannot afford coverage, what is covered, and (since its employer based) where you can work. As such, I would suggest to you that the solution to this lack of freedom is, paradoxically, the government. I can elect my representatives but I'm stuck with my UHC rep.

Tuesday, June 23, 2009

Back to Basics on Security

Last week we had a (thankfully) minor security breech that resulted in an a team member's cell phone being stolen off her desk. Someone from outside the company walked past the front desk like she knew where she was going and wandered the building for 12 minutes before leaving the way she came in. She then walked around the property for 8 more minutes trying doors (unsuccessfully) before leaving through the back field. By the time our staffer noticed the theft and reported it to her cell phone provider the thief had made 60 phone calls and sent 72 text messages, all to pre-paid phones. We identified one call recipient through a paid cell phone registry, pulled up her name in the local court website, and discovered a long history of petty theft and drug use. In other words, this was a professional job by professional petty criminals.

In reviewing video and talking to our employees we've discovered how this happened, and it represents a breakdown in some fundamental disciplines that we must reiterate.

  1. Front Desk Security: Challenging Strangers - We use the reception desk to give a positive first impression of the company. That won't change. However, these nice ladies don't know everybody, and sometimes people get ill with them if they stop someone who turns out to be an employee or long-time contractor. I have given them instructions beginning noon today to ask, "Can I help you?" anytime they don't know someone. Since they can't know everybody, some employees may get asked and that's okay. I urge you not to be offended as these ladies are doing this (a) under instructions from me and (b) for your safety.
  2. Front Desk Security: Requiring Name Badges - All non-employees are required to sign in daily to wear a visitors badge at all times. That is not a new policy, but one roundly ignored in some parts of the company. Beginning at noon today that policy will be strictly enforced. Nobody thought a thing about the young woman walking through our building because its not unusual to see temps, contractors, family members, etc... in the building without a badge.
  3. Children in the Building - Five people who saw this very petite young woman thought she was someone's teenager because its become so common to see children in the building. Our Handbook is specific and has not changed in eight years that the workplace is no place for kids. Visiting for a short period of time and escorted the entire time is fine. Staying with you after you've picked them up from sick day care just long enough to arrange alternate care or wrap things up and go home is also fine. Hanging out here with you half a day, or wandering the halls, or sent to your workstation unescorted from the front desk has to stop.
  4. Noticing People Who Look "Wrong" - You know what I'm talking about: sometimes you just see someone who looks out of place. Every employee in this building should feel empowered to say, "Can I help you?" and make eye contact with a stranger not wearing a visitors badge. If you feel uncomfortable doing that, call Facilities or HR and we'll do it for you.

I'm the first to acknowledge that our security is bass-akwards and has been for years. We should have swipe badges for access into the building. We'll make our fifth annual attempt at that with the next budget cycle, or anytime this year that we think the money might be available. Until then our security is each other and the array of security cameras operated by Scott Holloway's fine staff. Meanwhile please come see me if being asked who you are or asked to wear a visitors badge offends you. Just don't fuss on the nice ladies at the front desk.

Thursday, June 11, 2009

The Importance of Pushback

We're a relatively small company as corporations go. Aside of our core vendors, like printers, we're just large enough to need first-class service but too small to be a priority customer. To get first-class service you want vendors who also service large accounts like Coke and Google. The problem is that, by comparison, our business will almost never be such a vendor's priority. The common result is that you get second or third priority, your account gets served by trainees, and the service you receive suffers. Managing in a company like ours makes it more important than ever to master the skill of pushback.

This month I've had issues at ADP, one sub-group at Vanguard, a confidential potential vendor whom we've asked to quote, one internal department, and (through my Homeowners Association) the Metropolitan Police. I'm just back off vacation and still in Margeritaville mode and just wanting to slide happily through the days; instead I'm having to periodically put on my "SOB" cap and push back on bad service. With the exception of Metro's Thin Blue Bureaucracy, service is improving on all fronts.

So how do you push back when you have no leverage? Actually, I find that leverage is not required and the solution is to simply stand up for yourself and your business unit. I know that sounds corny or simplistic, but I see it more as a simple and elegant solution. If service isn't satisfactory, just say so. You'll immediately get an excuse and simply don't accept it. Ask the person giving the bad service for a solution, and if they don't have one ask them who in their organization or chain or command would have one. When you ask that question, what the vendor hears is, "He wants to talk to my boss." Nobody wants that distraction or negative feedback, even from a small customer.

This actually works for pricing and billing as well. If you don't like the price of something, ask for a better one. If they don't offer a better one, ask them how long this price is good for since you'll need to shop. I'm always amazed at the price-lowering power of walking away and shopping elsewhere.

If you get a bill that doesn't sound right, ask for an explanation. If you don't agree with the explanation, ask for a better resolution. If the vendor rep doesn't have one, ask who in their company or chain of command you'd need to talk to for resolution.

There is amazing power in not accepting an answer with which you don't agree. That power is multiplied by persistence; not satisfied x not going away = results. Just by making the people whom you're paying aware that you're "not satisfied and planning to stay that way until its fixed" starts a chain reaction that almost always results in a better situation; better service, better pricing, and better overall value.

There are people in this world who get less than they deserve because they won't push back. If they have stewardship responsibilities in a company, church, or other organization then whoever they represent is similarly not getting what they deserve. To be an effective head of anything, your family, a department, a ministry, or even a company you need to master the skill of effective pushback. Go ahead, give it a try...you'll thank me later.