Monday, January 30, 2012

What's This Blog All About?

Americans hold the answer to most of today's problems - not government or big business or any other convenient enabler.  Behavior has consequences.  Our behavior is the source of our crises.  Changing our behavior is the way out.  It's good news if you don't mind putting in a little work, but most people don't want to hear it.

One thing has remained constant over the past 30 years, our dissatisfaction with the direction of the country.  You've seen the polls, the statistics and complaints about education, poverty, obesity, retirement insecurity and a long list of woes.  Politicians promote solutions, but things don’t get better.  Meanwhile, political discourse and media reports degenerate into personal attacks and accusations.

Viewing problems from a behavioral standpoint changes the focus.  It's not about the person; it's about the behavior.  If something is going wrong, is it a consequence of what I am doing?  Can I get better results by changing my actions or decisions?  The answer is yes.

Most of the problems that media and politicians anguished over for that past 30 years are situations we have gotten ourselves into by poor choices.  Suddenly we discover that we are not victims!  Things are not beyond our control!  There is no reason to sit around acting helpless, waiting for the government to step in and fix things.  Quite the opposite, many government solutions defy common sense and severely restrict our freedoms.

To fix it, we must change the behavior that keeps digging us in deeper.  Behavior has consequences.  Our errors catch up to us when we are lax in the areas of discipline (knowing when to say “no”), responsibility (admitting when we own a problem), critical thinking (being skeptical about ads and promises), perspective (practicing moderation and distinguishing between wants and needs) and economic understanding (knowing that money spent by governments and corporations comes from us).  I am convinced from decades of observation that our salvation lies in improvement in these five categories.  In short, America is headed in the wrong direction because we, the people, are headed in the wrong direction.

This seems pretty theoretical until you learn to recognize and classify behavior.  Then it’s surprising how much of our misery is self-inflicted.  Every week I'll give a couple of examples of our poor choices, classify them and show how they link to bad outcomes.  I have been doing it for 35 weeks and find new examples all the time.  (Check out a few of my earlier posts.)  Everyone will not agree with all examples or may argue that these failures are simply “human nature.”  It’s true we can’t change human nature, but as our lives become more complex and interconnected and information flow keeps accelerating, the payback for these failings becomes quicker and more serious.  None of us is perfect, but some behavior change is the only real solution, not more laws or promises.  We alone hold the key to better outcomes, to turning the country around, but we must accept it and work together.

Friday, January 27, 2012

Healthcare Costs and Perspective

I have provided a short series on the healthcare dilemma of rapidly rising costs (most recently, January 2, 2012 and September 12, 2011).  I have argued that insurance for more people is not a bad thing, but it doesn’t address the problem of rising cost at all and has a good chance of making it worse.  Once again, let's apply a little perspective to the cost issue.

Today we have drugs and procedures that are saving and extending lives far better than what was available 50 years ago.  It should be obvious to anyone that these advances have come at a rapid pace and that some part of the cost increase that everyone complains about is directly related to these additional benefits.

Look at three articles in the news within the past week or so.  The first tells of a first generation of robotic devices developed to help paralyzed people gain more independence.  Researchers expect significant advancements over the next ten years as new capabilities are added.  The second article tells of a doctor in Virginia using ultrasounds focused on a specific point in the brain to relieve a condition called “essential tremors, a neurological disorder that causes patients to lose control of their hands, heads and voices.”  They locate the problem areas using an MRI and "operate" without surgery.  The procedure is painless and recovery time is essentially non-existent rather than days or weeks for traditional brain surgery.  The third is about the use of embryonic stem cells to improve the sight of people with severe vision loss.  This discovery “could provide hope for hundreds of thousands of people suffering from macular degeneration - one of the most common forms of blindness in developed countries.” (Regardless of your ethical stance on embryonic stem cells, this is still a significant medical achievement.)  By the way, only one article lists the cost - $100,000 for the robotic exoskeleton, probably not covered by insurance; but this new stuff, like any new product or service, usually is quite expensive initially.  In healthcare, the cost often stays high because the choice between having local access with a smaller client base and traveling a longer way to share technology with more people usually drives us toward the more expensive option.  Our competitive healthcare system and patient expectations tend to favor the local model.  (A large group of people pay less to support a single $1-million machine than smaller groups paying to support four or five $1-million machines.)

All the above examples are in the trial stage, but these procedures and devices that were unheard of only a couple of years ago may be things we take for granted ten years from now.  This has been happening for the past 50 years and seems to be accelerating.  So when people ask why healthcare costs (and health insurances premiums) increase so rapidly, part of the answer is that the range and sophistication of treatments are increasing so rapidly.  But we quickly take for granted last year's breakthrough technology and expect a trip to the doctor to cost about the same.

Monday, January 23, 2012

Professional Proposal Planners?

It's hard to believe how badly off we are after the recession or how serious the gap between the very rich and the middle class when there are businesses out there to help plan marriage proposals.  Apparently it’s not good enough to get down on one knee and pop the question!  No, you go out and hire someone for guidance.  We hear about young people graduating from college with huge debts, struggling to find a job, but there seem to be enough of them to support businesses that help you plan how to make a major production out of what used to be a simple personal interaction.

Beyond that, the average wedding now costs $26,542 – other websites give similar numbers but take care to notice their sponsors and sampling technique.  Even so that seems an awful lot to spend on the heels of a recession when employment security is still low along with retirement savings.  Could all this talk about the middle class disappearing be more hype?  Since the median household income in the United States is just under $50,000 (see blog dated January 9, 2012), this average cost of a wedding represents more than half a year’s earnings spent on a one-day celebration.  Let’s apply some perspective – moderation and distinguishing between wants and needs – and critical thinking – aren't these expenditures going to push the participants even further into debt?  Yikes!

Friday, January 20, 2012

Road Rage

A few days ago I was surprised to hear someone refer to road rage.  This is a term I hadn’t heard for at least 5 years.  Back when the economy was rosy and we had nothing better to worry about, the news media decided that road rage was a major problem.  Has it gotten better?  If so, why?  Has it gotten worse? My opinion is that there has been very little change in driver behavior, except possibly that they spend more time on cell phones – which has now become the big issue.  (I found this article from back in August 1998 opining that despite all of the publicity at the time, there was no real evidence of an epidemic of road rage.  There were instances from time to time and place to place, but no epidemic as the news would have us believe.)

What happens to these subjects that are promoted as big, important items at the time?  A list from the past may include such problems as West Nile Virus, various episodes of shark attacks, killer bees crossing the border from Mexico, Y2K, SARS and many others (including weeks of coverage of the Casey Anthony trial last summer).  During all this time, banks were writing mortgages for customers who had no ability to pay them off over the long term, the government continued to accumulate a growing debt, and Social Security and Medicare were (and still are) on shaky financial ground.  We allow the hype subjects (and the fluff) in the media to replace real news by showing more interest in it.  This is not the fault of news agencies; it’s ours for reacting.  Until we behave with perspective, these will be the consequences.

We must be alert, stay on our toes and exercise perspective to sort out the truly critical from the trivial.  It’s up to us to make the distinction, because history has shown that the news media and politicians won’t do it for us.  They will serve up whatever they believe will hold our attention so that they can sell their products or point of view.  We deserve and should demand better!

Monday, January 16, 2012


Bullying is getting so much attention on the news lately – almost as if this generation invented it.  Even the President had some comments on the issue.  True, there have been some reported suicides due to the peer pressure and harassment; and there are faster means of distributing misinformation, threats and insults, so the problem seems worse, but is it really?  And if it is, could it be another consequence of our societal behavior?

The truth is, bullying has been around for ages.  It’s not a recent invention.  It was dealt with in the past by parents and teachers.  Generally they worked as a team, rather than the parent automatically siding with the child.  They had more tools at their disposal for punishing miscreants and the person being picked on was encouraged to ignore or resist before adults became involved.  Still, children felt bad and had their feelings hurt and some people today carry psychological scars from being singled out or picked on.  Were there suicides?  Perhaps, but they were not broadcast nationwide as they are today, so we don’t know.  I do know that when I was picked on in school, President Eisenhower was too busy building an interstate highway system and fighting the cold war to worry about it.

Bullying is about power.  Part of that power comes from being bigger and stronger (and insecure).  Part of that power comes from parents and teachers who are too busy or distracted to supervise the children, too hamstrung by rules and regulations to take appropriate action, or too irresponsible to care.  Part of the power comes from the way other students cowardly keep the ball rolling after the bullying starts, believing, much like their parents that being “cool” and “in” is a top priority (see blog dated 10/17).  Part of that power comes from the person being bullied who has been brought up in a society where victimhood has been popularized, used by various advocates to gain a platform at the expense of their constituency.

In a society that promotes celebrating diversity, students who are different (and aren’t we all?) should be made to feel special and not inferior.  Unfortunately the institutional definition of diversity continues to be restricted, mostly not recognizing different talents and relevant experiences.

If bullying is becoming a bigger problem, it is very possible that the cause is largely related to societal failures in responsibility and our lack of perspective passed along to our children.

Friday, January 13, 2012

Performance Bracelets

While looking for a different article on the Placebo Effect, I found this interesting video.  As you know, the Placebo Effect causes people to recover or show improvement even when they are given only a fake remedy, the familiar sugar pill.  The power of the mind is amazing.  I recall an article a number of years ago stating that the improvement within the control groups in certain drug studies increased as the power of the real medicines increased.  They were getting the sugar pill but believed they were getting even stronger medicine, so had even better results – all psychological.  You can understand how this could play into the hands of "snake oil" salesmen.  They sell you a useless cure and let your mind do the rest.  They get a few believers who help them sell more.  That's why I always say, "Endorsements are not evidence."

Here is the  CBS News video testing the claims of a particular performance wristband, one endorsed by famous athletes, and touted to improve athletic performance.  When people were given the advertised wristband, performance on physical and balance tests did improve.  But when people were given a one-dollar replacement band and told it was special, performance on physical and balance tests improved comparably.  The video also explains how the bracelet company sets up tests to ensure the perception of  improvement.

The scariest part is the ending where, despite the fact that the $30-wristband claims have been debunked, shown to be no more effective than the $1 bands or in fact nothing at all, the participants still wanted one.  This is not critical thinking!  This is the kind of decision-making that leads people to spend money on worthless items instead of using it wisely, and then they wonder why they can't afford to retire.  It's the kind of thinking that leads us to vote for candidates based on endorsements or personal appearance or charisma instead of the leadership and ideas we need.  It's the kind of thinking that contributes to the decline of America!

Monday, January 9, 2012

Can You Live on $50,000 a Year?

An interesting article from NBC asks that question, but, as in all cases, the article must be read carefully.

The reason they pick $50,000 is that this is the new household median income, and (adjusted for inflation) it has fallen over the past few years.  They ask readers to send in their stories.  Just as I said last time, this idea of telling someone’s story is typical of reporters and often misleading.  They are trying to get examples of people to show how they are struggling to make it.  (This is my assumption, that they are trying to highlight another "crisis." I admit that I am reading into their motives.)  None of these examples, however, will be typical, because later in the article they explain that the median income of a family, two or more related people living together, is about $62,000 and that of a single person is just under $30,000.  So a family at $50K would be below average and a single person at $50K would be above.

Nevertheless, my main point comes from the interesting graph near the top of the article.  It shows the median income (adjusted for inflation) over the last 50 years.  Despite the recent dip, the overall trend is upward.  Looking at the big picture, the long term, in other words using perspective, we see that on average we are better off than we were in 1965, 1975, 1985, 1995, even 2005 (in pure dollars, adjusted for inflation).  If we could get by then, we should be able to get by now – unless our needs and expectations have change significantly.  As usual, there is no crisis, just a problem of behavior.

What drives the question of whether we can make it on $50K is the underlying assumption that we must be on a continuous upward slope, with no year-to-year dips.  As our resources increase, so do our appetites - our wants, not our needs.  The graph shows that the world doesn't act that way.  The upward slope is punctuated by dips and sharp rises.  Why should we expect different?  This is what, not too many years ago, led so many people to be lured into buying houses they eventually couldn’t afford.  They were encouraged (by bankers and realtors) to assume that their income and the value of their house would both move on a continuous upward path.

The article presents a picture of America self-deceived with the notion that life will steadily get better, with no temporary setbacks, either personally or nationally.  How unrealistic!  Based on that assumption, wants from years ago become the needs of today and we seem unable or unwilling to adjust.  Our requirements keep growing, and what was sufficient to live on comfortably ten or twenty years ago, no longer is.  As C. S. Lewis so well put it:  “Whatever men expect, they soon come to think they have a right to:  the sense of disappointment can, with very little skill on our part, be turned into a sense of injustice.”  What's needed is a sense of perspective.

Friday, January 6, 2012

Extending Unemployment Benefits

First, this is not about the pros and cons of extending unemployment benefits.  It’s about using critical thinking to deal with the information we receive on any subject.  This just happens to be a good example.

At the end of this CNN Money article they ask:  “Do you receive unemployment insurance? Have you not been looking for a job as hard because you are getting benefits? Email [address] with your contact information and you could be contacted for an upcoming story or video.”

Two thoughts.  As I have pointed out many times before, testimonials or anecdotes are not evidence.  These reporters will receive e-mails and sort through them to find ones to support the story they want to tell.  Second, even if they condensed the information received and delivered a summary, this is an extremely poor method of sampling.  Their data would not be representative and any statistical conclusions would be meaningless.  How many people do you seriously think will e-mail to say that they are just sitting around until their unemployment runs out, making no effort to find a job?

This practice of finding an individual example and selling it as the plight or experience of many is common among reporters, politicians and advertisers.  They want to put a face on the crisis, but it borders on deception.  Often the purpose is to gather support for a cause or product by eliciting an emotional reaction from the viewers or voters.  It steers us away from the kind of critical thinking and analytical problem solving required to get us (the US) out of the mess we are in.

Monday, January 2, 2012

Shopping for Healthcare

Suppose you walk into a sporting goods store to buy a pair of gloves.  At the checkout the clerk told you that the manager is an expert in outerwear and to ensure every customer is properly attired, you are not allowed to buy gloves without also buying a winter jacket.  You also know that if you walk out without the gloves or the jacket, you will be charged for the time spent serving you.  Outrageous!  How would they expect to stay in business – unless all their competitors acted the same way?

Almost that exact thing happened to me a couple of years ago, except in a doctor’s office.  I had my annual checkup and one aspect of the blood work was slightly elevated, so I was asked to return in six months to retest and monitor the possible problem.  When I returned and sat down to have the blood drawn, two test tubes appeared.  I commented that it was a lot of blood just for one test.  No, I was told, the doctor’s policy was to order a full set of tests each time.  (Can’t buy your gloves without buying a jacket; it’s the rule.)  I explained that I was on a high-deductible insurance plan, that it only pays for one preventive screening per year, and that I did not want to pay out of pocket for the extra, unnecessary tests just to placate the doctor.  While I sat there with my sleeve rolled up, the technician left to get permission to order the single test.

Under a different insurance plan I may have been paying a $20 co-pay either way and would not be concerned how much blood they took or how many tests they ordered.  How are we supposed to be good consumers and try to control the cost of healthcare under this current system?  Under today’s system you walk in without knowing what services you will be getting or what each will cost.  Often the doctors don’t even know or care about the costs.  Even the components of a routine physical vary from one provider to the next.  Weeks after the fact you receive an explanation of benefits from your insurance company telling the cost of each, what they will cover and what you owe.  Many people, too busy to check the accuracy of these, just pay what they are told.  (Mine was a comparatively minor example, but see this article about how preventive care can turn into diagnostic without you even knowing about it and cost you money.)

We can’t be smart consumers of healthcare, when we have so little information about the total costs or the intentions of the providers, and remain a third party to the financial transaction.  I’m not against universal healthcare as a concept, but providing everyone with insurance will do nothing to change the upwardly spiraling cost.  Under the current system it would only increase the number of people who have to deal with the headaches of working through the insurance providers instead of working directly with their healthcare providers.