Health Care and the DMV

With all respect to the good people who work at departments of motor vehicles (DMV) around the country, the DMV, for many, is synonymous with inefficiency and a surly approach to customer service. As a teenager, I remember going to the DMV office in Jamaica, Queens, and waiting on long lines, only to be treated poorly, with little respect for my time or needs. The stereotype seemed to have a legitimate foundation. I’m happy to report that my more recent dealings with DMVs, both in California, and also last year back in Queens, have been much improved and quite efficient.

At lunch the other day, a good friend and somebody for whom I have great respect, mentioned that he believed nationalized health care along the lines of “single payer” would make going to the doctor a lot like dealing with the DMV. His comment was a response to my mention of the way insurance companies deal with health claims, and the high cost of health care administration that goes to insurance companies. The labyrinthine system seems designed to frustrate both patients and health care providers, at great cost to all concerned. Eliminating the red tape and unnecessary paper work associated with insurance claims ought to be high on the list of health care reforms that the Obama Administration tackles.

The added problems with the frustrating manner in which insurance companies deny benefits, refuse coverage, and make patients re-submit claims, that should have been paid in the first place, drives doctors into early retirement and inflicts emotional pain on patients. It often takes lawsuits or government intervention to put a stop to these abuses. This, is a waste of time, money, and inflicts a cost on families when they are most vulnerable.

So back at lunch with my friend, the other day, I had a moment of clarity when he compared the specter of nationalized health coverage to dealing with the DMV. My response was simple. The insurance companies have become the DMV.

Smile at the Small Stuff

At the preeminent moment, when Chief Justice of the United States John Roberts uttered the familiar words of the oath of office, President Barack H.Obama had the presence of mind to pause and allow the Chief Justice to correct the mistake he just made. When he failed to get it right the second time, the new president just repeated the Chief Justice's error and went on with the ceremony. NPR had the best line about this simple but glaring gaffe: How many Harvard Law Review editors does it take to screw up the oath of office? The answer is two. Both President Obama and Justice Roberts served as editors of the law review.

The otherwise near perfect spectacle of the peaceful transfer of power, in the presence of Washington's largest crowd ever, sends the sort of message we need. That there was a glaring but ultimately meaningless ceremonial error is refreshing. We will gladly accept--even acknowledge and celebrate--the fact that even these two high achievers, the heads of two out of three co-equal branches of government, can make mistakes. As for the third branch, I'm sure Congress will screw something up, too; its members seem to be pretty good at it!

My hope and prayer is that the mistakes of the future--and there will be mistakes--stay on a small scale. And because they may be more meaningful than a misplaced adverb, we, the people, need to keep our focus on demanding the best and raising our voices when it looks like the sort of large scale errors of the last eight years are about to be made. Our vigilance will serve our leaders well and is consistent with the kind of government President Obama says he wants to lead.

Allowing Miracles to Happen

US Air Flight 1549’s emergency landing in the cold waters of the Hudson River, followed by a remarkable rescue effort, sustain and affirm the notion that happy endings are the product of competence and hard work. The plane’s captain, 57 year old Chesley Sullenberger III, made quick decisions and handled his aircraft with the skill acquired flying planes for more than three decades. The first responders on the water worked swiftly and calmly to rescue the passengers and crew.

To see an airliner flying low near the George Washington Bridge, as it headed for its landing spot on the river, surely must have frightened those who saw the plane descend. Gov. David Paterson called the landing the “miracle on the Hudson”.

Miracles happen when we don’t get in their way. So many factors could have caused this plane’s short flight to end with injuries and death rather than 155 souls surviving. Under the command of Capt. Sullenberger, and the leaders and first responders on the water, the outcome was remarkable. Competence, experience, training, and hard work, allow good outcomes—or miracles, if you prefer—to prevail. All the prayers on board probably didn’t hurt, either.

As we begin a new era in American leadership let this unusual incident with a very happy ending remind us that there is no substitute for competence, no tolerance for poor or inadequate training, and hard work must be rewarded. If we honor these simple values, we allow miracles to happen.

Stars & Scoundrels--Predictions & Questions

Next week, Barack Obama finally will be sworn in, after the long campaign and transition. Our new president will enter the White House with enormous good will, but a shortened honeymoon because of the many crises he will face.

A month after we learned about the arrest of “Rod from Chicago”, he’s still in office, though now facing impeachment. He’ll go down fighting, but down he will go. How many will he take with him and at what additional cost?

“Bailouts” become “stimulus”; billions go to banks while the little guys are still waiting. Words matter but priorities need to change.

The movie awards season offers exciting entries and a rich mix of memorable characters. Sean Penn, Mickey Rourke, and Kate Winslet stand out in a field filled with great performances; don’t neglect to notice the current golden age of acting and film making that is now.

On the Broadway stage, In The Heights lifts the spirits and serves as the ideal antidote for recession and psychic fatigue of the last few years.

Netherland, by Joseph O’Neill, is a must read for anyone interested in evolving class distinctions in the urban global economy. This novel describes post 9-11 New York beyond the headlines and boundaries of Manhattan. Beautifully written, with insight and sensitivity, it tells personal stories of striving and struggle as diverse lives intersect.

The automakers’ reprieve will keep them going for months, at least. Will only the strong survive?

Corporate excess may not disappear, but moderation will intervene. At least the public spectacles of junkets while the government writes checks, flying in private jets while plants are closing, and begging for bailouts while accepting big bonuses, will be managed better for the public’s eyes.

Media will continue to become more distinct as technology makes grassroots approaches more powerful. The MSM will flail about figuring out what works today, while continuing to react to tomorrow, instead of leading the way. The tension between corporate media and personal expression will actually work to improve each other, as the balance of power tips even further to the entrepreneurial.

Global conflict will not go away. How it is managed and where war wages will change. The United States will play a more useful role toward quelling conflict and improving economic conditions.

Personal health and the way we manage the earth’s environment and food supply will be more closely linked, leading to long range benefits.

Service will become a more cherished virtue. Greed will not disappear but will be forced to change its face. Self interest will continue to motivate but align better with fulfilling, rather than trumping, the collective needs of our communities. And we will be surprised.

On a Clear Day

The desert wilderness that is the American Southwest stretches as far as the eye can see. Sand, a few mountaintops, and scattered small towns, mark the cloudless view from my window seat at six and a half miles above the earth. The strange symphony of iPod, laptop, and airliner, denotes progress and potential while the landscape below reminds us we are small. Even as we challenge—even conquer--limitations and create new ways of linking each of us to others, we need to remind ourselves that we walk in and out of the wilderness throughout our lives. The wilderness offers perspective. Timeless tales, of wandering and seeking, place the wilderness as a pathway to encounter with the ineffable.

The paradox of human destiny is that greatness comes from recognizing our place in the universe as we go from wilderness to lands of promise. Along the way we decide the existential choices that define us; true greatness can mean contracting rather than expanding. How will we use our skill, intelligence, and talents? Rich, poor, brilliant, dull, ordinary, exceptional, what ever our gifts or hardships, at some point we’ll face the wilderness whether literally or metaphorically.

So, this afternoon as we cross the desert between San Diego and Houston, the week old year is chronicled in the New York Times on my lap and the Newsweek I just placed in my briefcase. The current moment is rich with potential. New beginnings grounded in solving problems, and choosing well, put the wilderness in perspective. But the desert is there to remind us that the picture out the window remains rich, meaningful, and timeless, a more commanding view than our printed reports of world events. Wilderness diversions spawn creativity. We only need to pay attention.

All of this may seem trite, even naïve, in the face of wars, genocide, terror, and poverty. My answer is not to abandon or ignore conventional solutions to the problems that inflict pain and harm. But until we confront the spiritual dimension of our situation in ways that are more creative than in the past, no political, economic, military or cultural approach will be sufficient. So as not to be misunderstood, whether you are Jew, or Christian, Muslim, or Hindu, Buddhist, atheist, agnostic, or simply a seeker, the wilderness will find you. The point is to recognize the transformative power of the encounter and to not get stuck.

Inauguration Day

In a little more than two weeks, President Obama will give his inaugural address. Here's a sample of what I'd like to hear him say.


My Fellow Citizens and Friends Around the World: I come before you today firmly grounded by the reality of our current challenges and acutely aware of the compelling demands of these perilous times. We are prepared to meet these challenges by the strength of our history and the courage and creativity of this great country. As our founders dreamed of an exceptional future, we too must build, so our children, and their children’s children, will continue to reap the fruits of an American dream that will inspire the world.

Preserving life, liberty, and the pursuit of happiness requires collective commitment and personal sacrifice. We live in times that demand nothing less. President Kennedy asked us to ask not what our country can do for us, but rather to ask what we can do for our country. Forty-eight years later his question remains relevant and urgent. So many Americans struggle to find work and to pay bills, yet there is work to do. Others avoid going to the doctor because the costs are high and insurance is out of reach, yet we have the human skill and technology to save lives that would have been lost just a few years ago. And we know brave soldiers, marines, sailors, and air force men and women who return from war with catastrophic injuries and few prospects. This must change. We commit ourselves to those challenges as top priorities for this Administration.

The United States of America remains a magnetic presence inspiring our native born citizens to achieve greatness beside our newest residents who come from every country in the world. The attraction of America abides because we draw strength from our diversity and power from the notion that it is not who you are that matters but what you can do that counts. My own story serves as a step toward realizing Martin Luther King, Jr’s great dream that men and women be judged by the content of their character and not the color of their skin.

So, I stand before you today, in the presence of the great American legacy, from Washington and Jefferson, Madison and Jackson, Lincoln, of course, and Susan Anthony and the nameless who struggled in cotton fields and sweatshops, and Roosevelt and Eisenhower, King and Chavez, so many giants whose names we know and whose names we will never know. They did great things, often against great odds. We must become the inspirational legacy of the next generation by rising to meet today’s challenges with clarity of purpose, a capacity for the hard work required, and the humble spirit that made the greatest generation great, and will make our generation one worthy of carrying the torch that is passed to us with such hope and anticipation.

A Spirit of Penitence

As we begin 2009, my friend, Dan Cieloha, suggests we encourage penitence and expect our leaders to approach the year ahead with contrite hearts and reflection on what went so terribly wrong. So many of this week's New Year's celebrations mentioned how hopeful we are that 2009 will be better than the last year. This is good. But repentance is appropriate because new beginnings mean coming to terms with past failures, both temporal and spiritual. It would be gratifying to see Bernard Madoff, Rod Blogojevich, and the many corporate executives who squandered our money express themselves in a way that shows their own willingness to repent. Of course, the most notorious malefactors rarely admit their own wrongdoing so it's not likely we'll see them apologize. But in some way, some of them may acknowledge their own part in the economy's collapse and seek the forgiveness of those they harmed.

We--the collective, societal "we"--also enabled the excesses and abuses that got us into trouble, not all of us, but enough to matter. The danger is only blaming others and avoiding personal responsibility. My hope is that when President-elect Obama becomes President Obama, he will encourage a national consciousness that is intolerant of arrogance, repulsed by greed, and receptive to humility. Maybe he'll even acknowledge a spirit of penitence that can only make us stronger. In the soaring rhetoric of inauguration day we will be inspired to feel good about ourselves, our country, our leaders. This will help us move ahead and rise to meet the many tough tasks that we face. I will also look forward to some acknowledgment that our predicament is predicated on failures requiring penitence. Then we can rise to new heights that raise our spirits and help heal the wounds of the world.