When Ethics Means Life and Death

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We know that terrorists follow very different ethical standards than the rest of us.  That is, if what they follow can be defined as ethics in any sense.

What we may not appreciate are ethical differences between executives of some major corporations and the rest of us.  The latest poster child for the unimaginable is Olympus corporation of Japan.  Yes, this is the same company that once produced cute little cameras.

Endoscopes are magnificent devices that permit doctors to perform minimally invasive surgery.  The core of the device is a long flexible cable only millimeters thick that can be threaded through the colon, through major arteries or veins or through the belly button and can bendoscopee used to see and act on problems in the body.  The can be used to remove polyps, clear blockages, remove cancer cells, and enlarge or reduce breast size, among a host of other uses.

Endoscopes are throw-away devices.  They’re expensive and are reused.  That means they need to be cleaned thoroughly after each use and before being used on a new patient.  Manufacturers have elaborate devices and procedures to ensure a thorough cleaning.

At least most do.

Olympus manufactures these devices and apparently introduced a new model sometime in the last 5 years that was very difficult to clean.  Why is anyone’s guess.

  • Since 2013, 46 patients have died from infections from Olympus endoscopes.

After initial deaths in Europe, Olympus headquarters determined (another email leak) that there was no need to report the problem to US authorities.

“1. Olympus officials allegedly told European customers in January 2013 about a contaminated scope after French and Dutch hospitals reported two dozen infections. Laura Storms, vice president of regulatory and clinical affairs at Olympus America in Center Valley, Pa., became concerned about a similar outbreak in Pittsburgh, and asked Tokyo officials if they would be communicating the same information to U.S. customers regarding the outbreak.

2. Susumu Nishina, the company’s chief manager for market quality administration, replied via email  that it was not necessary “to communicate to all the users actively”  because a company assessment of the infection outbreak in Europe found the risk to be acceptable.”

Source:  http://www.beckersasc.com/gastroenterology-and-endoscopy/olympus-under-fire-internal-emails-reveal-us-execs-told-not-to-issue-warning-about-possible-fatal-scope-infection-10-takeaways.html

Since 2013, 35 patients in the US have died from infections from contaminated Olympus endoscopes.

The outbreak was the subject of a Senate investigation in 2015.

It took until January of this year for Olympus to own up to the problem and commit to redesigning the device to correct it.  Until January, all of the problems were written off as user error.  In fact, after the initial infections, Olympus raised the price for its endoscopes.

Does your doctor know about this issue?  Is he/she still using the tainted equipment?

Is Olympus a brand worthy of trust?

Companies deserve severe punishment until we know with certainty that public safety comes before profit.

Were you aware of this?

 

Sources:

(a) Rechtoris, Mary, “Olympus under fire: Internal emails reveal US execs told not to issue warning about possible fatal scope infection — 10 takeaways.”  Becker’s GI & Endoscopy.  July 25, 2016.

(b) Peterson, Melody, “Olympus to recall and redesign medical scope linked to superbug outbreaks.”  Los Angeles Times.  January 15, 2016.

 

 

Pot and What??

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A new study from a researcher at the University of Michigan identifies impacts from regular use of marijuana over a period of time.  OK there are effects . . . maybe.  But are they positive or negative?  You decide.

The research team created a game that study participants played while undergoing an MRI brain scan.  The game involved cash rewards in some rounds and no rewards in others.  The researchers expected the players to be more motivated to win in the rounds in which there was a cash reward and the release of dopamine in the brain to be greater with cash wins.

The researchers reported that heavy pot users experienced a lower dopamine reaction to cash wins than did lighter users.  They interpreted that to mean that the drug was “hijacking” the pleasure center of the brain and making users less responsible to social incentives.

What they actually did was to show that heavy users may be less money-oriented than others.  Is that bad?

Is pot a potential cure for gambling addiction?

Better, should we be giving life-time supplies of pot to CEOs and politicians?

Regardless, without replication, there is no confirmation that these findings are correct. Another pipe dream? [Pun intended.]

Sources:

(1) Meghan E. Martz, et. al., “Association of Marijuana Use With Blunted Nucleus Accumbens Response to Reward Anticipation,” JAMA Psychiatry. Published online July 06, 2016. doi:10.1001/jamapsychiatry.2016.1161

(2) Madeleine Gerson,  “New marijuana study shows drug can affect pleasure-related cognition,” The Michigan Daily, Tuesday, July 12, 2016 – 11:33am 

 

 

 

Health Insurance: the Uniquely American Jungle

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17456_1269532813224_1076952025_30803996_7657050_nTo paraphrase a quote from a friend, it doesn’t matter who helps you with insurance until it does.

Your daughter breaks her arm playing basketball at school.  The doctor’s bill is $1200.  How are you paying for it?

You’re overdue for a colonoscopy.  Do you know that the cost can vary wildly depending on where it is done?  Will you be out of pocket for this or will your insurance cover the cost?  Do you know?

In medicine, it is the case that “an ounce of prevention is worth a pound of cure.”  Catching any illness in the early stages of development makes it easier and less costly to treat.  Most Stage I cancers are easily treatable at little cost; most Stage IV cancers are fatal and very expensive to treat.

For consumers, this means that annual check-ups aren’t optional.  doctor-clip-art-doctor-clip-art-4Nor are mammograms, colonoscopies or esophageal endoscopies.   By the time you become aware of a blockage of the esophagus (without a screening), it’s Stage IV and your five-year survival rate is less than 10%.  You’re basically done.

The problem for consumers is being able to pay for check-ups and screenings.  That’s where the fine print in your health insurance becomes critically important.  Some policies will cover screenings and some don’t.  If your policy doesn’t, and you have a high deductible, you could be liable for thousands of dollars in costs.

As the New York Times reported (10/17/2014 and 11/15/2015), there are consumers who have health insurance and still can’t afford to see the doctor.  They can’t pay the deductibles and copayments, so the simple act of buying insurance becomes largely irrelevant.  The Affordable Care Act (aka ACA or Obamacare) simply didn’t go far enough to solve the problem of affordability.  A lot of that is related to accommodations required to overcome resistance to passing the law.

There are some resources, although some in Congress and the states are trying to cut the budget for them.  Planned Parenthood provides mammography for poorer women, but has become a target for other services in which it is involved.  There are also public health clinics, but these are only in limited locations.

Ultimately, the consumer is faced with an array of options and costs:

  • Private insurance, Marketplace insurance, Company-sponsored insurance or no insurance
  • Low or high deductibles
  • Low or high copaymennts
  • Whether to include options such as dental, vision or supplemental health insurance
  • Choice of insurance company
  • Choice of doctor and hospital
  • Whether insurance covers travel out-of-state (some plans don’t)

Even seniors have to make choices between Medicare, Medicare Advantage and Medicare supplement plans.  Nothing is simple anymore.

Very few people can afford the high-end plans that cover everything with next to nothing out of pocket.  Even in the Marketplace, such plans can cost upwards of $2,000 per month, which is more than a  lot of people make in a year.  That’s higher than most mortgages.

That brings us back to the question of who advises you about health insurance.

  • Most agents are sales reps, trained to sell a particular policy and not necessarily familiar with the options that consumers may have.
  • With substantial turnover among agents, a lot of agents you meet will have been in the business for less than a year.  Some of these will make mistakes in presenting what their own policies do and don’t do.  That’s not a criticism.  Think about it: that’s why there are learner’s permits for drivers.
  • Under a new and controversial rule, investment advisors are required to place the well-being of the consumer ahead of the advisor’s financial interest.  There is no similar requirement for health insurance agents, although there should be.

So you can either hit the books and become an expert in health insurance yourself, or find someone who is.

There are agents with experience, knowledge, and who place the well-being of the consumer first.  We’re not perfect, but if we don’t know something, we tell you and then we do research and find the answer for you.  We don’t rush you into purchase decisions, but when we work together, we design a plan or set of complimentary plans that will take care of what you, your family and your employees need within your budget.

We’re here to help.

Vic Crain
Partner
Crain Insurance
vic@craininsurancellc.com
609 510-3712

 

 

 

 

 

Virtual Walls and Reality Checks

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berlin09-1Do you have a business and wonder why customers aren’t pounding at the door to buy your great product?  Are you a high schooler and wondering why every college isn’t recruiting you?  Are you simply a person who wonders why someone doesn’t like you?

Sometimes the answer is both simple and out of your control.  Some people have odd tastes and idiosyncratic needs that you simply can’t satisfy.  That happens.  To repeat something your grandmother probably said, “you can’t please everyone.”

However, there are times when we’re at least partly responsible for the problem.  We surround ourselves with barriers that discourage others from wanting to deal with us.  Examples:

  • Language: the use of overly formal language or slang makes us seem difficult to understand or standoffish.
  • Appearance:  the initial reaction most people have to you is based on how you look, not what you say.  That’s where the Internet offers a great advantage, because it allows words to come first.
  • Word-of-mouth:  people tend to be skeptical about what you say about yourself, but they listen to what others say about you.

What they say is affected by things you’ve done in the past, some of which you may not even remember.  If you have a business, what they say is affected by what your staff do and don’t do.  However, you can’t deal with an issue if you don’t know about it.

Trust in what others say is what makes bullying so nasty.  Bullying takes a trusted information channel and fills with with lies and slander.  Victims can feel helpless, although they have things they can do.  Identifying the problem really is half the battle.

Every so often, you need a reality check.  That can take the form of a heart-to-heart conversation with people you trust or having a researcher do an audit with your customers.  You need to know what they really think and decide whether you need to make adjustments to achieve what you want.

And that brings us to another old saying inscribed in a wall at UChicago, “you shall know the truth and the truth will set you free.”

When was the last time you did a reality check?

 

Pharmaceutical Payoffs to Congress

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The main reason Americans pay more for the same drugs than patients in other countries is Congress.

Why does my Advair inhaler cost $70 in Canada and $440 in the US?  Congress.  It’s the same product from the same manufacturer (GSK) with no differences in effectiveness or safety.

Question:  If Medicaid and Medicare could pay the Canadian prices for drugs, would these programs be less costly to operate?  Is Congress itself running up the costs and then complaining about them?

Congress gives drug companies extended protection against competition and bars consumers from buying the drugs from vendors in other countries.

Why is Congress so nice to drug companies?  Its because drug companies PAY THEM.

Drug companies have given 310 Congressmen more than $7.2 million dollars, with the largest contributions going to two Republican leaders, House Majority Leader Kevin McCarthy ($290,000, who represents the California 23rd District in the Bakersfield area) and House Speaker Paul Ryan ($293,000, Wisconsin’s 1st Congressional District).

In the three years leading up to the 2016 election, the pharmaceutical industry gave an additional $10.2 million to various Congressmen.

The other Congressmen who received large donations opposed an effort to reform Medicare Part B to reduce costs to patients and taxpayers.  The big winners in drug donations include:

U.S. Representatives Who Signed the Republican Letter opposing a reform of Medicare Part B to reduce costs to patients and taxpayers 2016 Pharmaceutical / Health Products Industry Contributions
Shimkus, John M (R-IL) $220,490
Brady, Kevin (R-TX) $202,751
Paulsen, Erik (R-MN) $183,650
Upton, Fred (R-MI) $164,350
Ellmers, Renee (R-NC) $141,949
Guthrie, Brett (R-KY) $137,449
Lance, Leonard (R-NJ) $134,100
Tiberi, Patrick J (R-OH) $121,400
Walden, Greg (R-OR) $120,250
Blackburn, Marsha (R-TN) $113,585
Brooks, Susan (R-IN) $108,450
Meehan, Patrick (R-PA) $108,410
Dold, Bob (R-IL) $107,150
Scalise, Steve (R-LA) $102,300
Costello, Ryan (R-PA) $101,150

So, are you voting for someone who is hurting you financially?  Don’t you think you should know?

 

Sources:

(1) http://www.beckersasc.com/asc-coding-billing-and-collections/pharmaceutical-companies-pay-7-2m-to-lawmakers-opposing-medicare-part-b-proposal-4-insights.html

(2) http://maplight.org/us-congress/interest#sector=Agribusiness

(3)  Public Citizen, “Pharma’s Orders”.  Washington, D.C.  11 July 2016

Take Down the Walls

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Frost wrote the New England adage that “good fences make good neighbors” and that may be true.  However, walls aren’t fences.  Walls block oral and visual communications.  That makes them good for hermits, and problematic for the rest of us.

Humans are social animals.  We require some level of interaction with others for our own mental balance as well as for sheer survival.  Three hundred years ago, an individual could get a patch of land, clear part of it, use the wood to build a house, and grow his own crops.  Even then, the pioneer would have to buy tools, weapons, nails, cattle, seeds, etc.  You have to go back a lot farther in history to find a time when a person could thrive on his or her own.

Walls can take various forms:

  • Physical walls are relatively rare, although walled residential communities are a common site in St. Louis and Las Vegas.  In other urban settings, planners have used a combination of buildings, highways and parks to restrict access between areas of a city — for example, to keep ghetto residents out of college campuses.
  • Some people use pets as barriers.
  • Virtual barriers are quite common.
    • Call screening is obvious and commonplace in both homes and offices.  Are you not there or avoiding me?  If I leave a message, will you listen to it?  Will the message be garbled by your device?
    • Perceptions are barriers.  “I’m not going to tell him about X because he won’t be interested.”  “I won’t shop at Y because they don’t carry anything I can afford.”  “I can’t tell  Z what I really think because it will hurt the cooperation I get from him.”  Maybe that’s true, maybe its not.
    • The there’s the Internet . . . .

The Web and social media were designed to  facilitate communications, but they actually do just the opposite.

  • Posts and emails tend to be cryptic, if only because a lot of people don’t like to type.
  • Posts are devoid of the physical cues that communicate so much about emotional content.
  • Senders spend little time thinking about what they write, so word use is inferior and meaning can be hard to decipher.
  • Safety issues encourage people to communicate as little of substance as possible, since you don’t know who else might see the message.

So we wind up getting messages like “I’m at XYZ Dance Studio.”  Why do I care about that?  What would you really like to tell me?

Barriers are the reasons sales trainers stress the importance of listening skills.  The seller needs to be able to identify and address the barriers to communications in order to get the potential buyer to listen and understand.

Arguably, listening skills are essential life skills and not just for sales.  Doctors and lawyers lose clients because they don’t listen.  Individuals lose friends for the same reason.

Once you learn to listen intently, you will gain insight into why word choice is so important.  That in turn will make the messages you send more precise and effective.

However, you can’t practice listening skills without tearing down the barriers to communications.  That means being available for communications and being willing to listen to people whose opinions may differ from your own.

 

The Ignorant Writing for the Ignorant

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As if we needed it, we got another demonstration that what’s published on the internet is only as good as the person writing it.  Some of it is not good at all.

Inc Magazine reported the results of a poll in honor of the 4th of July about which brands Americans perceive to be the most patriotic.  (See http://www.aol.com/article/2016/06/28/these-are-americas-50-most-patriotic-brands-guess-which-famous/21420689/)

Now, what every researcher should know — and what any thinking adult could figure out — is that when you ask a superficial question you will get a superficial answer that doesn’t mean much of anything.  Very few people spend time thinking about which brands are most patriotic.  How much time do you spend thinking about that?  The results might be amusing, but aren’t worth anything more than that.

Now, if you have some lead in question, like “what’s your definition of patriotism?”, you might get people thinking and get some interesting responses.  There’s no evidence that the people asking questions in this case used a thoughtful approach.

They also didn’t spend much time thinking about the results.  According to this report, the two most “patriotic” brands are Jeep and Disney.  The writer scoffed at consumers for saying that.  What do these brands have to do with patriotism?

Jeep2

Well, think about that.  Prior to Desert Storm and the advent of the Hummer, the Jeep was the go-to vehicle for the US military for more than 50 years — WWII, Korea, Nam and a host of other places.  While current Jeep advertising does wave the flag from time to time, that 50 year legacy is rather hard to ignore.  Gee, what’s patriotic about being identified so closely with the US Army?

Mickey-mouse-photos-and-flags-nb6340

Now, why was Disney up there?  Well, history buffs know that Disney produced films for the US government and military during WWII.  However, most consumers probably don’t know that.  What consumers do know is that Disney has an outstanding reputation for quality, epitomizes basic American values, and has been an ambassador for American culture for more than 80 years.  Gee, what could be patriotic about that?

No, what Inc Magazine has given us in this case is superficial analysis by someone who doesn’t have the knowledge base to write something worthwhile.  The article isn’t even cute; it’s just silly in a non-flattering sense.

The fact that this got published represents a failure of editorial controls at Inc.  That unfortunately is typical of a lot of what appears on the Internet.  Fact-checking and thought are often sacrificed in the interest of posting something.  That’s sad.