Tuesday, January 19, 2010

Great Book on leadership!

"Leadership and Self-Deception" is one of the best leadership books I have read in years! Written in fiction format it is easy to read and to understand! The concepts, while simple, are the most profound thoughts on leadership that are currently out there today. The Arbinger Institute does a great job of penning this tale of a guy who's personal life is a wreck and things are getting out of control at the office too. Realizing we are "in the box" is the first step, and then learning what to do to get out of the box is the key to success. Two major themes emerge quickly - "Seek first to understand, then to be understood." And "Due unto others as you would have them do unto you." The twist is understanding the psychological damage that occurs when we all remain in our box and refuse to get out. This book is worth the read.

Sunday, September 13, 2009

Healthcare Reform hits home!

As many of you know I work for a medical device company - BBraun Medical. As congressional leaders continue to reach for anything that might gain traction in the health care debate - they are now considering a tax on medical manufacturing companies to the tune of $40 Billion. OK this makes a lot of sense...lets tax the evil capitalist medical device companies because they are rich and can afford it. Guess what folks, even if this is the case(and it's NOT), what do we all know will happen when companies are faced with increased cost? They raise their prices! This idiotic idea that taxing health care companies will somehow reduce the cost of medicine is classic liberal mentality to "tax the rich" and "spread the wealth". Ultimately it leads to higher costs and a system more broken than before. Yesterday the CEO of BBraun USA sent out this message to all employees. I encourage you all to check this out and feel free to reach out to your congressional leaders to let them know how much you disagree with this kind of tax.

Dear Fellow Employees:

We need your help because B. Braun needs your help.

The U.S. Senate Finance Committee is currently considering a new $40 billion tax ($4 billion during each of the next ten years) on medical device manufacturers, including B. Braun.

If this new tax becomes law, B. Braun will not have the profits to make the critical future investments that B. Braun needs to stay competitive. In our opinion this tax needs to be stopped! It’s critical to the future of B. Braun.

If you would like to help, we urge you to act immediately by sending a letter to your Senator:

Click on this link to AdvaMed’s Website www.capwiz.com/advamed/issues/alert/?alertid=14011871&type=CO to read the information
Under Issue Area--select "tax"
Under Editable Text--Type in "B. Braun" and "your facility's location" (within first line; and you may also edit the letter as you like)
Under Sender Information complete all asterisked (*) information (NOTE: if you do not have an email address use notax.us@bbraun.com)
Click "preview letter"
Click "send email"

But, don’t stop there...

Share this with your customers, vendors, family and friends and ask them to join you in this effort to stop a public policy that would stunt the growth of the very companies that hold the keys to better quality and more affordable healthcare. Have them follow the above steps.

And, if you feel as strongly about it as we do, call your U.S. Senators’ offices today. (A list is attached.) Tell them an excise tax on medical device manufacturers would be a huge mistake. Tell them your future and the future of your family depends on their vote against it.

We will keep you updated on our progress in stopping this tax.

We urge you to take a stand by calling or sending an e-mail letter today. B. Braun's future depends on our collective voice.

Regards,

Caroll H. Neubauer

B.Braun Medical Inc.
EB-US-US02
Phone: 610-997-4000
Fax: 610-849-5400
Email: Caroll.Neubauer@bbraun.com

Post from Advamed's Website:
Medical Device and Diagnostics Value Added Tax
The Senate Finance Committee is contemplating a $40 billion excise tax on medical device and diagnostics products. AdvaMed strongly supports the Committee's health care reform efforts and has worked cooperatively with Congressional leaders to advance the goals of health care reform; however this medical device tax is bad policy that AdvaMed opposes.

It is our understanding that the proposed tax would be levied upon all manufacturers of medical device and diagnostics products as defined by the Food Drug and Cosmetic Act. Under that definition, as many as 80,000 products currently sold in the US would be taxed ranging from toothbrushes to eyeglasses to condoms to stethoscopes to syringes to blood pressure monitors to hospital beds to artificial heart valves to pacemakers to advanced diagnostic equipment. The tax would apply regardless of the size of the company or their profitability. Recent independent estimates indicate annual domestic sales of these products at approximately $131 Billion. A domestic market of that size would require a tax rate of roughly 3.1%, which, depending on the company, would be roughly the equivalent of a 10-30% income tax surcharge. Such a rate would dramatically increase the overall effective rate of manufacturers, and, in turn, constrain resources used for research and development, investment in physical manufacturing capacity, and jobs.

The excise tax on medical products is bad policy.

* The tax will raise health care costs. It would be assessed against thousands of products ranging from eyeglasses to stethoscopes to a hospital beds to artificial heart valves to advanced diagnostic equipment. Such a tax would in turn increase costs for consumers, physician practices, hospitals, and patients.. While on paper it may help balance a Congressional Budget Office scorecard, the real effect will be to raise health care costs-exactly the opposite of a key goal of health reform.

* This tax is counterproductive and burdensome for patients. Much of this $40 billion tax will end up being passed on to patients, especially patients who are the sickest and need complex, high cost technology. It does not make sense to finance health reform by taxing the countless products necessary to treat every patient who walks through the doors of a physician's office, hospital, or nursing home. Bearing the burden of illness is tough enough on patients and their families; but to financially penalize patients for their efforts to get better seems particularly wrong.

* Medical device and diagnostics companies will be contributing as a result of other parts of the health care reform bill, and this tax amounts to a double hit for one industry. The device and diagnostic industries are not generally paid directly by the government, insurers or patients. Instead, we are suppliers to providers who are paid for services. The hundreds of billions of dollars in cuts in the bill for device and diagnostic industry customers like hospitals, nursing homes, clinical laboratories and home health agencies will be passed on to our industry roughly in proportion to our share of their costs. Loading a special device and diagnostic tax on top of the cuts that will already hit our industry is unfair.

* There is no device and diagnostics industry windfall from healthcare reform. Proponents of the tax argue that the device industry will benefit from expanded coverage by gaining additional customers, and the excise tax is a fair way for the industry to repay some of this windfall. This argument doesn't hold water. The device industry benefits less from expanded coverage than most other segments of the health care industry, since the newly insured are, on average, younger, healthier, and relatively low users of devices relative to other types of medical care. Companies making products used for the Medicare population will see reduced revenue growth as hospitals react to the substantial Medicare cuts in the bill. On the flip side, these same companies will see only limited volume increases because their patients are mostly over 65 and already insured through Medicare.

* The medical products tax places an unfair burden on small businesses. Small businesses are the backbone of the device industry and the source of many of the most novel, cutting edge new treatments and cures. There are more than 6,000 medical device companies in the U.S. Less than 5 percent have sales of over $100 million annually. The tax will hit these small companies especially hard, since some have no profits and almost all rely entirely on domestic sales for their revenues.

* The medical products tax ignores the impact of health system reform on the device industry. The device industry is highly competitive and has kept prices quite low. Overall, prices for devices and diagnostics have increased at one-quarter the rate of other medical prices and one-half the rate of the consumer price index. The device industry supports reforms that will have a substantial impact on utilization of its products and on its contribution to health costs, including value-based purchasing, pay for performance, comparative effectiveness research, preventive health and other measures to change the incentives in the system toward quality and efficiency. In addition, devices have high costs of production. A gain in volume adds up to a much smaller gain in profits. A $4 billion a year excise tax may account for as much as one-sixth of total industry profits, which will have a significant dampening affect on funding available for future research and development.

Thursday, August 20, 2009

Thoughts on Healthcare reform and HR3200 specifically.

Does America need Healthcare Reform? Is HR3200 the right kind of reform?

Yes and no. First of all if you have not read HR3200 yet – you should. Just Google HR3200 and download the bill in .PDF format. Do it today and read it.

There are a few things that get lost in all the bickering and fighting going on with this issue. So let’s make a few points. First, every single person in America – even illegal immigrants are currently covered catastrophically. What does that mean? You can currently walk into any state funded or city funded hospital in America and receive medical attention and anything else you need. Recently many private facilities have adopted the “do not turn away” approach as well. Technically speaking the U.S. does offer healthcare coverage for every person in the country. The questions arise when discussing issues like routine exams, physicals, and ongoing medical conditions like cancer and other illnesses.

America does need reform in this area, I would agree. However what we really need is insurance reform, tort reform and pharmaceutical reform. Without these three things – nothing else works. Any healthcare plan that does not include reform in these areas is doomed to failure. Ah, but there is a major challenge: The attorney lobby owns the democrats and the insurance lobby owns the republicans – so we have old fashioned Washington grid lock. What lacks is the leadership to make both sides give enough to pull this off and make it work.

What we know for sure is that Medicare is just about totally bankrupt and even President Obama himself said the system has about ten more years to live. So do we really want a government run healthcare plan – when they can’t even keep the one we have solvent? Anything the government tries to manage becomes the deep dark whole in which billions of dollars flow into and we just never seem to get the ROI that is expected. We need key leadership to make the changes necessary to create the kind of change this country really needs. A government run healthcare plan is NOT the way to go. And certainly not a single payer healthcare plan.

OK, so what do we do about the roughly 46 million Americans or 15% of the population that do not have healthcare coverage? This group is mostly made up of people in their 20’s and older folks who are pre-Medicare ages. The younger ones I am not as worried about because they are basically healthy and other than catastrophic things (of which are covered) they will probably get along just fine until they can afford healthcare coverage. The older folks are who I worry about because they are having heart trouble and getting cancer and other diseases. We could in fact lower the age for Medicare eligibility to say 50 and capture all those folks in this category. Obviously it would require a re-structuring of Medicare so it can remain solvent – but it is an option with an existing plan that is already in place.

So let’s look at those three key areas I discussed up top. Insurance reform; why are insurance rates and certain coverage’s completely out of line and in some cases not covered at all? Lawsuits. Because of the out of control casino style judgments in many of these frivolous lawsuits – doctors are forced to order way more tests than they should or normally would – just to cover themselves in case something is missed. In the 90’s they were dubbed “lawsuit Millionairs”. There are doctors that I know personally – surgeons, OBGYN’s and others who pay in excess of $500,000 per year for malpractice insurance – that is crazy! Lawsuits with HUGE judgements drive up the cost of healthcare astronomically.

Next we need to bring the margins down on these ridiculously high drug costs. I know that drug companies have overhead and development costs - but lets face it - by not allowing other companies to have access to patented formulas, and the drug companies ability to keep them locked up for X many years, leads to overtly high drug costs. All they have to do is shorten the time frame before drugs go "generic" and that will solve that issue. Generic drugs are cheap - problem solved. Right now drug companies hold patent rights on drugs for 7-10 years. Just shorten that time to 3 years.

So this then brings me full circle to the leadership issue. President Obama needs to take a page from a recent great leader before him and look to what worked and rallied both parties and all of America to embrace MAJOR change. Do you remember the Tax Reform Act of 1986?

In 1986, Ronald Reagan and Bill Bradley were able to create a legislative miracle. They created a tax reform that stripped loopholes, political favors, payoffs, patronage and other corruptions out of the tax system. With the resulting savings, they lowered tax rates across the board. Those reductions, combined with the elimination of the enormous inefficiencies and ridiculous incentives that go into tax sheltering, helped propel a 20-year economic boom. The current proposed health care plan HR3200 proposes to fix our extremely high-quality (but inefficient and therefore expensive) health-care system with 1,000 pages of additional complexity -- employer mandates, individual mandates, insurance company mandates, allocation formulas, political payoffs and myriad other conjured regulations and interventions -- with the promise that this massive concoction will lower costs. It needs to be stripped and simplified NOT made more complex....Dems and Repubs alike rallied behind Reagan and his reforms - because they were true reforms not added government bureaucracy. This is what this country needs and what scares me about the proposed healthcare plan.

America needs a strong leader now more than ever - I guess this is where I want President Obama to step up and be the leader I think he could be and abolish the grid lock! It's this very kind of stalemate that will continue to eat up cost and NOT solve the real issues.

Tuesday, June 16, 2009

A tough week!

Last week was a very difficult week for many reasons. Troubling, confusing, frustrating, tiring, numbing – all words to describe the week. I am sure there are more good words, but these are all that hit me at this moment. Much like the death of a close family member or a trusted friend – the emotions of last week left one feeling blah and tired. Perhaps because the folks involved were so close? Perhaps because so much was and is at stake? Perhaps because now, forever lives are changed – never to be quite the same again. What happened is not as important as what was learned from the experience. Clearly when something like this occurs it causes you to reflect and take account of your own life and your own values. Could this happen to me? Would I/could I allow this to happen in my own life? The answer is absolutely yes! We are all possessed with the human condition. We all fall short and occasionally fall down all together. So how do we respond? Clearly we are not in a position to judge seeing as this could easily happen to us. After the anger subsides then you must offer grace and mercy. The very same grace and mercy that God extends to us through Jesus Christ when we falter. After repentance comes healing. In the end this process brings hope! Hope that next week will be better, healing will occur, and life will continue! And sure enough it has and will the next time too. Thank you Lord for the grace you grant us all – help us to measure our fellow brothers and sisters as you measure us – and extend the same grace and mercy that you offer us when we fall down when we repent and beg your forgiveness.

Thursday, March 19, 2009

Medical Device Industry

I have been involved in the Medical Device Manufacturing/Sales marketplace for over 20 years. What is great about this market sector is that it has always been a safe place to weather virtually every economic storm. Even in the tumultuous times we are now in, customers are still buying, upgrading and staying competitive. This is a good thing for the overall economy as well. People will always get sick and there needs to be stability in this sector in all times to support the illness's that besiege us from everywhere. In fact, in these times of high stress and fatigue, it could be argued that illness is even more rampant and to have stable health care is critical to the overall well being of our population. Yes, the rising costs of health care need to be evaluated and managed, however we must be very careful not to throw the baby out with the bath water. There are many things - in fact most things work very well in this industry. We need to look closely at those things that really drive up health care cost's and make adjustments where necessary. So what is one of those areas? TORT reform is HUGE? It is because of frivolous law suits and GINORMOUS settlements that have dramatically increased insurance rates and premiums. The reason people are uninsured is because they can't afford the insurance premiums. Insurance premiums are sky high because the insurance companies have to maintain stability - and when they lose HUGE settlements they have to re-coop their losses somewhere. The proverbial "brown stuff" floats down hill and ultimately lands squarely on each of our shoulders individually. Something to think about!

Monday, February 16, 2009

Red Dinner 2009!






Red Dinner has become a HUGE Valentines Day tradition at our house. Kelly began this tradition long ago when the kids were little with just a few red items served as part of the meal. Since that first meal it has progressed to EVERYTHING is red - including the red heart shaped butter, the red heart shaped ice cubes in the glasses, yes even red bread! This meal is a lot of fun. As Kelly admits however - it is a ton of work. Many of the red items need to be prepared in advance - like the butter and ice cubes. In recent years we have shared red dinner with family and friends and it always puts smiles on everyone's faces to see the final product. I am amazed at what this meal has evolved to over the years - and it is just one of the ways my amazing wife has continued to bring joy and laughter to this family. Her hard work and extra effort is our gain - she is truly an amazing lady with so much creative talent - it even comes out in the food she prepares on nights like red dinner night. Last night Kelly capped of the amazing red meal with little heart shaped red velvet cakes with red cream cheese icing - YUM! EVERYTHING is better with cream cheese icing. Hats off to Kelly for another successful and amazing red dinner - can't wait for next year!

Who am I?

I find myself asking this question more and more these days? There is so much "clutter" in the world telling us who we should be/need to be. So who am I? Why can't I have more, do more, be more? Why am I afraid to let others truly see who I am? But, if I don't even know who I am - maybe that's where the fear lies? Why am I so controlling? Why do I always have to win the argument? Why do I struggle with my ability to surrender it all to God? Surrender seems like loss, like becoming less - only "losers" surrender! Once again I find myself caught up in the the worlds interpretation/translation of surrender. What does God's interpretation of surrender look like?
Who is my argument with anyway? Is my argument with God? Perhaps I am just arguing with myself? I want to have it all, be all, do all, end all - Am I trying to be god?
A.W. Tozer said, “The reason why many are still troubled, still seeking, still making little forward progress is because they haven’t yet come to the end of themselves. We’re still trying to give orders, and interfering with God’s work within us.”
WOW, there it is - control - who has control? We think we do, but in reality it is only a facade - our own reality, not reality. We have no control. Life happens and we are unable to control it or stop it. We say, "let go and let God" - but somehow for some reason we always take the reigns back from God.

Reading some C.S. Lewis recently caused me to realize that my thoughts are certainly not new - He struggled with these issues too? Once again I am reminded that life is about the struggle not about the destiny. There is no such thing as "winning at the end" - it's about winning one day at a time, by submitting all to God each and every day. And then perhaps we begin to see our true selves emerge as the whole human that God intends us to be....maybe some day I will get this....someday, but today I have things I must get done....

C. S. Lewis observed, “The more we let God take us over, the more truly ourselves we become – because he made us.He invented all the different people that you and I were intended to be. It is when I turn to Christ, when I give up myself to His personality, that I first begin to have a real personality of my own.”