The Cowtown Chronicles

A good friend of mine brought up an interesting point of view that I hadn’t considered in the Health Care debate.

He said that he opposes massive overhauls to the health care system because he likes the idea of companies and entrepreneurs being motivated by profit to conduct research and take risks, thereby advancing the quality of care in the US.

I didn’t think of it at the time (we had been drinking, of course), but this argument is kind of a false choice. I don’t think there’s any evidence that the amount or quality of health-related research would decline under any of the proposed reforms. As far as I can tell, none of the reforms would turn healthcare into a not-for-profit business.

Forgetting the profit motivation for a moment, I have to wonder about WHY people go into heath-related fields. I’m sure there’s a not insignificant number of folks who do it because they see an opportunity to make a lot of money.

I don’t think that’s the whole story, though. If people were only motivated by money, we wouldn’t have firefighters, a professional military, police officers, elementary or high-school teachers, and a whole bunch of other public-service folks who don’t make squat relative to the education required or risks they face. Humans are hard-wired to look out for each other. Some people manifest this urge more than others. I call it the “hyperactive public service gland.”

I think that if there was still a chance to make a decent living, we wouldn’t see any decline at all in the amount or quality of medical research in this country.

Let’s also look at the focus of this research and WHY the research needs to be done.

An excessive amount of research dollars are spent on diseases that are either preventable (diet-related things like diabetes, heart disease, high blood pressure, etc.) or could be greatly reduced through a healthier lifestyle and environmental fixes, like various cancers. Focus on preventing those problems (which would be REALLY, REALLY cheap to prevent compared to the ongoing costs of trying to fight the problems after they’ve developed), and you’ve freed up all kinds of money that could be spent on research to solve the really hard things like HIV/AIDS and the like.

Once again, if you’re only focusing on the current outcomes when looking for places to reform, you’re missing the big picture and the easiest and cheapest reforms which would make a world of difference.

I regularly read Penelope Trunk’s blog — probably more for the entertainment and stream-of-consciousness writing than for actual business advice.

The article she posted today, though, motivated me to comment, which I normally don’t do. Unfortunately my comment is being held in a SPAM or profanity filter (sorry mom), not because I cursed out Penelope, but because I used my usual salty language to describe what the business community is doing to itself.

Essentially my thought is this:

How can any rational person look at our economy/business climate — where it’s not only okay, but widely expected and encouraged, for companies to not pay for services they’ve received — and think that this is healthy or good?

I don’t blame Penelope for doing what she had to do to keep her company and family solvent. I can’t say that I exactly blame the investor who gave her the money with the requirement that it not be used to pay back debt.

I DO blame the business community in general for their complete and utter disregard for honesty and fair dealing with other people. The (real or imagined) expectation of double-digit growth every quarter is causing people to completely lose their minds. Companies cut corners and build unsafe (or minimally functional) products, they cut support staff for those products, pissing off their customers, they cut pay and benefits for their employees, all so they can report that they’ve beat their estimate for the quarter to please some institutional investor to whom the company is just a 3-letter abbreviation and a share price. It’s bullshit, it’s wrong, and until that behavior stops, we’re going to continue the death spiral our economy and country is in.

The not only knowledge, but EXPECTATION, that startups screw vendors over all the time is infuriating to me. I thought the gold-rush, grow exponentially, expand-expand-expand days were over? What happened to slow, responsible, sustainable growth?

The knowledge that I can expect to be treated this way is one of the main reasons I’m so fearful of becoming a freelance anything. How can I willingly risk everything I have creating a new business if I can’t count on the people who contract for my services to pay me? They expect to be paid for the services or products that they provide, right?