Tuesday, March 24, 2020

On My Mind: Let the Process Break

This week, what's on my mind is change. Large, sweeping, long-overdue change. The kind that comes from the complete and total failure of an administration, an industry, and a national individualistic mind-set.

Once upon a corporate life, in the heyday of "do more with less," I had my weekly status meeting with my boss. We were dusting off the ashes of surviving the latest layoffs and trying to squeeze everybody else's "Priority 1" into our already overbooked schedules. I showed her my "escalations" list and her face went blank. Two heartbeats later, she took my hand, looked me dead in the eye and said,

"Let the process break."

Wut? My overworked brain didn't grok what she was saying. Was she setting me up to fail? Was she putting me on the firing list? (She wasn't.)

"No one knows how badly things are broken if you keep bending over backwards to fix them. 
Let things break. 
Projects will either get scrapped because they weren't really that important
 or they'll be properly resourced."

Twenty-ish years later and I still think of that moment, that lesson, that sanity-saving insight.

This week, I'm wondering if we, as a nation, can see how continuously and consistently screwed over we are by industry and politics that real change, beneficial change, will come from it. For example, is our healthcare industry broken enough now that for-profit health will be replaced by actual care? We're good, sort of, with the actual care providers: the nurses, the doctors, the orderlies, the environmental services. But the insurers? The administrators? The bloated bureaucracy feeding off our human problems? Have we learned our lessons yet? Or will we have to see the tens of thousands of dollars charged by insurance companies for a COVID-19 patient being treated by an "out of network" ER doc? How about the privilege of being charged a couple grand for being denied a test? Oh, then there are the lab bills because the tests are being processed by facilities who didn't pre-negotiate a contract with the insurer. And don't think for one moment the inflated cost of the PPEs that are in such staggering short supply isn't going to show up a patient's bill. Hospital stays are over $15k/night before beds ran out; tack on ICU, ventilator, and the battery of drugs they hope will work and you're over $20k/night, easy. That's if you're lucky enough to be "chosen to live." Better hope your insurer allows the doctor to sedate you if you draw the short straw, since you can't breathe and are drowning in your own blood and fluids.

Gods forbid you survive the worst of this because now you have a pre-existing condition and a government that's bound and determined to make sure you aren't entitled to healthcare because someone will actually have to treat you...which means less money in the pockets of the industry CEOs and stockholders. You can get in line behind the mass shooting survivors, coal miners, cancer patients, military, civilian DOD injured in the line of duty, and 50% of the non-senior citizenry.

And if you don't have insurance? Bankruptcy is your only option. (No, suicide won't help you; your bills get passed on to your family.) Congrats, you get to lose everything! Hope you're not looking to the government to help with that homelessness problem. What's that? Scar tissue on your lungs? Can't breathe without aid? You want welfare? Are you kidding? You think you're some multinational corporation entitled to government bailouts? Bootstraps, boyo!

Is 30k dead from a pandemic enough to prove that the healthcare industry is broken? Will it take 300k dead to make the shift? 3 million? 30 million? What's the magic number that makes us as a nation say, "enough"? What is the number that finally frightens the politicians into doing what's right for the people instead of the corporations? The motivation has got to be fear because ethics isn't working and neither is shame.

Sadly, I don't think we've reached the tipping point. I don't think the tragedy is real to enough of us to affect change. Not yet. Not enough to last through November, certainly.

Don't let this screed make you horribly depressed, I hope it makes you angry. Angry enough that whenever you can push for change, you push. HARD.