Articles

Retro Repost: The Public Option

In Politics on May 16, 2016 by thebetweenthoughts

(Originally published by The Rapt in 2009)

The Public Option
How will America deal with the growing healthcare crisis?

Life, liberty and the pursuit of happiness.

We expect our government to help create opportunities for success.  We expect our government to protect our freedom.  But when it comes to the most basic ideal in that founding phrase – life – should we expect our government to be responsible?

For the next few weeks, Congress will be intensely debating the concept of a “public option” in the healthcare reform bill they hope to pass by August.  For Republicans, the public option is another step towards a socialist state.  For Democrats, the public option is a method to control the rising prices of private insurers and to provide healthcare insurance to the tens of millions of uninsured.  For most of the American people, the public option has no meaning at all.

We treat our healthcare system the same way we treat our health, we only deal with it when something is gravely wrong.  The government has ignored the problem of rising healthcare costs because the American people have not seen it as a priority.  Currently, healthcare expenses are consuming 16% of our GDP.  At nearly $8,000 per person, America has, by far, the costliest healthcare system of any country.  Yet, healthcare reform has only recently become a topic in the national conversation.  In times of economic prosperity, we can afford to be ignorant.  Money, although not the best solution, generally tends to be the quickest and simplest one.  Our incomes were rising along with our premiums and deductibles, so we failed to notice a difference.  The financial crisis has taken away the safety net and has exposed various economic issues across the country: the inefficiencies of the automobile industry, the poor budgetary management of California, and the deep flaws in our healthcare system.

Although rising costs and a growing population of uninsured citizens are the most pressing concerns being addressed by the government, the deepest flaw in our healthcare system may be our general ignorance towards the inner workings of the healthcare industry.  Most Americans have no idea how their health insurance works; their only interaction with the healthcare industry involves their initial application and yearly renewals.  Healthcare has become nothing more than a few dollars automatically deducted from our paychecks.  No one knows how physicians are compensated, how insurance companies operate, how the pharmaceutical companies work with both to increase their own profits – it is an ignorance we treasure because in the end, we hope that we will never have to use what we have purchased.  With any other “product” this attitude would be absurd, but with healthcare, the most personal and vital purchase we will ever make, this is the norm.

The current free market healthcare system promotes profits over patient health.  Insurance companies have no reason to attract the sick and elderly, no reason to accept claims – their business model is based on denying coverage.  Pharmaceutical companies focus on drugs that will increase their profit margins, not necessarily on what will provide the greatest health benefit.  This same revenue-driven mentality carries over to providers, physicians and hospitals, who overutilize treatments to increase the money they will be reimbursed from insurance companies.  The physicians’ motto, “Do no harm,” applies to our bodies, but apparently not to our wallets.  Is this solely their fault?  No.  It’s a culture created by our indifference to our health.  Just as we have turned a blind eye to warnings about smoking and obesity, we have overlooked the fundamental inconsistencies in healthcare compensation.  Healthcare professionals are only working within the framework that we have given them.

Where does this ignorance come from?  The healthcare industry is intricately linked.  It is complicated.  But it is knowable.  The information is out there in the public domain, we just choose other streams of entertainment and distraction instead.  Sadly, this ignorance is just our standard approach to things we feel are beyond us.  If a topic is not force-fed to us through employee trainings, school or television, we feel no need to learn about it, regardless of its importance to our lives.  As the amount of information available to us has increased, so has our indifference to it.  We close off our minds to only the easiest of thoughts.  We have stopped being active participants in government and only engage in thoughtful discourse after issues have been distilled to their simplest and most visceral forms.  Healthcare reform is just another “large” concept that we, as normal citizens, do not feel capable enough to weigh in on.

Given the intricacies of our current system, one tidy solution does not exist.  One bill cannot replace an industry that has lasted for half a century, but it can establish the foundation for change – a change that will ensure all citizens are taken care of for their basic health needs.  On the surface, universal care seems like a path to higher costs for taxpayers.  But in our current system, the uninsured become even greater burdens on taxpayers as they often receive their health services through a costlier path: the emergency room.  The majority of uninsured ER services are billed to the government; the services that are not billed become absorbed by the hospital and eventually result in higher expenses for other insured patients.  A government-sponsored plan also benefits the insured, as a larger pool of insured citizens will lead to lower premiums and deductibles.

Universal care is only the first step in reform though.  We need to embrace our market-driven healthcare system and become informed consumers.  We need to dedicate ourselves to understanding the products the insurance companies, hospitals and pharmaceutical companies are offering.  We need to think about preventative care and how we can best utilize these offered products – not just for illnesses, but also for how we can continue to be healthy.  The public option we are facing is not a government health plan, but the decision of whether or not we are going to take full responsibility for our health.

;P

Articles

Creativity vs. Consulting

In Life on May 9, 2016 by thebetweenthoughts

Management consulting is all about creating structure and forcing the ambiguous into some sort of logical framework.  Consultants specialize in turning chaos into order and synthesizing the complex into something simple.  The fuzzy edges and the blurry margins are generally sacrificed for the sake of a “clean” storyline.

It’s ironic that we use the term “storyline” in our presentations, since what we’ve developed is the antithesis of creativity.  If anything it’s the “anti-story”, as we’ve eliminated any room for interpretation or any chance of ambiguity in our message.

Going on 10 years of being in the management consulting field, I wonder if I have any creativity left in me.  My creative outputs will always be the things that I’m most proud of – the comic strips I made in grade school, the short stories I wrote in middle school, the screenplays that I wrote in high school.  These were initial sprouts within my creative garden.  But of course, like any good future-fearing Asian-American, I decided to go down the path of science and a respectable career once I started college.  The move to New York was an opportunity to rekindle those creative fires, but once again respectability, responsibility…and the cost of living in NYC, managed to snuff out those flames.

And now I wonder if a career of not allowing my mind to explore and imagine…of structuring and defining…has extinguished that creative spark for good.  Creativity isn’t exactly nurtured in a management consulting environment.  More often than not, we’re helping a large enterprise  manage their risks and prioritize their investments.  There really isn’t any room for bold thinking.  We’re just trying to dole out advice that isn’t going to adversely impact their bottom lines.

When you’re constantly organizing thoughts and finding logical threads, it limits your ability to be absurd.  But absurdity isn’t the key to new and original thought?  It’s the path to breaking free from worn down lines of thinking.  Do our clients want original thoughts?  I honestly don’t know…

With each new framework that I see or develop, another piece of my creative side is wiped away.  Another structured way of thinking eliminates the random idea that could lead to something special.  Maybe I’m just deluding myself into thinking that I had a creative side at all…

It’s a conflict that probably will not be solved anytime soon…but I wonder how much time I have left to debate it.

;P

Articles

The Trolling of America

In Politics on May 5, 2016 by thebetweenthoughts

So…we’re really doing this Trump thing, huh?

[I’ll put aside the normal ramblings about not writing consistently enough – more than a year since the last post! – and save that for another post…which hopefully will happen in less than a year.  No promises!]

As fascinating as the Republican primary has been…did anyone really think this was going to happen?  We were all reveling in the trainwreck of the Republican party (Disclaimer: I once considered myself a Republican…I fit all of the demographics in terms of income status and fiscal theories…but I can’t honestly accept a party that has become so anti-science…anti-logic…anti-anything, really.]…but I think we all thought that at some point during the process, the Republican base would wake up to the disaster that a Trump nomination would be.  Well…that point has come and gone.  And now, we’re left with a caricature of a human being at the top of the Republican ticket.  You can’t blame “The Donald” though…he was the only one on the Republican side to figure out what was fueling politics in this day and age…blind anger.  (Bernie Sanders is doing the same on the Democratic side, but he’s going against the Clinton political machine.)

Trump was able to tap into the id of America and foster this rage against all things “un-American” – which by his rhetoric includes Mexicans, Muslims, the political establishment, anyone that disagrees with him and protests him, and, of course, coherent thought.  I don’t fault Donald Trump though – as with any savvy (or smarmy) businessperson, he identified a weakness in the market and exploited it.  It’s just that in this case, the opportunity that he’s exploiting is the American people.  I’m more disappointed and scared for us as a country that we could give credibility to someone like Trump.  Are we truly that fed up with the “political establishment”?  Are we really in such dire straits and hopelessness that we would hand the country to a man with a bankruptcy-filled business record?

Admittedly, I live in New York City, so maybe I’m just not aware of the state of the rest of the country.  But, as a consultant, I travel to some pretty small and middle-class urban areas…and I haven’t seen the level of decay that Trump (and the rest of the Republicans) talk about.  Our country isn’t falling apart…it doesn’t need a savior.  Yet the two candidates that have sparked the most enthusiasm in the country are the ones calling for a revolution.

What happened to us?  Eight years ago it was about hope and change…we were in low point economically and politically…and (I thought) we came together through a candidacy of optimism.  Where did we go wrong?

Internet trolls are the people that harass others without any fear of recrimination due to the anonymity of the internet.  They incite anger and devolve conversations into single-minded, insult-driven affairs.  There really isn’t a point to their anger, they just want to bring out the worst in us.

…other than the anonymity, I think that pretty much describes what Trump has done to the political process.  Are we going to realize this anytime soon…or will Trump soon be trolling the rest of the world?

;P

Articles

Hillary for America?

In Politics on April 15, 2015 by thebetweenthoughts

Nothing inspires me more than a completely open Presidential election – let’s do some bloggin’!

Hillary for (those that don’t really vote in) America!

I actually liked the Hillary’s announcement video.

(Random sidenote: Is it a good or bad thing that we reference her as just “Hillary”? All of the Republican nominees are known by their full names…even the one with some history [I’m looking at you Rand Paul]. Why do we ignore the “Clinton” aspect of her candidacy? Is it just because we know the name so well…or are we trying to ignore the association?)

Given the focus on Hillary’s personal and professional failings recently, the video was an interesting shift away from her and to the “everyday Americans (her term not mine)” for which she’s fighting. The implication here of course is that she’s going to fight the 1% who have been ruining our country (at least that’s the phrasing that I have in mind when she made that line). It’s an interesting tact that appeals to the population who vote in the Presidential elections, but don’t vote for anything else. With America’s general apathy towards politics and voting in general (but coupled with a propensity to bitch about everything), we basically vote ourselves into a corner every four years. “The People” vote in their President and then “The People” fail to support them in the intervening years.

Do I think Hillary is going to win? Probably. With the most name recognition (a more important factor in the Presidential election – notice a theme here?), she has the best chance of connecting with those voters who show up to vote once every four (or 8…or never) years. The video actually appeals to a broad coalition of “underserved” – small business, minorities, same-sex couples – which of course means the flip side is that it might actually repel the older, white base that represents the bulk of the voting population. But this is the problem with politics obviously. All it does is push people to the extremes – Democrat or Republican, liberal or conservative, yes…or no. It seems as if we’ve lost the ability to make nuanced decisions. We especially have lost the ability to explain…and subsequently understand nuance.

Surprisingly, Hillary does seem like the candidate most likely to embark on this nuanced path though. Through her experience in the State Department, we’ve seen her react not on liberal or conservative lines but in ways that represent a painstaking decision process. As a President, this thoughtfulness doomed Obama. But as a candidate, this might still be an appealing trait.

We all speak from our own political leanings – I can only voice the perspective of someone totally jaded by the political process (who votes every four years…maybe)…someone with a well-paying job (not 1%…but top 30%?…hopefully)…who is liberal in his social policies, but lean towards the fiscal conservative side. I’m in favor of the Affordable Care Act. I’m was in favor of the bank bailouts. I’m confused on immigration reform. I’m for same-sex marriage. I’m also an anarchist at heart…yet have one of the most conservative and status quo promoting jobs. Ha.

I don’t know if I’m representative of my generation at all – a 30-something demographic that have decent jobs, but aren’t really invested in what is happening around us. We recycle when we remember (or are guilted into it). We donate to non-profits (but rarely care what happens to that money). We bitch about unfair taxes (until we hit the next bracket). We are the apathetically ascendant. We stand to inherit the country, but we’re fine with our parents running things for now.

Will I vote for Hillary? Probably. But that’s more a function of the lack of current competition. (Which I’ll cover in a future post.) It’s going to be an interesting campaign season. I’ll watch every minute of it…and then try to remember to vote.

;P

Articles

The Role of a Consultant

In Life on April 10, 2015 by thebetweenthoughts

I’ve been in the “management consulting” world since 2003 (I put that in quotes, since I still can’t define what that means to people.  Sure, I can BS a definition…but in the end, what do I really do?  Who knows…) – subtracting out some years of b-school and non-profit work, I’m basically at 8-9 years of doing this.  And based on that near-decade of experience, I can say one thing definitively – “it sucks.”

One of my old managers once told me that people use consultants for two reasons – (1) they’re too stupid (i.e., they need an expert opinion or a set of tools they don’t have access to) or (2) they’re too smart (i.e., they don’t want to deal with bitch work).  Based on my last few clients, it seems as if there’s a third reason – they’re looking for a punching bag (both for them to beat up on…but also to offer up to their peers when they’re in hot water).

As the external consultant, it’s difficult to say anything back.  I’ve heard as of late that I should stand up more to the various stakeholders, but how am I supposed to do that when I’m a fungible resource in their eyes.  They know that I’m just here on an external, temporary basis…they have no real respect for me…they have no reason to display any goodwill towards me…why would they?

I’m reliant on the kindness of strangers to get my job done…and unfortunately, more often than not, it’s a kindness that never appears.  With any large corporation, you’re going to have silos.  Departments and groups that work independently and are only willing to contribute to “their area”.  Once their piece is done, they’re more than happy to ignore any and all requests from that exist either on the input or output side of their place in the workflow.

As the external consultant, you come in and try to break that up a bit.  You try to foster collaboration.  You try to increase stakeholder involvement.  You try to make the dysfunctional…functional.  But in the end, all that happens is that you become the center of the shitstorm.  (I should just change my title on LinkedIn to that…Alek Bituin – Center of the Shitstorm.)

I left consulting awhile back because of a variety of reasons…and this was definitely one of them.  No real impact.  No real ownership.  Basically a walking toilet going around a company and…well, you can probably finish the imagery.  I still wonder how I ended up back here.  What happened to the guy that left his “high-powered” consulting job to be a writer in NYC?  At times, it feels like my first few years in NYC were just a dream (random AZN clubbing, attempting to write at every Starbucks in Manhattan, actually finishing two screenplays…) and I’ve woken up to the frustrating reality of my previous life in consulting.

Sadly, the chances of me writing something of note is about the same as the chances of a client ever truly respecting and valuing me.

Fun times…

;P

Articles

A New York Story

In Life on January 30, 2015 by thebetweenthoughts

So that last entry went down a path of unexpected melancholy…apologies. A man can’t be held responsible for what he types at 4:45 in the morning at an airport terminal.

As recompense, I’ll tell you all a little story:

I was waiting for the M34 bus on 34th and 7th after work a few months ago, when I saw a man approaching me. It’s never a good sign when a stranger starts walking towards you in New York – we’re all used to operating in our selfish little bubbles and if someone choose to break into that bubble and ruin the social pact that you’ve made with all other New Yorkers, it generally means they want something from you (sign a petition, money for a “bus ticket”, information on how much the specials are at the Japanese restaurant you’re standing in front of [true story!], etc.).

Now, I feel like I need to describe the man approaching me and the reason why my “crap, I need to put my headphones in” warning sign started to flash. He was of the Jewish variety…and although he never stated as such…he wore the general accoutrement (black hate, curly hair, etc.) that I associate with the stereotype in my mind. This really isn’t an important fact now, but the rest of the story may confirm and refute any stereotypes you have in your head right now.

I had just finished work, so I was dressed in full business attire (suit, tie, laptop bag)…which I guess made me a likely target for his opening question. “Do you work at Goldman Sachs?” I have a few friends that have worked at Goldman Sachs, I’ve seen employees in the media…they’re really just like you and me. So, I’m not really sure what he saw in me that made him jump to the conclusion that I work at Goldman. Wishful thinking, maybe? And I could see the disappointment in his face when I responded with “No, I don’t work at Goldman.”

Stranger Danger: “Do you work around here?”

Me: “Nope, don’t work around here.”

Let’s be honest – there really isn’t any direction that this conversation could go that would be positive for either of us. Yet, he still chose the path that went resulted in the worst line of conversation.

SD: “Wow, you speak really well?”

Me: “What?” (In a tone that clearly conveyed “quit, while you’re behind buddy”.)

SD: “You speak really well.”

Me: “Why would you assume that I wouldn’t speak well?”

SD: “I’m just saying that I’ve never met someone like you that has spoken well.”

(So it’s obvious at this point I should just stop engaging with this person. There is nothing to gain from this…and we’re moving closer and closer to a point where I’m going to have to tell my friends that I spoke with a racist today. Not there yet though…)

Me: “Never met someone like me? What does that mean? What do you think I am?”

SD: “You’re Mexican.”

(And there’s the racism.)

Me: “Excuse me? No.”

SD: “Native American?”

(Where’s the fucking bus???)

Me: “No.”

SD: “You have to tell me. I’m really curious now since I’ve never met someone like you that has spoken so well.”

(Really? This is the point where you feel like compounding the racism. Not only have I been misidentified, but the intelligence of the race of “whatever I am” is being questioned. Bonus points for this guy.)

Me: “No.”

Thankfully as this point I can see the bus, so it’s only going to be a few more minutes with this guy. What else could he say that would be more offensive?

SD: “You have to tell me.”

Me: “It’s just going to be one of the great mysteries in your life.”

The bus pulls up and I start walking towards the door…and he continues to follow me and to pester me with questions on my race. Since, obviously, I need to be catering to his thirst for knowledge about ethnic identity.

Finally I break down…

Me: “I’m Filipino.”

SD: “So I was right. You’re Latino.”

Motherf*cker…if it wasn’t for the shock that I had at that statement, I probably would have punched him. I won’t get into the finer details about racial identity and ethnic origins, but just to set the record straight – Filipinos are not Latino. He’s probably the only in the person in the world who would disagree with that fact, but I just wanted to put that out there.

Ah…New York. You never know when the stage is being set for memorable story.

(So how’s the stereotype I mentioned earlier holding up? Does my story confirm or refute your own biases?)

;P

Articles

Who am I?

In Life on January 23, 2015 by thebetweenthoughts

When you’re waiting at the Nashville airport at 4:45 AM on a Friday morning, you tend to have these types of existential thoughts.  It’s natural to present a different persona depending on the situation.  With friends…with family…with your wife (or future wife-to-be in my case)…with your coworkers…with your clients…they all see a different side of you.  We’re essentially just a collection of personalities housed within the same fleshy exterior.

At times like these though, I feel as if those in the “management consulting” profession are extreme examples of this phenomenon.  As a result of the demands of the job and the travel schedule, we’re literally leading two different lives.  From Monday to Thursday, I’m “professional” Alek – a client-facing, work-driven, objectives-focused lonely individual.  Friday to Sunday, I’m allowed to be “personal” Alek – someone who really just wants to relax and not give a shit about anything.  The Monday-Thursday period is interesting though, as consultants tend to live in this odd little bubble where everything is paid for, you have concierge services to help you out with anything, and you never have to wash your sheets.  It’s during this period where you’re the most alone in life though.  In a “foreign” place…alone in a hotel room…left only with work…or your own thoughts about life.

(Okay…this might just be me.  I remember when I lived alone in my studio, I would have conversations with myself without even really noticing.)

So amongst all of these personas, who is the real you?  Is the real you the collection of these personalities…or is there one true self hiding underneath it all?  At what point do we realize and understand who the true self is?

While doing stand-up, the person I was on-stage wasn’t really me…it was more of a caricature of me.  It helped to disassociate myself from the person telling jokes on-stage in order to deflect criticism, but also to not take the applause as anything more than a passing moment of adulation.

So, why have I decided to “re-enter” the blogosphere with a post about self?  I’m at a crossroads, and it’s always healthy to question the fundamentals in your life in order to give direction on the future.

The next time that you see yourself in the mirror – don’t just ask “who am I?”, but also “why am I?”.

;P

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