Raining again in Durham. After the drought of 07, I steel myself not to complain as the waters fall. And we’re 3x the usual for this time of year. My form of lemonade for this circumstance would be snow, which is a stretch for Central Carolina in late Fall. Healthcare and the associated reform movement perplex me. Participated recently in a well-managed discussions within this topic. Duke’s Fuqua School hosted a day-long series of panel discussions on how we, the nation and its array of providers, payers and patients, might find a way to get most of the healthcare that we pay for. By now, it is common knowledge that the USA pays the most per capita without being close to the top in quality of care received. Tangentially, we’re applying the same thinking to the war in Afghanistan, i.e. we must do the right thing even if it is neither affordable nor is victory, however measured, likely with this continued investment of resources. “Turn him to any cause of policy,
The Gordian Knot of it he will unloose, Familiar as his garter” (Shakespeare, Henry V, Act 1 Scene 1. 45–47)

Back to Fuqua. The participating senior members of the government, the sincere consultants, the MDs turned economists and the very bright business school students (Fuqua competes with Wharton for the top spot in HMS (Health Management Systems- the program once known as Masters of Hospital Administration)- were thwarted by the complexity and interconnection of the elements of our problem. If we solve one part, we penalize an important constituency; if we resolve that part, we anger this other important constituency. The hovering bomb, of course, is the unfunded liability, now estimated to be $59 trillion dollars, for Social Security, Medicare and Medicaid obligations. Occurred to me that the sole and probable solution, unless we want to continuously spend 20%+ of the GDP on healthcare, is to prepare for the collapse of the system. Some hope remains if the likes of this MBAs attack the root causes of this mess. With enough time and authority, they will make an important difference. If they venture into healthcare front as a second option to employment on Wall Street, then it’s welcome to HCA – HealthCareAfghanistan.

By the way, some argue that the Push-Up is the best indicator of physical fitness.

4 inches yesterday, some remains today, all gone tomorrow. Sounds like one of the major banks. Why is Bank of America 30% more valuable than it was yesterday; although, still only $6.68 per share. Does the market like talk of nationalization? Did it have a chance to re-read President Obama’s address?!

I enjoyed his remarks and did not find them to be on par with Abraham Lincoln’s 2nd Inaugural. Really enjoyed the benediction and Aretha Franklin, especially the way that she include Martin Luther King’s ‘I have a Dream’ phrases into her rendition of God Bless America. Much work ahead of us. Much necessary and useful and purposeful work ahead of us. A good start to a new chapter for America.

Returned to my office yesterday from the televised inauguration to learn that an interview for a business magazine was just published. Amazing what a competent editor can do to make a 30 minute phone ramble coherent. I am eager for different & difference: different ways of living, relating, behaving, enjoying. Must admit, so far, so good.