It's Soylent Green All Over Again!

Remember the movie "Soylent Green"? Maybe you are not as old as I am, but it was a big hit in the 1970s when I was a kid. It told the story of a highly efficient, futuristic world where old people were required to undergo a peaceful euthanasia when they hit a certain age. At that point in time, they were considered wasteful in society; no longer capable of working 40 hour weeks and contributing to the tax base.

Sometimes I feel that the ultra-conservative movement in America reflects a "Soylent Green" mentality. Ironically, the Bible and Christianity is used to justify an ideology that is far from what Jesus preached. In recent weeks, I have encountered several Republican women in my community circulating petitions for signing which state that the Health Reform Act is "Unconstitutional." I usually politely decline signing these petitions and tell them that I support Health Reform. One woman at the county fair wanted to argue with me, however. And so I engaged (briefly).
I told her that I am a Social Security Disability attorney and every week I help people who have lost everything (and I mean everything) due to a devastating family illness. I have seen literally hundreds of hardworking local residents lose a lifetime of retirement savings, their homes with full equity, and their peace of mind (i.e. they cannot sleep at night due to mounting, unpaid medical bills), due to an illness. These same people cannot get the medical care they require, even in cases of terminal illness. I also reminded her that 32 million people are uninsured in America today. Someday she could be one of them.
In response, the thirty or forty-something year old woman said "That's too bad. I feel sorry for them, I really do. But it's not my problem."
Does she really "feel sorry for them"? I don't think so. The 32 million people that I reference are simply numbers in the heads of people who have not been truly affected by the plight of the uninsured. I deeply believe that this woman, and others holding those petitions, would change their minds if one of their loved ones: a mother, a sister, a sick child, was a part of that 32 million statistic.
Circulating petitions stating that Health Reform is "Unconstitutional" is the ultimate Republican spin. In my first year as a law student at UC Law School 13 years ago, I was instructed that the US Constitution included a Bankruptcy Clause because the drafters acknowledged that losing all of one's financial resources through job loss, or sickness, or failure to keep a business afloat, could quite literally lead a person to suicide. Bankruptcy was the merciful solution provided by the government to relieve a citizen in that time of stress.
But now, for some reason, a person's right to be slaughtered by medical bills (more than half of all bankruptcies are the result of unpaid medical bills) is Constitutionally PROTECTED? That's a farce. It's a lie.
The private insurance companies have made a killing on sick Americans through unjust policies regarding pre-existing conditions and countless other profiteering tactics. Politicians like John Boehner support these money making private companies and convince Americans that their corruption is somehow Constitutionally protected. The Founding Fathers are rolling in their graves.
The United States of America is the only industrialized Democracy that does not require the right of basic health care to its citizens. So if this mandate is so "Unconstitutional" and demands repeal, then why have no other industrialized nations required such repeal based on their respective (Democratic) Constitutions?
I have said it many times: a society and its government is only as strong as its treatment of its most vulnerable citizens. Case in point, the Nazi regime. Only the strong and the young were valued in that Godless system. There is something very dark about saying one "sympathizes" with a fellow citizen and then denying his or her access to basic medical care.
Finally, I say to the healthy woman who told me that "she feels sorry for the 32 million" but that "it's not (her) problem": someday it WILL be your problems. You will grow old and/or sick and not have proper coverage, or your loved ones will need medical care and not have coverage. It's not enough that you supposedly sympathize with people in these sad situations. As Americans, we must EMPATHIZE with their plight, recognizing that someday it will be us, or our loved ones in the same predicament.

Bringing Balance to Southwest Ohio: The other 32 million

Bringing Balance to Southwest Ohio: The other 32 million

Containing Costs the IT Way

Governments are in financial crisis, Ohio included. Simply put, we have run out of money. Tax revenues  have dropped as property values have tanked and household incomes dwindled. Falling prices for stocks and real estate have further injured previously underfunded public pension plans. Unemployed workers have increased the demand for welfare and Medicaid services. This year, Ohio faces a 300 million dollar shortfall in its budget and unlike the Feds, we don't have the luxury of printing dollar bills and living on credit. Our state leaders must find practical ways to aggressively cut waste and make the government that we have "lean and mean." One of the best ways to do this is through Internet Technology (IT). Below is an interview with my husband, Chris Howard, addressing this issue. We hear a lot of emotional rhetoric from partisan and nonpartisan groups. Now let's starting talking REAL solutions.

Tell me briefly about your job

I am a Chief of Research at Gartner, a technology research and advisory firm. I am responsible for setting and executing a high-value research agenda for technology professionals within the public and private sectors. In my job, I travel extensively worldwide and interact with clients at all levels of leadership. I have worked with various levels of government in North America and Europe.

What are the common differences you see between private companies and government agencies? Why do those differences exist? Are there differences in management and employee mindsets? Do you approach these groups differently?

Public and private sector organizations have different primary drivers and motivators. Whereas profit and competitiveness are primary for most companies, cost containment and accountability are crucial for government. In a sense, they both have similar stakeholder responsibilities: corporation to its shareholders (and others); government to the citizens. The essence of the difference is that corporations exist to generate wealth. Governments exist to govern.

Governments and corporations both consume information technology (IT). Over the past several decades, each have spent billions adding software, hardware, networks, data centers, and staff to create and support the IT environment. The result for each is a complex, expensive, poorly-understood collection of equipment and functionality where money can leak out in a torrent. The growth of the IT environment should be controlled by effective standards and vendor management policies. Unfortunately, and this is especially true in governments, standards often don’t exist or are not enforced. As a result, complexity compounds, fragmented contracts add cost, and change becomes more difficult to implement. Uncontrolled complexity creates additional cost and this, ironically, is an internal governance issue.

In IT, there are a handful of mindsets, common in both public and private sectors. Some people are constantly curious and always learning: searching for better ways to craft solutions. Others are what we call “lifers”: people who attach themselves to a particular technology or system and ride it out into retirement. Lifers are resistant to change because they perceive it as a threat. Those who remain open and curious are more likely to embrace change but are also more likely to take maverick steps that require management support and intervention.

Another similarity between corporations and governments is the often fractured nature of business lines/agencies. In large organizations, silos develop that are aligned with lines of business, product, services, or some other function. As a result, you may have multiple groups that are doing very similar things, but collaboration is limited and difficult. The more fractured the environment, the harder it will be to effectively serve the needs of the customer/citizen.

Provide examples of ways that you were able to help a government body save money.

In my work as an advisor, I help executives spot the opportunities for consolidation in their environment and counsel them on dealing with political issues that will arise. At the end of the day, the discussion is not about technology solutions: those are pretty straightforward. Most inertia in organizations is caused by culture, habits, and broken relationships.

Most governments worldwide, at all levels, are working on shared-services solutions that consolidate common functions across agencies. This involves reaching consensus on what can be made common and reusable. It is complex work, and requires analysis of existing workflows to determine where redundancies can be collapsed. It is a balancing act: not everything should be centralized, and agencies need some level of autonomy to be effective.

Computing infrastructures are also candidates for consolidation. Using new virtualization technologies and emerging cloud computing capabilities, governments can reduce their spending on data centers. Some of my government clients are making decisions about whether to build new data centers or retrofit their existing ones. In many cases, older government facilities are not appropriate for new data center architectures and they should build a modern facility that incorporates new approaches to power, heating, and cooling. In the long run, such a facility will save them money. In the near term, governments should start by reducing the number of physical servers and replacing them with virtual machines running in their existing data centers.

Consolidation and computing infrastructures come together in effective ways. The Canadian Federal Government, for example, built a completely virtualized infrastructure for shared services that supports most agencies. Virtualization allows for quick provisioning of computing power at lower cost than traditional methods. In this scenario, everyone wins: standards and policies mandate use of the shared infrastructure, turn-around time for new functionality is accelerated, and cost (and technology sprawl) is contained.

Why is the move to e-government just a surface solution?

E-government is an important strategy. It places more control in the hands of the citizen as they interact with their information and services. It also potentially reduces “customer service” costs and personnel. The challenge with e-government is that it may not go deep enough. Truly effective e-government requires refactoring of the underlying systems to create integration and consolidation. Most of these legacy systems were put in place before the concept of citizen self-service (or the internet for that matter) existed. Human workflow will also need to be refactored to support a more integrated environment.