Tag Archives: deadly diseases

Decades Later The USA Health Care System is Still a Deadly Disease for Our Economy

Decades ago W. Edwards Deming named 7 deadly diseases of western management. One of those was excessive health care costs. Sadly that deadly disease has become much worse in the last several decades.

Americans pay 300% more for this prostate cancer drug than much of the rest of the world

Xtandi, a prostate cancer drug co-licenced by Japan’s Astellas Pharma and Medivation Inc. was developed at a U.S. university with grants funded by taxpayer dollars. That gives the federal government the right to revoke the patent if the terms are unreasonable, said the letter, dated Monday.

“We do not think that charging U.S. residents more than anyone else in the world meets the obligation to make the invention available to U.S. residents on reasonable terms,” said the letter, which had Sen. and presidential candidate Bernie Sanders, Sen. Elizabeth Warren and Rep. Elijah Cummings among its signatories.

This specific example also highlights what I classified as a new deadly disease in 2007 – the broken patent and trademark system.

Both of these deadly diseases greatly damage the USA economy and the economic condition of USA citizens. It is disgraceful that the Democratic and Repulbican parties have allowed these deadly diseases to ravage the USA economy for decades.

The drug price situation in the USA is greatly exsaserbated by the corrupt political process. Drug companies give large amounts of cash to those we elect and then those we elect create system that damage the USA economy and provide drug companies huge extra profits inside the USA (those profits then allow the companies to charge other countries even less and still make a great return on their investment). I wrote about this in 2005: Excessive Drug Prices in the USA (and several times since then, Drug Price Crisis [2008] – it is a long term, huge economic problem for the USA).

Health care is extremely expensive everywhere. But in the USA the health care system is twice as costly as other rich countries. This is an enormous burden on the USA economy. Nothing else comes close to being as costly in terms of direct spending. And there a a great deal of other damage done that can’t be seen in just the 100% more the USA spends on health care than other rich countries spend. And the health outcomes are no better for the extra hundres of billions of dollars spent every year for health care in the USA.

The costs of decades of failure are extrodinary. We shouldn’t allow the political parties to continue to fail to sensibly address these problems. Even if we can just get to the point of costing 50% more than other rich countries our economy will be greatly enhanced, but we have not even been able to reduce the health care tax the USA health care system puts on us to just 50% more than other countries. That is a pretty sad state of affairs especially when you consider that other countries are not doing a great job – so we are twice as costly, not as some extremely wonderful amazing system but twice as costly as mediocre comparisons.

Extremely inflatted drug prices in the USA are a significant part of the problem but still only a portion of a system that has been costly the USA economy and citizens hundreds of billions of dollars a year (and untold soffuering in many other ways) for decades. We have to do better.

Related: USA Health Care Spending 2013: $2.9 trillion $9,255 per person and 17.4% of GDPThe Growing Market for International Travel for Medical CareCEOs Want Health-Care Reform (2009)Can We Expect the Health Care System in the USA to Become Less Damaging to the Economy? (2011)

Compensation at Whole Foods

Compensation at Whole Foods Market [the link that Whole Foods broke was removed]

Most large companies also pay their executives large amounts of stock options in addition to large salaries and cash bonuses. However, this is not the case at Whole Foods Market. As the chart below indicates, the average large corporation in the United States distributes 75% of their total stock options to only 5 top executives with the remaining 25% going to everyone else in the company (actually most of the remaining 25% goes to the next level of executives below the top 5). At Whole Foods, the exact opposite is true: the top 16 executives have received 7% of all the options granted while the other 93% of the options have been distributed throughout the entire company with all Team Members eligible for a grant after 6,000 hours of service to the company.

This is the kind of data you would expect if people are the organization’s most important resource. If instead senior management thinks the company exists to fund their lavish lifestyle and only needs to do other things like provide value to customers, reward investors, provide meaningful work to all employees… as a way of funding lavish living by CEOs you get the behavior discussed in: Graph of Obscene CEO Pay, More on Overpaid CEO’s and Excessive Executive Pay.

Whole Foods CEO Pay [the broken link was removed]

Related: Excessive Executive PayThe Purpose of an OrganizationWarren Buffett’s Shareholder LetterStarbucks: Respect for Workers and Health Care

More on Overpaid CEO’s

CEO pay up big – but not performance:

The Corporate Library analyzed the compensation of nearly 1,400 chiefs for its annual report on CEO pay. The group’s median total compensation rose 16 percent between 2004 and 2005. A year earlier, CEOs got a bump of 30 percent in total compensation, which includes salary, bonus, perks, exercised stock options and other long-term incentive pay.

This is more bad news. As Drucker, Buffet and many others have said CEO overpayment is bad for companies, workers and shareholders. Even when they are fired they often take away tens of millions of dollars. Absolutely ridiculous. I sure hope the bubble of CEO pay bursts soon – the only suitable comparison this century is the internet stock bubble. But every year it just gets worse. I would add overpaying CEO’s to Deming’s seven deadly diseases of western management.

Related: Excessive Executive PayWarren Buffet on ridiculously out of line executive compensationExcessive CEO PayMore on Obscene CEO Compensation

Excessive CEO Pay

Overpaid CEOs and Underpaid Managers: Fairness and Executive Compensation by James B. Wade, Charles A. O’Reilly, III and Timothy G. Pollock:

We also find evidence suggesting that CEOs serve as a key referent for employees in determining whether their own situation is “fair,” and this influences their reactions to their own compensation. More specifically, we find that when lower-level managers are underpaid relative to the CEO, that is, underpaid more than the CEO or overpaid less, they are more likely to leave the organization.

Essentially if the CEO is extremely overpaid, even if other executives and managers are overpaid (compared to those outside the company) the others feel they are not being treated fairly and turnover increases. Their data is from the 1980’s and they argue (sensibly to me) that the effects may be larger now. We have all seen CEO pay become much more excessive in the last few decades. That fact, convinced Drucker that the issue of unfair CEO pay demanded very strong denunciation from him over the last decade of his life.

Related: Excessive Executive PayMore on Obscene CEO PayWarren Buffett’s Shareholder LetterManagement Guru Peter Drucker 1909-2005Trust: Respect for PeopleDrucker Opinion Essays from the WSJToyota’s CEO ethical pay:

In a reflection of Toyota’s team-oriented approach, its executive pay is paltry by U.S. standards. Analyst Ron Tadross at Banc of America Securities estimates the total annual compensation of Toyota’s CEO at under $1 million – about as much as a vice president at GM or Ford Motor Co. makes in a good year.

CEO’s that take such unethical large pay today are the robber barons of today and will deserve the judgement of history for the actions they take (I would imagine they are perfectly happy to take the money now and worry about opinions later). And those that approve such pay also deserve sharp criticism.

Intellectual Property Rights and Innovation

How intellectual property influences innovation and growth in the economy depends on the application of intellectual property law. No intellectual property (IP) rights would hinder innovation. Complicated application of confusing and overreaching IP rights also hinders innovation. Now I see the USA systems as having overreaching claims of IP rights, IP rights granted for obvious ideas which then are used to extort those actually producing value and overall a system much in need of improvement.

Lawrence Lessig does the best job of presenting the value of improving our application of IP law.

Related: The Patent System Needs to be Significantly ImprovedPatent Review Innovation – Is the US Patent System Endangering American Innovation? [the broken link was removed] – Do Intellectual Property Rights Help or Hinder Innovation? [the broken link was removed] by Amy Rowell

PBS Documentary: Improving Hospitals

Clare Crawford-Mason and Llyod Dobyns have teamed up on a new documentary. Previously they created If Japan Can-Why Can’t We? and the Deming Library Tapes.

Good News – How Hospitals Heal Themselves (broken link was removed)
A One-Hour Documentary Airing on Public Television Spring/Summer 2006
Reported by Former NBC Anchor Lloyd Dobyns

This rare good news documentary reports on a surprising solution to escalating costs, unnecessary deaths and waste in America’s hospitals. Doctors and nurses tell how they did their best, working overtime, while hospital conditions worsened. They were delighted to learn a new way to improve patient care dramatically and reduce unnecessary deaths, suffering, errors, infections and costs without additional resources or government regulations.
Continue reading

Innovation and Creative Commons

Creative Commons is a license that lets the creators of intellectual property clearly define how that property may be used by others. Partially this license is a reaction to the poor way copyright law is being viewed today (see links below).

Partially it is tool that gives creators a way to provide for more interaction with their ideas. And this interaction is a great way to market, in the right circumstances. More managers should be thinking about how their organizations can use this tool to improve performance.

A great example is found in this Wired article, Open Source Opens Doors to SNL [the broken link was removed]:

Live from New York, it’s — three comic talents who first made a name for themselves on the internet.

Andy Samberg will become a performing member of Saturday Night Live’s 31st season cast debuting Oct. 1, while Jorma Taccone and Akiva Schaffer have joined the show as writers. But all three got their first big break online, thanks in part to the viral popularity of video shorts they released on the net. In a move that may have helped fuel rapid grass-roots distribution, the comics released their work under Creative Commons licenses, which essentially let anyone copy a given work for free provided that person doesn’t try to profit from it.

This was an effective strategy to get their work into the public eye and market themselves.

Copyright background links:

Update: Learn more on the new deadly disease (systemic impediments to innovation through systemic copyright and patents failures).