PBMs -- Scorpions and Dogs

In January of the year 2000, the Henry J. Kaiser Family Foundation issued a report titled: The Role of PBMs in Managing Drug Costs: Implications for a Medicare Drug Benefit.  It is one of those special reports in that it is clear, fair and balanced in its presentation. Some thirteen years later, it is good to reflect back on what it said and to analyze the current state of PBMs and their impact on healthcare management, both for efficiency and cost. The results, by and large are abysmal for the nation, while wildly profitable for the largest providers.

I draw your attention to the goal espoused in the opening pages of the report:

The intent behind proposals to use PBMs is to apply private sector best practice techniques to a publicly funded benefit.

In a nutshell that is a euphemism for applying devious, underhanded tactics to charge customers as much as possible just shy of having the client revolt.

PBMs are not servants to their clients. They are corporate pariahs whose goals are profit maximization at the customers’ expense.

To that end, PBM contracts essentially prohibit clients from knowing any more than the PBM thinks they should know. In most cases, this means the client should know that his costs went up again this year, as they have in years past, without asking for an in-depth explanation. In other words, “Trust us.”

It is possible that the acronym PBM was chosen to simplify the words Pharmacy Benefit Manager. It is also possible that this title and the acronym were chosen because the terms Shell Game and Smoke and Mirrors, while more accurately reflecting what publicly traded PBMs do, were already taken.

While PBMs smile and talk softly, the wording of the contracts belies their true purpose. Think of it as the dog (customer) and the scorpion (PBM), together on one side of the river. The scorpion says ever so gently, “The river is moving way too fast and I fear I can’t get across on my own. Can you take me there on your back?”

“But you’re a scorpion. Your venom is fatal. Why would I do that?”

“I promise I won’t sting you. Look, I only ask for safe passage to the other side. That’s all. Trust me.”

Safely ensconced atop the dog’s head and just barely above the waves, the scorpion watches as the shore comes ever closer. Within yards of landfall, his pincer penetrates the dogs skull and, immediately, his paws cease their strokes.

“Why did you do that?,” the dogs asks plaintively, as his body starts to roll with the waves. “Now we’re both going to die.”

“Yes, replies the passenger. I’m a scorpion. It’s what I do.”

PBMs might also stand for Pariahs… you provide the rest.

Not All PBMs Are Alike

The most pernicious PBMs are large, publicly traded corporations that have as their mission to maximize profits for their shareholders – no matter what, no matter how. The top three control between them some 80% of the market and spend millions each year on lobbyists and PR firms in Washington to give them access to legislators with the goal of solidifying their grip on contracts like Medicare.  Americans must take note and beware of these giants because they go beyond feasting at the trough, to gorging themselves lavishly and without remorse on our tax dollars.

Having said that, there are among the hundreds of smaller PBMs, those points of light who have as their mission to provide management services transparently and in the spirit of fiduciaries. It is to these PBMs we should look for management services, because their missions are more consistent with the needs of their clients – to provide good service at a fair price, transparently. They openly state that they seek fiduciary relationships, whereby they serve their customers in every way and openly share each element of their charges to back up their claims.

These PBMs, true servants all, offer every service that the Wall Street listed counterparts without hidden fees, inflated prices and without holding back rebates.

To be clear, here is a comparison of the two models of PBMS:

How PBMs charge for their services

                                                Wall Street Listed                        Smaller, Independent

Admin fees            Very low, may waive them                        Prefer a per member

to get the pharma business             per month fee that a customer can budget                                   

Data Selling                             Make a bundle selling information            Do not sell Data         

                                                to large insurance companies. Data

mining is big business but an

imposition on doctors’ privacy

Spread *                                  The add-on charge for prescription            Do not Spread. In fact

Drugs can range from pennies to            they show the client

Tens of dollars per prescription             exactly what they

filled. Passed on directly to the            paid the just there’s

client for pressing a key.            no doubt.

                                   

Discounts                                Call many discounts by other                Pass along all names

names to keep from passing                         discount

them along.                                               

Delayed Price Changes            Price increases are passed along            Do Not Delay

                                                to the client immediately but they

                                                defer paying them to enhance the

                                                spread

Others yet to be discovered

* Business Owners/CEOs  How would you feel if you discovered you were charged $120 for filling an employee’s prescription when the PBM managing your benefit program paid $30 to buy it? Check your wallets.

How to Be Sure Which PBM You Have

Read the contract and all its fine print. Large PBMs never hide what they’re doing, In fact, they’re quite up front about it. It’s all spelled out in great detail. They tell you there is no fiduciary relationship and they define transparency differently than you or I might.  They key is that it’s not what they say but, rather, how they say it. Most contracts are so well written, it’s hard to discern the truth in what they’re doing.

The best PBM will spell out what they charge, how they charge and, most importantly, what they DON”T charge for or pass through quietly, under the radar.

What is this costing me – Right Now  -- This Minute?

That’s a perfectly good question. After all, if you’re going to go through a rigorous analysis, three should be a good return for the effort. From my research, I find that if a company counts up all the prescriptions it paid for in a year (or a quarter), and multiplies that number by five, it can safely assume the resulting total is a fair estimate. So, for example, if a company with 250 employees on a plan fill 20,000 scripts/period, the savings conservatively accrue to over $100,000 for that period.

Impact on Profits

For simplicity’s sake, let’s assume a company works on a 5 per cent profit margin. That $100,000 savings to the bottom line is the same as a sales increase of $2 MILLION. You do the math. Imagine if, in these hard economic times, your margins are only 2.5%.You decide if it’s worth your time to look.

http://kaiserfamilyfoundation.files.wordpress.com/2013/01/the-role-of-pbms-in-managing-drug-costs-implications-for-a-medicare-drug-benefit.pdf  

Amigos

En un momento, un grupo de voluntarios llamada Remote Access Medical (RAM) trajo médica, dental y de la vista a las zonas remotas de los países del tercer mundo como Guyana y Haití. Hoy, el sesenta por ciento de su trabajo está en el tercer país más nuevo del mundo - los Estados Unidos de América. Proporcionan servicios a los condados y ciudades remotas alejadas como Los Angeles, California y Knoxville, Tennessee.

En cualquier fin de semana, los voluntarios médicos, dentistas y optometristas servirán unos tres mil estadounidenses. Lamentablemente, al final de su fin de semana, ya que cierran las puertas, cientos más se quedarán en pie, no se ha cumplido.

Imagine un país donde los políticos están tan llenos de sí mismos que no tienen tiempo para el 30% de sus conciudadanos que han caído en tiempos difíciles. Imagínese las personas que ganan millones de su gobierno, pero censuran a sus hermanos y hermanas, mujeres y niños de cuidado de la salud, educaciones trabajo o incluso una comida caliente. Hay algo mal aquí. Visita

www.ramusa.org y ver el video.

¿Líder del Mundo Libre? No lo creo.

Graciás por leer.

Joe Malgeri


At one time, a group of volunteers called Remote Access Medical (RAM) brought medical, dental and vision care to remote areas of third world nations like Guyana and Haiti. Today, sixty percent of their work is in the newest third world country -- the United States of America. They provide services to remote counties and remote cities like Los Angeles, California and Knoxville, Tennessee.

On any given weekend, volunteer doctors, dentists and optometrists will serve some three thousand Americans. Sadly, at the end of their weekend, as they close the doors, hundreds more will be left standing, unserved.

Imagine a country where the politicians are so full of themselves that they have no time for the 30% of their fellow citizens who have fallen on hard times. Imagine people who make millions off their government but decry their brothers and sisters, women and children health care, educations jobs or even a warm meal. There is something wrong here.  Visit www.ramusa.org and watch the video.



Leader of the Free World? I don't think so.


Thanks for reading.  Joe Malgeri

Remembering Hugo Chavez

One of South America's most colorful leaders is gone and some of his nation mourns.

In the United States a similar pattern unfolds. Many, like myself, remember a wild man whose vision was of a sovereign nation committed to improving the lives of all its people while working with other nations in the region to establish national sovereignty for themselves, free from the dominance of foreign influences like the United States.

Others will rejoice at the passing of a quasi dictator who set the nation back decades while padding his own pockets. They will point of the high inflation rates, rampant poverty and horrific living conditions. The truth lies somewhere in between.

Nationalizing industries at the expense of foreign ownership was an offense against the oil companies whose repatriated profits came at the expense of the Venezuelan people. On the other hand, the revenues then flowed into the nation's coffers. paying for improved medical care, new schools and infrastructure for all, especially the poor and disenfranchised.

Chavez's Venezuela was a thorn in the side of US interests. Chavez gifted, or sold at reduced prices, millions of drums of oil to relieve the plight of the people in numerous lesser nations, including the United States, where the company it controls, Citco, provides heating oil to non-profits such as Citizens Energy, run by former U.S. Rep. Joseph Kennedy II.  An article posted at  http://www.foxnews.com/politics/2013/03/06/ex-us-rep-joe-kennedy-mourns-death-chavez/ 
reports, "A spokesman for Kennedy said Chavez and the people of Venezuela have donated about 200 million gallons of heating oil over an eight-year collaboration with Citizens Energy. The charity distributes heating oil to lower income families in 25 states and Washington, D.C., offering 100 gallons per family."

Disturbing to this writer is the way Chavez was depicted in the US media. Was he a friend to the people of the United States? Yes. Was he a friend of our government? Not so much. To be fair, the same holds true for just about every Central and South American nation, most of which have been victims of US foreign policy directed at mining the wealth of those nations at the expense of the people and their rights as sovereigns.

Below is a link to the kind of one-sided reporting done over the years that paints Chavez in a negative light while making it appear that his actions threaten the United States. The truth is that he saw his nation as sovereign, independent and free to choose its own destiny, a view contrary to the interests of key capitalists in the United States.  I have taken the liberty to comment on key elements of the article to point out the ways in which the paper seeks to color the true issues. You can draw your own conclusions.

http://www.washingtontimes.com/news/2007/mar/6/20070306-090345-8553r/

Losing Latin America

By The Washington Times                                                          Tuesday, March 6, 2007

When President Bush leaves tomorrow on a five-nation tour of Latin America, he will be entering a region that has become more important to our national security than at any point since the Cold War.

Not too long ago, Latin America was a vital front in the fight against communism, and if recent events are any guide, it could become equally important in the war on terror. Note that no mention is made of the terrorism perpetrated in various nations of Latin America by the United States over decades. 

A fresh wave of authoritarianism — fueled by petrodollars, populism and anti-Americanism — has cast a dark cloud over the future of freedom in our hemisphere. In order to deal with this emerging threat, we need to dust off the Cold War playbook and become increasingly active in helping our friends to the south.  This allusion to “authoritarianism — fueled by petrodollars, populism and anti-Americanism” can also be taken to mean, Now that they’ve taken charge of their own countries and gotten out from under the thumbs of US interference, these leaders are acting to get fair value for their countries resources and are using those revenues for the benefit of their people. They are establishing schools, providing health care and, by and large, taking care of their own.

The problem starts (but doesn’t end) in Venezuela, a nation that once enjoyed a 50-year democratic tradition, but is now in the early stages of a dictatorship. Venezuela’s messianic president, Hugo Chavez, has basically become a power unto himself. Last month, elected representatives abdicated their responsibility and gave the Venezuelan leader the sweeping power to rule by decree for 18 months so he can impose sweeping economic, social and political change.  Hugo took charge of his nation and he tossed US imperial interests like the oil companies out. He had the nerve to take the monies that were being sent to US companies and using them for the national good. And now there are others -- Ecuador, Bolivia to name just two. Imagine what is written about their leaders in the US press.

These dictatorial powers would be alarming in anyone’s hands, but they’re particularly dangerous in the hands of Mr. Chavez. The strongman rules an oil-rich nation that exports 1.1 million barrels of oil to the United States per day, which amounts to 14 percent of our total oil imports. Mr. Chavez has already colluded with other OPEC nations to raise oil prices, and if he’s successful in nationalizing multibillion-dollar crude projects in the Orinoco Belt, there’s a risk that prices could jump again. Chavez is the worst of the worst, He’s colluding with other world leaders to get the most for their nation’s limited resources instead of letting the US dictate what they want to pay. The bastard!

This could have a severe impact on the pocketbooks of American families and small businesses. According to some economists, every time oil prices rise by 10 percent, on average 150,000 Americans lose their jobs. Mr. Chavez has used his nation’s windfall oil profits to buy political support at home and stir trouble abroad. He has said that Venezuela has a “strong oil card to play on the geopolitical stage” and “it is a card that we are going to play with toughness against the toughest country in the world, the United States.”  Don’t you just love it when a supposedly ‘quality’ news outlet uses phrases like ‘According to some economists,’ to make their points. FOX News does a lot of that.  WHO ARE ‘some economists?

In his struggle against U.S. “imperialism,” Mr. Chavez has found a useful ally in the world’s largest state sponsor of terrorism — the government of Iran. He is one of the few leaders to publicly support Iran’s nuclear weapons program, and the Iranian mullahs have rewarded Mr. Chavez’s friendship with lucrative contracts, including the transfer of Iranian professionals and technologies to Venezuela. Last month, Mr. Chavez and Iranian President Mahmoud Ahmadinejad revealed plans for a $2 billion joint fund, part of which will be used as a “mechanism for liberation” against American allies. This could help achieve Mr. Chavez’s vision, shared in an earlier meeting with Mr. Ahmadinejad, when he said, “Let’s save the human race; let’s finish off the U.S. empire.”

WOW! Some nations got together to collaborate to loose the shackles that US business employs to keep them enslaved and we attack them for working in their (not our) self interests. Note the collaboration of England, France, Germany and other European nations working against the sovereign nations in the middle east. Note that Saddam Hussein was our friend before he became our enemy and in both instances he was a brutal dictator who, as our friend bought all sorts of weapons from us. The Shah of Iran was our friend. After all, we deposed his rightful predecessor*.

Mr. Chavez has grown bolder by interfering in the elections of several Latin American countries, and his brand of revolutionary politics has made gains in some of them. Bolivia’s newly elected president, Evo Morales, has nationalized the energy industry, rewritten the constitution and promised to work with Mr. Chavez and Cuban dictator Fidel Castro to form an “Axis of Good” to oppose the United States. What some call collaboration, others call interfering. When the US sent in the CIA to overthrow the government of Chile, replacing duly elected president Allende with the brutal dictator, Pinochet, most Americans had no idea. Likewise, similar actions in Honduras, Nicaragua and other Central American nations. You really need to pay attention to what the press is saying (and for whom it is saying it) and what it is not telling us. (Read Confessions of an Economic Hit Man by John Perkins, a man who actually did the bidding of his US corporate handlers).

Perhaps most ominously, the former Soviet client Daniel Ortega has returned to the presidency of Nicaragua. During the 1980s, Mr. Ortega ruled his country with an iron fist until U.S.-backed freedom fighters ousted him from power. Nicaragua’s democracy prospered for the next 16 years, but now he is back. In response to the Ortega victory, Mr. Chavez chanted “long live the Sandinista revolution!” Then, in his first week as president, Mr. Ortega met with Iran’s Mr. Ahmadinejad, and told the press that Nicaragua and Iran “share common interests and [have common] enemies.”

Left unchecked, Messrs. Ahmadinejad and Chavez could be the Khrushchev-Castro tandem of the early 21st century, funneling arms, money and propaganda to Latin America, and endangering that region’s fragile democracies and volatile economies. If these two pariahs succeed, the next terrorist training camp could shift from the Middle East to America’s doorstep. 

We need to face reality and confront this threat head-on. At the pinnacle of the Cold War, Ronald Reagan seized the initiative and repulsed Soviet efforts to set up camp in our hemisphere. The Gipper’s leadership should serve as a model in thwarting the advance of tyranny and terrorism in our times. (The kind of tripe in this paragraph is the call to action based on facts not in evidence or skewed information supportive of the interests of a few, not the many honest, sincere and honorable US citizens who believe in fair dealings with others.

We should build new bridges to our friends in the region — pressing forward on free trade, development aid, military cooperation and exchange programs. Let’s take the necessary steps today, so tomorrow we won’t have to ask: “Who lost Latin America?”

Free trade and development are euphemisms for worker and resource exploitation. 

Military cooperation means training other militaries to suppress their own nation’s populations, Be aware that what our government has learned over the decades undermining other nations it can now apply against its own people, with coverage by a dependent press.

Sen. Kay Bailey Hutchison of Texas is chairman of the Senate Republican Policy Committee.

·      During Mohammad Reza's reign, the Iranian oil industry was briefly nationalized under Prime Minister Mohammad Mosaddegh before a US-backed coup d'état overturned the regime and brought back foreign oil firms.  

               Excerpted from: http://en.wikipedia.org/wiki/Mohammad_Reza_Pahlavi

To:Tennessee State Legislators

To: Tennessee State Legislators*                                                                      9/24/12

Subject: One Question: What would your children say?

I awoke this morning after a restless night in which voter suppression played out in conversations in my mind.

For weeks leading up to this morning, I had been involved in this issue as a recorder of activities protesting the voter I.D. law and the actions of the Knoxville Election Commission in closing a voting site of sixty years based on one bogus complaint.

I video-recorded speakers at rallies in Krutch Park and made special trips to register on video the complaints of Knoxville citizens who were victims of this abuse of the legislative process. I recorded

1. Citizen Mark Harmon as he stood on the handicap access ramp of Belle Morris Elementary School to make the point of its existence to challenge the Commission’s contention that they closed it for lack of access. I recorded him at the designated alternative, the Cox Center, with its obvious lack of parking, some twenty spots at a site where almost 1300 voters will attempt to cast ballots. I recorded his observations of Gloria Johnson, local resident and also a Democratic candidate for state office who pointed out that residents had just now received new voter cards with the new polling site on them, many of whom would just put them in their wallets without a thought and show up at Belle Morris School on voting day, only to be redirected, and who then may not vote when they cannot park in the new location.

http://youtu.be/P15ZRqZ9D7k

2. Citizen Brian Stevens, a professor at the University of Tennessee, who held in his hands two photo I.D.s: one, his own faculty I.D. which is accepted as proof for voting, and an almost identical Student I.D. which is not. He made his case that the reason for the difference is to keep a distinct group from voting.

http://www.youtube.com/watch?v=h9OBcc7Sx1k&list=UUajjuX7HzzKObxrTqnZJrdA&index=1&feature=plcp

3. A woman who spent an entire day taking her 90+ year old aunt from place after place to gather up the five pieces of information her poll worker said was needed in order for her to continue to vote, as she had done without incident since 1948.

http://www.youtube.com/watch?v=dAkqyUIp4R8&list=UUajjuX7HzzKObxrTqnZJrdA&index=12&feature=plcp

The recordings are many, and they are posted on various internet social media sites, so you’d think I’d be happy that I did my part. But the voices of the disenfranchised are ringing in my mind still. And, this morning, I awoke thinking, what do legislators tell their children about cheating, about lying and stealing. Because, each one of them, and they together as a group decided to cheat the voting process, to lie about their reasons for doing so and, in the process steal the votes of thousands of individual citizens whom they promised to serve. What will you, State Senator Steve Southerland from Morristown, tell your children about the virtues of honesty, integrity and honor and how they guide your actions as a legislator, now that your vote is recorded? You must be so proud.

*

Representatives voting aye were: Alexander, Brooks H, Brooks K, Butt, Campbell, Carr, Casada, Cobb, Coley, Dean, Dennis, Dunn, Elam, Eldridge, Evans, Floyd, Forgety, Gotto, Halford, Hall, Harrison, Hawk, Haynes, Hensley, Hill, Holt, Hurley, Johnson C, Johnson P, Keisling, Lollar, Lundberg, Maggart, Marsh, Matheny, Matlock, McCormick, Miller D, Montgomery, Niceley, Pody, Powers, Ragan, Ramsey, Rich, Sanderson, Sargent, Sexton, Shipley, Sparks, Swann, Todd, Weaver, White, Williams R, Wirgau, Womick, Madam Speaker Harwell

 Senators voting aye were: Bell, Campfield, Crowe, Faulk, Gresham, Haile, Johnson, Kelsey, Ketron, McNally, Norris, Overbey, Southerland, Tracy, Watson, Woodson, Yager, Mr. Speaker Ramsey

Replying to Dr. Adizes' Question, Is There a Problem with Democracy?'

This post is a reply to Dr. Adizes' recent article, Is There a Problem with Democracy, found at:
http://www.ichakadizes.com/blog/?utm_source=Is+There+a+Problem+with+Democracy%3F&utm_campaign=Ichak+Adizes+Blog+September+2012&utm_medium=email

I encourage you to read his thoughts.

Dear Dr. Adizes,

I have on my book shelf a copy of your book, "Lifecycles", which I bought decades ago and refer to quite often.  I regret not having had the opportunity to study under you. Happily, I find your messages a way to stay linked.

I write in response to your article Is 'There a Problem With Democracy?'

In a democracy, there should be demonstrations, as demonstrations are an expression of one’s demands to redress wrongs or, indeed to demonstrate support for something.

You rightfully point out the major flaws, corruption and lack of trust, but these are not reactions to a highly complex system being hard for people en masse to understand. The reality is that they, indeed, ‘get it’. They see that the system is corrupt, that their elected representatives are bought by corporate interests and no longer represent the interests of their constituents. They understand full well that the opposition is also corrupt, and their intent is to regain power so they can refill their coffers at the public (and private) trough.

One side wants to work for the public interest by imposing their beliefs on others and by raiding the tax system for the benefit of their corporate owners and their rich friends. The people understand that the other side is ‘in theory’ fighting for individual rights and redistribution of income – while writing laws that legalize the arrests of anyone, citizen or not, anywhere I the world, use trade initiatives to further weaken the nation’s competitive position in the world, and move people into poverty. What is there to trust?  It matters not who we elect under such a ‘system’.  

Imagine, professor, a classroom with two rows of tables, with fours students per table, all eager to learn. I announce we are going to ‘hire’ a number of them, but only the best. To determine who is best, I have them remove all the desks from the left side of the room, leaving space for a race.

We pair people up and have them run from the back of the room to the front, with the winner labeled ‘best’. After all the races are complete, we proceed to part two of the selection process. Here we have a second race, in which the ‘winners’ race against the losers. This time the losers must run in the same area as before but the winners must race down the row that still contains the desks.

At first, the people are confused, and say rightfully that there are desks in the way, obstructions. I agree, and maintain that this is part of the phase two test. What am I teaching?  That in a crappy system, it doesn’t matter how good you are, Even the best cannot win against a rigged (corrupt) system,

The complexity you refer to is not that hard to understand. It’s often times transparent. The values you refer to are still at their core good. The system manipulators have broken their implied contract with their constituents, who unfortunately were too busy with their lives to pay attention.

“Entitlements”  are systems in which people paid in their own monies with expectations of deferred rewards. The politicians ‘raided’ the treasury. Financial special interests viewed the size of the pot and lusted after it for the profits denied them, then sought by legislation to avail themselves of them.

Democracy is not the problem, Criminals are the problem. There’s nothing wrong with Christianity – except the Christians (see Jews, see Islam). All have noble precepts. All, over time, are corrupt. I call your attention to your bell curve, and the phases of decline you refer to as Early Aristocracy and beyond.

The phases always occur, as predictable as your life cycles. They occur because, over time, the systems fall victim to neglect. We neglected our people, forgot to teach history, civics. We forgot to retain emphasis on learning, let our standards fall (collapse?). You know all this. The failing occurs when religious leaders yield to, and participate in corruption, when politicians work for themselves, when our military is used to advance our empires at the expense of those upon whose rights we tread,

Democracy is not the problem. That we no longer have one is.

The Jobs that Aren’t  --  And Won’t Be

All major activities that serve mankind follow a pattern. First, large numbers of people are mobilized to provide an in-demand product or service. Local farmers fed their communities, The general store owner served the needs the surrounding area.  Over time, advances in technology make it possible to automate the process but not everyone wanted to automate or could afford to buy it. Those that wanted to, did, and they become more profitable. They then bought out their competitors who could no longer  keep up.  This held true with agriculture, retailing, manufacturing, now financial services, the list goes on.

Historically, technology replaces masses of people needed under the old system, leaving them behind with only the skills of the past. What jobs are there for them, individually or en masse, after the transition? In my first book (Imagine the Future  -- A Teenager's Guide.....),  I wrote that behind every ATM were six new aerobic instructors, You understand.

High volume production jobs were lost to outsourcing or to technology throughout the land. In manufacturing, when we say high volume production jobs, most people imagine assembly lines for cars and appliances. But numerous other industries have also felt the sting of alternative technologies. The lines at banks that once processed millions of transactions every day, one client at a time, had a similar effect.  Bank branches were everywhere and each had a small complement of happy, helpful tellers. That they were replaced by ATMs is no less painful than displaced assembly line workers. (One huge difference was that the tellers usually had better skills than the displaced auto workers who, while working at union scale, brought home an excellent wage. The useful, marketable skills on their résumés qualified many, at best, for work at the local burger joint.

In the 2000s, automation is eliminating tens of thousands of jobs in areas that historically were high income with positive long-term outlooks, like the financial services industry. Today, sophisticated algorithms created by software designers make it possible for computers to make buy/sell decisions in nanoseconds with less risk to the investment company. When the financial markets collapsed in '08, thousands of people were made redundant (laid off, fired) but they expected that they'd be called back as the market rebounded. Not so. In the interim, companies installed the newer decision making software and found that it outperformed its human assets. So, when the market rebounded, 40% fewer people were needed. Companies that were already making bucket loads of profit were now making even more, with lower trading risks to boot.

What is missing in this story is people’s realization that more and more work at almost any level can be reassigned in one of four ways: to technology, which replaces human effort; to intellectual insights, which can replace the need for the product or service to begin with; to low cost labor, where the first two choices don’t yet apply, or, to a combination of one and three, where automated technology is operated by low-price labor.

As humanity moves ahead (that’s all of us), our usefulness as purveyors diminishes. Increasingly, the things we do and the material things we want are being inexorably replaced, leaving us with a myriad of problems, social, economic, philosophical and moral, to list a few.

Should we invest in our educations as we currently do, taking on massive debt in the process, only to accept positions at the local Apple Store? Should we earn the degrees in the hope that what we learn will give us the “AHA!” moment in which we create the next big thing and thereby insure our financial success?

Ask yourself (and your friends) "If the jobs of the future can by and large be designed for automatons, what use are we?" 

There are many good answers to that question. I have some of them but I elect not to share them at this time.  I want you to think about your own answers. That’s no simple assignment but it is worth the effort. My giving you some answers would be a disservice.

First, you really do need to give this some serious thought. If I share my thoughts, you might take it as a signal that you don't have to.

Second, you should pass this along and start a dialogue about it. it matters less at my age than yours, and if you're married (divorced) with children, this question is critical, both from in economic sense and in a social sense.

Finally, consider this. Within a decade (you do the math), there will be some 3.4 BILLION people vying for some 2.4 BILLION jobs. You will be one of them. Your spouse (Ex) is another. How about your kids?  Get the picture?

Feel free to share them in the comment section.  

In my next blog, I’ll discuss distribution.

What Can Our Children Learn -- And When? Advancing the Cause of Human Relationships

Aaron, four, sat on the carpet under the arch between the dining and living rooms scribbling in a pad while his brother, Chris, seven, sat by the coffee table learning his multiplication tables. Their mother, Lynn, sat on the sofa turning flash cards toward him.

“Nine times three.”, she would say.   “Twenty seven.,” he would reply and await the next challenge. At some points, he’d hit a snag and have to pause a few seconds. “Twelve times 9.” (Pause)

It was then that Aaron would chime in with the answer, “One Oh Eight.” he would say without lifting his head from drawing figures. He did not try to answer each question, but he often jumped in when there was a pause.

Chris would bite his tongue until he couldn’t take it any longer. Then he would say, “Look, I’m the one who’s learning this. You’re only four. I’m seven. You’re not even supposed to know this yet.”

What this tells us is that children, like adults, learn when they learn. They learn when they are exposed to things, from math to hunger. And learning opens the door to more learning and more growth. The real question is, “What can we expose our kids to that will help them grow and develop into the people they can become.?”

Fast forward to 2011. Educator John Hunter is presenting to an audience at a TED conference recounting his journey as a teacher and as the designer of the World Peace Game (http://www.ted.com/talks/lang/en/john_hunter_on_the_world_peace_game.html)

In his game, now some thirty years old and current with the times, Hunter brings challenges to nine year olds that far and away transcend multiplication tables, and it is clear that his students are up to the challenge. No one says. “You’re not supposed to know this yet.” Which brings me posit this question: Have we limited our children’s personal growth and development by setting artificial barriers to what they should know and by when?

Some might reply that these are ‘gifted’ children, above the norm. I concede they are. But I also believe that there are many others just like them who have the same abilities but who were not blessed with a nurturing home environment where they could flourish. For them, such challenging classes can elevate their performance and increase their desire to participate in school for just those reasons. They can be exposed to serious issues and not lose who they are. They can, instead, become more than they might have had they not learned.

One boy in the video particularly stood out when he reflected on what he learned. He said, “One of the things I learned was that other people matter. In this game, one person can’t win, everyone has to win. And I think that taught me a lot about cooperating with other people, being generous, and having an attitude that, if you work together, you can achieve anything.”

Before adding your comments, please look at the clip from the video,  a documentary about this special program. http://www.youtube.com/watch?v=lCq8V2EhYs0 . Ask yourself, “Can I as a parent learn from this and start different dialogues with my own children?”

As a grandparent of a 2 year old boy and 2 month old girl, I have to consider what I can do to elevate our dialogue together. After all that I have done, or not done, to this planet. I owe them that.