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Some 22 years ago, a routine women's OBGYN screening revealed the presence of pre-cancerous cervical cells -- terrifying news to me at the time, as I had a one-year-old baby, not much money, and yet enough insurance to pursue it, to have my doctor excise the cells and to allow me to continue with routine screenings. I'm now 51. I would not have lived to be 51 if I had been unable to afford not only the initial screenings, but the treatment required to remove the tissues that were determinedly marching toward full-fledged cancer. The cost, both to my insurer and to my husband and me, was not inconsequential; the cost of addressing the situation months or years after the tissues were first analyzed, when those renegade cells would have become cancerous and would've metastasized, would've been tremendous. That is, if I'd survived. Without the screenings, I wouldn't have known anything was wrong, and years or months later, I would've become very, very sick and would've shown up at the emergency room -- too far gone to save, despite the valiant and expensive efforts of the ER doctors mandated to pull out all the stops in trying to do so.<br><br>My story is multiplied literally millions of times a day. Even if cost is all that matters, it's too expensive to manage a healthcare economy that way. At some point, though, we just might begin to consider the human cost, something that market with its invisible hand doesn't give a rat's ass about -- and can't.<br><br><font style="" color="#8064a2"><font style="font-size:12pt" size="3"><font style="" face="Verdana">Keely<br>www.keely-prevailingwinds.com<br></font></font></font><br><br><div><div id="SkyDrivePlaceholder"></div><hr id="stopSpelling">Date: Wed, 18 Jan 2012 12:51:32 -0800<br>From: jborden@datawedge.com<br>To: thansen@moscow.com<br>CC: vision2020@moscow.com<br>Subject: Re: [Vision2020] More Proof Preventative Health Care Saves<br><br>
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</style><div class="ecxWordSection1"><p class="ecxMsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">My heart goes out to the folks behind the examples you cite during your (hopefully brief) stay in the ICU… but they have nothing to do with human nature and prevention. Your examples strike towards insurance and coverage… not preventative medicine.</span></p><p class="ecxMsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"> </span></p><p class="ecxMsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">The most recent personal example I have doesn’t deal with health care, so I’m sure it will be attacked as irrelevant… but it certainly strikes at human behavior. (If you consider it too irrelevant, then chalk it up to ‘personal analogy’).</span></p><p class="ecxMsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"> </span></p><p class="ecxMsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">My second company (a widget producer) is the result of my taking over a bankrupt enterprise nearly two years ago. The previous owner was severally in debt, was in the process of declaring personal bankruptcy, and was in the process of just walking away from the entire business.</span></p><p class="ecxMsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"> </span></p><p class="ecxMsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">Without diving too far into detail about the business, I found that the company was in financial ruin because of the sheer number of returns of widget sub-components. An excel spreadsheet told me that there was over a 200% return rate for the widgets… (for every widget sold, a customer (on average) would return it for an exchange/replacement at least twice). </span></p><p class="ecxMsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"> </span></p><p class="ecxMsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">As the number of exchanges grew, the previous owner (fearing customer backlash at product quality) would increase the length of the warranty, and try to off-set the replacement cost by raising the price of the widget.</span></p><p class="ecxMsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"> </span></p><p class="ecxMsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">Lengthening the warranty period only made the problem worse… customers had a larger window to return the widgets for replacement.</span></p><p class="ecxMsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"> </span></p><p class="ecxMsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">Turns out the problem had nothing to do with design… it was customers not bothering to read or learn anything about proper use of the widgets, or trying to use the widgets for a completely different purpose altogether. </span></p><p class="ecxMsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"> </span></p><p class="ecxMsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">Tack on a free replacement guarantee, and customers didn’t bother to self-educate… they just let the company “fix the problem” with the warranty.</span></p><p class="ecxMsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"> </span></p><p class="ecxMsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">The first thing I did was change the warranty policy… and I shortened to a VERY SHORT length of time (to allow for ‘out of the box’ failures). I followed this up with a dramatic reduction in price, making “true” failures after a length of time affordable to replace. </span></p><p class="ecxMsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"> </span></p><p class="ecxMsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">The problem went away overnight. Immediately customers started calling/emailing… wanting to know more about proper installation procedures, proper use of their product, and “whether it would work in misc. environment X”.</span></p><p class="ecxMsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"> </span></p><p class="ecxMsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">As soon as it became the customer’s responsibility to take care of the widget, it suddenly had increased value to them, and they were more careful with it and made sure they used the widget properly.</span></p><p class="ecxMsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"> </span></p><p class="ecxMsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">The difference between the has been one of business SUCCESS vs. business FAILURE.</span></p><p class="ecxMsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"> </span></p><p class="ecxMsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">The (new) company has survived… customers have a parts solution… and life has continued.</span></p><p class="ecxMsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"> </span></p><p class="ecxMsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">Yes, I realize that many of you will probably dismiss this as irrelevant, since it doesn’t contain “health care”… but it’s human nature. People tend not to care about something when someone else foots the bill. </span></p><p class="ecxMsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"> </span></p><p class="ecxMsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">Whether you’re talking about widgets or high-blood pressure… if someone else is footing the bill and responsibility, people will generally tend to not think about the consequences or the price tag, and just go with whatever is easy.</span></p><p class="ecxMsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"> </span></p><p class="ecxMsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"> </span></p><p class="ecxMsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">Jay</span></p><p class="ecxMsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"> </span></p><p class="ecxMsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"> </span></p><p class="ecxMsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"> </span></p><p class="ecxMsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"> </span></p><div><div style="border:none;border-top:solid #B5C4DF 1.0pt;padding:3.0pt 0in 0in 0in"><p class="ecxMsoNormal"><b><span style="font-size:10.0pt;font-family:"Tahoma","sans-serif"">From:</span></b><span style="font-size:10.0pt;font-family:"Tahoma","sans-serif""> Tom Hansen [mailto:thansen@moscow.com] <br><b>Sent:</b> Wednesday, January 18, 2012 11:56 AM<br><b>To:</b> Jay Borden<br><b>Cc:</b> Donovan Arnold; <vision2020@moscow.com><br><b>Subject:</b> Re: [Vision2020] More Proof Preventative Health Care Saves</span></p></div></div><p class="ecxMsoNormal"> </p><div><p class="ecxMsoNormal">Jay Borden stated:</p></div><div><p class="ecxMsoNormal"> </p></div><div><p class="ecxMsoNormal"><span class="ecxapple-style-span"><span style="font-size:11.5pt;font-family:"Calibri","sans-serif";color:#1F497D">"I can tell you first-hand my experiences on how human behavior changes as soon as fiscal responsibility to pay is shifted to the individual as opposed to a faceless 3<sup>rd</sup> party."</span></span></p></div><div><p class="ecxMsoNormal"><span style="font-size:11.5pt;font-family:"Calibri","sans-serif";color:#1F497D"><br><br></span></p></div><div><p class="ecxMsoNormal"><span class="ecxapple-style-span"><span style="font-size:11.5pt;font-family:"Calibri","sans-serif";color:#1F497D">Care to share some of your "first-hand experiences", Mr. Borden?</span></span></p></div><div><p class="ecxMsoNormal"><span style="font-size:11.5pt;font-family:"Calibri","sans-serif";color:#1F497D"><br><br></span></p></div><div><p class="ecxMsoNormal"><span class="ecxapple-style-span"><span style="font-size:11.5pt;font-family:"Calibri","sans-serif";color:#1F497D">Or perhaps I should share some of mine . . . after spending 30+ days in the waiting room of Sacred Heart Medical Center's ICU (12/15/2011 - 1/17/2012), like . . .</span></span></p></div><div><p class="ecxMsoNormal"><span style="font-size:11.5pt;font-family:"Calibri","sans-serif";color:#1F497D"><br><br></span></p></div><div><p class="ecxMsoNormal"><span class="ecxapple-style-span"><span style="font-size:11.5pt;font-family:"Calibri","sans-serif";color:#1F497D">. . . the one I mentioned earlier concerning the patient, whose activity on the left side of his brain was ever so slowly recovering, and his mother who was extremely concerned about how her son's medical care was going to be financed . . . two months after he was laid off, and</span></span></p></div><div><p class="ecxMsoNormal"><span style="font-size:11.5pt;font-family:"Calibri","sans-serif";color:#1F497D"><br><br></span></p></div><div><p class="ecxMsoNormal"><span class="ecxapple-style-span"><span style="font-size:11.5pt;font-family:"Calibri","sans-serif";color:#1F497D">. . . the family who, while their father lay terminally ill not fifty feet down the ICU hallway, were openly discussing who was going to contribute how much to pay their father's medical bills, after having already cashed in his life insurance, and . . .</span></span></p></div><div><p class="ecxMsoNormal"><span style="font-size:11.5pt;font-family:"Calibri","sans-serif";color:#1F497D"><br><br></span></p></div><div><p class="ecxMsoNormal"><span class="ecxapple-style-span"><span style="font-size:11.5pt;font-family:"Calibri","sans-serif";color:#1F497D">. . . remember that fatal accident that happened about two miles outside of Reardan, Washington (reported in the Spokesman-Review) on New Year's Eve. The critically injured were transported to SHMC ER and in to ICU. Talk about a reality wake-up call . . .</span></span></p></div><div><p class="ecxMsoNormal"><span style="font-size:11.5pt;font-family:"Calibri","sans-serif";color:#1F497D"><br><br></span></p></div><div><p class="ecxMsoNormal"><span class="ecxapple-style-span"><span style="font-size:11.5pt;font-family:"Calibri","sans-serif";color:#1F497D">Care to share yours with us, Mr. Borden?</span></span></p></div><div><p class="ecxMsoNormal"><span style="font-size:11.5pt;font-family:"Calibri","sans-serif";color:#1F497D"><br><br></span></p></div><div><div><p class="ecxMsoNormal">Seeya later, Moscow.</p></div><div><p class="ecxMsoNormal"> </p></div><div><p class="ecxMsoNormal">Tom Hansen</p></div><div><p class="ecxMsoNormal">Post Falls, Idaho</p></div><div><p class="ecxMsoNormal"> </p></div><div><p class="ecxMsoNormal">"If not us, who?</p></div><div><p class="ecxMsoNormal">If not now, when?"</p></div><div><p class="ecxMsoNormal"> </p></div><div><p class="ecxMsoNormal">- Unknown</p></div></div><div><p class="ecxMsoNormal" style="margin-bottom:12.0pt"><br>On Jan 18, 2012, at 11:35 AM, "Jay Borden" <<a href="mailto:jborden@datawedge.com">jborden@datawedge.com</a>> wrote:</p></div><blockquote style="margin-bottom:5.0pt"><p class="ecxMsoNormal">I can tell you first-hand my experiences on how human behavior changes as soon as fiscal responsibility to pay is shifted to the individual as opposed to a faceless 3<sup>rd</sup> party.</p></blockquote></div><br>=======================================================
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