Last week, I appeared at the National Press Club an event sponsored by the Century Foundation, the AARP, and the Commonwealth Fund to discuss health care reform.

In preparing for that event, I came to realize that my vision of a national health policy has undergone refinement since I started my blog a few months ago. So here it is, although in abbreviated form:

• Any national health policy has to be based on the goal of maximizing health, safety, well-being, and productive capacity of all Americans.

• These goals, if achieved properly, will improve economic growth and competitiveness. They will not drain our economy, and we will not need to ration care to achieve them.

To achieve these goals, our health system will have to be based on six principles, all of which need to be followed:

• Americans need to know how to engage in healthy behaviors, and to be in an environment which encourages healthy behaviors in a healthy environment.

• We need universal, affordable, comprehensive health care coverage, and everyone needs to have that coverage. (more…)

In the past week, I read a New York Times article which favorably reported on the initiative of a for-profit company, which has a business based on getting people to pay for being taken off mailing lists and for having a tree planted on their behalf. I also attended the premier trade show for the production print and mail industry, Graph Expo, which showcased the best-in-class solutions for direct mailers and chaired a meeting of our Mailing Industry CEO Council to discuss strategies for improving the value of the mailstream.

I was struck by the contrast between the absolutely arrogant and uninformed view of direct marketing mail reflected in the article and the sophistication and thoughtfulness of the people who provide the print and mail services to direct mail marketers. I was also struck by the fact that, as I have learned more about the many for-profit organizations that are peddling services to get people off mailing lists, their motivation is to make money by playing upon the fears of identity theft or the apparent environmental benefit of reducing mail-related waste to make money. The most startling learning is that they have essentially rejected the fundamental principle of the Direct Marketing Association’s Mail Preference Service, informed consumer choice, to get people to do something detrimental to them if it costs them as little money as possible and if they can increase their profit margins.

Most of us receive unsolicited and unwanted marketing mail in annoying quantities every year, and the direct mailing industry can do a great deal more to reduce the volume and annoyance factor of that mail. But banning 80-90% of all unsolicited marketing mail, as the company referred to in the New York Times article wants to do, is wildly off the mark and would be horrible for the American economy and the environment. Most Americans don’t realize the mail supports $900 billion in economic activity and nine million jobs. (more…)

I continue to be disappointed by the incompleteness of the discussion of issues in the national health care debate. There is abundant discussion of coverage and affordability, considerably less coverage of preventive and wellness, almost no discussion of what is needed to assure adherence to required treatment programs for chronic diseases, and little discussion of the issue of access gaps.

Everyone associates unnecessary emergency room visits with lack of insurance coverage. Certainly, many people in emergency rooms are individuals lacking insurance coverage. However, there are many people who have relatively minor illnesses or injuries, but who go to emergency rooms because they incur their medical condition after their primary physician’s office closes for the day or on a Sunday, when their physician’s office is most likely closed.

The first question we need to ask is why physicians have office hours comparable to the hours of business for American retailers over 40 years ago. The main reason is that the majority of medical practices are either sole practitioner or small groups, with little ability to provide Sunday or late evening coverage.

Beyond that, there simply are many areas that do not have what we have in Stamford, Connecticut, an urgent care center that is open seven days a week, the Tully Center, which is part of the Stamford Health System. I have been in communities as diverse as downtown Chicago, downtown Los Angeles, and King of Prussia, Pennsylvania, that have had no non-hospital-based urgent care facilities for minor illnesses and injuries. (more…)

In the last few weeks I have found myself on the campuses of many colleges and universities. Some are Pitney Bowes customers, some have been venues for meetings I have attended, some are campuses I have shown my 16-year-old son, who is starting to look at colleges, and I have visited my 21-year-old son, who is a student at the University of Southern California, and my 14-year-old daughter, who took a summer class at Princeton University. I also had occasion to visit the University of Wisconsin and Harvard Law School, the schools from which I received my degrees.

I have several observations:

• All of these schools have more global reach than ever. Our primary and secondary education systems are inferior to many other countries, but we still are a magnet for undergraduate and graduate college students from around the world, especially from the Asia-Pacific area. I also am seeing an increasing number of students from Eastern European countries - who not only come to school here, but are most likely to be filling the summer jobs at resort areas and in big cities that used to be filled by American students.

• There is an incredible amount of construction going on everywhere on every campus I visit. Interestingly enough, some of the buildings being replaced are newer than some of the buildings being renovated. At the University of Wisconsin, some of the buildings built in the 1950’s and 1960’s are being demolished, whereas older buildings are being renovated. I was also surprised to learn that much of the Harvard Law School is under reconstruction and renovation and will be resituated within Cambridge over the next few years. I get piecemeal announcements informing me of these events, but its impact is much more dramatic when you actually see it happening. (more…)

This past week, I spent a lot of time driving in various parts of the Northeast and Mid-Atlantic states. I hit horrific traffic problems, which is not surprising to anyone who has spent time in areas like Boston, New York, or Philadelphia.

Two things are worth noting, one of which is a broader point about our society today:

• Traffic congestion is popping up in areas in which we have never experienced it before. For the past 15 years, my family and I have been going down to South Bethany Beach, Delaware for a week’s vacation. This year, for the first time, we experienced horrific traffic delays at odd times at places like the Delaware Memorial Bridge going into Delaware, State Route 113 south of Dover, and even some of the county roads between Route 113 and Bethany Beach. Much of this is a result of continuous over-building of new housing in areas in which the infrastructure is not there to support traffic.
• The bigger issue is that our infrastructure in many places has no flexible capacity. Driving from Peabody, Massachusetts, into Cambridge, Mass. last week, we experienced a horrific delay getting across the Tobin Bridge because of a problem on Storrow Drive that had an effect that radiated across a good part of Boston. (more…)