Saturday, January 23, 2010

Work Hard Play Hard

Well, thanks to the TSA I made it safely to Miami and I have come to a critical realization. My epiphany is that vacation is so much better than working. I don't mean a little bit, but immeasurably so. As the years have transpired my need and desire for more vacation time has increased. At first I took a couple of vacations a year for several days each. Now I need to have a vacation planned every 3 months and not just for a few days but it seems to have stretched into 7-10 days per vacation. I used to feel guilty when I took time off but now I have the need to have planned or to be planning at least two vacations into the future.

The paradox is that I suspect I enjoy vacation so much only because of how difficult and stressful work is. I think one's enjoyment of vacation is directly proportionate to the difficulty, the work hours and the stress of one's occupation. It seems that I cannot tire of vacation time but I suspect if I take too much vacation at some point I will not enjoy it as much as it will become routine. I am still trying to find the right balance but for sure I am still vacation deficient and overworked.

At one extreme all work and no vacation leads to burn out on the job and ultimately poor job performance. The opposite case of all vacation and no work is termed retirement. I see many retired people in the office and I really don't think they can appreciate retirement. The reason is that they lack a balance between work time and leisure time. I do not have scientific data to support this observation but my anecdotal opinion is that older people that continue to work are healthier overall than their nonworking counterparts. So not only does work enable one to appreciate leisure time but it also leads to a healthier longer life (my opinion).

One of the best pieces of advise I have received and I try to pass along to my children is to work hard and play hard. It is about striking the right balance between work and play but additionally to put maximal effort into both. Leisure time is not just the absence of work but requires effort to achieve its potential. Playing hard enables one to be more refreshed and productive at work while working hard enables one to afford and appreciate his/her leisure time. This week I will try to play hard as I board a cruise later on today. As soon as I return though, I will be on my computer planning my spring and summer vacations.

Monday, January 18, 2010

New Jersey to Miami via Ben Gurion

At the end of this week I am heading to Miami with my family and I was thinking about the safety issues regarding the flight. It is clear that the security that is in place to give us the impression that we are safe is completely ineffective and purely theatrical. The TSA officers are busy worrying about a little old lady with an oversized tube of toothpaste rather than a single guy named Ahmed traveling alone with his prayer rug. The only effective security deserving of the word is El Al’s.

At first I thought the only secure way to get to Miami from New Jersey by air is to fly from New York to Miami with a stopover in Tel Aviv. This way I could get El Al security for my trip to Miami. El Al does fly roundtrip from Miami to Israel and although this is the safest itinerary I would spend my entire vacation in the air. Obviously, I would also have to fly back from Miami to Israel then to New Jersey. It would also be a rather expensive nonvacation for me and my family. I figure at least 20k just for the flights as opposed to about 2k if I fly directly. There must be a better way.

On a more serious note, I started asking some people if they would pay an extra fee if everyone on their flight was subjected to real El Al security. Everyone I spoke to was willing to pay some sum of money from 20 to 100 dollars for the added benefit. Perhaps there should be certain flights which include this heightened level of security for all the passengers. It would clearly cost more per ticket but I think there is a market for such a designated flight. A person can choose to pay extra or he could choose to go on a flight with standard TSA security. It would be interesting to see whether there is a market for such a product.

So at the end of this week I am placing my security in the hands of the TSA as I travel direct from New Jersey to Miami. I figure the odds are pretty good that nobody will opt to blow themselves up and I don’t want to spend the extra time and money stopping over in Ben Gurion (although I could go for decent shwarma). But given the option of added El Al security on my direct flight, I would certainly pay an additional fee for the piece of mind, knowing I am flying under the protection of Israeli security.

Monday, January 11, 2010

Terrorism Risk Assessment Profile (TRAP)

A suggestion to identify who is likely to be a terrorists and more importantly who is unlikely. Terrorism Risk Assessment Profile (TRAP). Similar to a credit score a person would have a TRAP score based on multiple criteria.

Country of Origin/ Home address
Middle East Country +20, Europe +10, USA +0
Religion
Christian/Jewish +0, Other +40
Name
Middle Eastern +25, non-Middle Eastern +0
Age
Less than 13 -20, 14-35 +30, greater than 36 +0
Travel Companions
For each child travelling with you -10, travelling alone +25
Method of Payment for Flight
Cash +40, Credit Card -10
Type of Ticket
One way +40, Roundtrip +0
Luggage
None +20
Marrital Status
Single +20, Married (Crapshoot. May make one more or less apt to blow up oneself)
Education Level
High school or less +20, College or greater -20
Criminal History
Yes +30, No +0
Travel History
Previous travel to Middle East +50, No travel to Middle East +0
Credit Score
Greater than 600 -20, Less than 600 +10
Net Worth
Less than 50K +10, Greater than 250K -30
Occupation/employment
Unemployed +20, Employed (depends on occupation ?postal worker)
House of Worship
Synagogue, Church, etc.
Psychiatric history/meds
Yes +40, No -10
Other/tips
Father calls CIA that you are radicalized- Don't bother

The best thing about this system is that it is completely voluntary. If you voluntarily participate and your TRAP score is less than 100 you can show up at the airport two hours in advance and go through routine identification and screening.If your TRAP score is greater than 100, or you do not volunteer to participate you must show up at the airport 6 hours early and be subjected to an interview, and a full body search at your expense. Lets inconvenience the potential terrorist NOT the general public. Seems harsh? Too bad.

Lets face it. There is no way we can have an Israeli type security system. We are not good at identifying a terrorist amongst thousands of travellers by interviewing them and noticing nuances in their behavior. However, we are good at collecting data on people and we should use this to PROFILE. We can use this objective data to determine a TRAP score and then finding a terrorist amongst a smaller number becomes a lot more realistic.

The travelling public should demand that profiling should start immediately as we know this is our only chance at identifying a potential terrorist. Until this is implemented we should boycott any nonessential air travel. Our most powerful weapon is the use of our dollars.

Monday, January 4, 2010

Enough With the Twinkies

This past week I saw a patient weighing 700 pounds who needed his tracheostomy tube changed. It got me thinking about how much is being spent on this person’s care who has a chronic disease that is mostly or predominantly self-inflicted. The real change that is required in today’s health system is to affect people’s health and lifestyle choices and incentivize people to live a healthy existence. A significant portion of health care dollars are spent on people with largely preventable chronic disease. By changing people’s behavior to live a healthier lifestyle we will be a more productive society, spend much less on health care, and empower the individual to control his own health status.

Where in this bill is the incentive to get people to get off their couches and go for a walk? Where is the incentive to stop eating twinkies and devil dogs and instead get a fruit or some nuts? Where is it in this bill that encourages people to stop lighting up those tobacco cancer sticks? Where is the incentive to empower the individual to take control of his/her decisions to pursue a healthy lifestyle? The answer is it is not there because the designers of the bill do not want to put any responsibility on the individual. They do not care to empower the individual, only to create more reliance on government.

The true method to control run-away health care costs is to create a system where good health is paramount and incentivized. This will lead to a dramatic decrease in the use of services. Continuous cutting of payments to providers is not productive. It leads to rationing, poor quality health care, and eventually a lower quality of providers. Remember, you get what you pay for. If you pay providers less you will get less, guaranteed.

The question remains how one creates incentives that will coerce the individual to put down the twinkie or get off the couch and go for a walk. One would think that just the fact that a healthier life leads to a longer and more enjoyable life would be incentive enough. For some this is the case but obviously not for many. Financial incentives would probably be an incentive for some and should be used. Encouragement by a role model such as a parent or doctor or athletic star may work. This is where I think BO could have a dramatic and long lasting impact.

BO should explain to his constituents that they should not rely on government but they need to assume personal responsibility to make the right health choices. He should actively encourage all people to throw down the yodels, turn off the TV and go for a walk with their child, spouse or parent. He has a powerful ability to influence the lifestyle of many people, especially young people, and should focus on empowering people to live healthier lifestyles. This is the most important step he can take as president to improve the lives of people and will also lead to a dramatic decrease in health care spending.

Monday, December 21, 2009

Market Psychology Under BO

One of the benefits of working as a doctor is coming across a wide selection of the workforce. This allows me to me to get a decent read of the economic activity of the local and national economy. I see realtors, factory workers, small business owners, Wall Street bankers, UPS workers, local bankers, day workers etc. I often ask them how business is going to get a feel of the general business climate.

This past week I saw a man who works for a fund that invests in real estate. He told me that they are not buying anything now and not expecting to in the foreseeable future. When I asked him why, he explained to me that his investors have been turned off by the current administration’s attitude towards the financial industry. I am sure if there was money to be made these people would find a way to invest but it is interesting how these psychological factors have affected their investment decisions and thus the economy.

The most critical group of people responsible for economic expansion are the entrepreneurs, the risk takers. They are the ones who establish new businesses and create jobs. For multiple reasons they are inactive including fear of federal regulations and taxes, fear of continued economic malaise, and fear of inflation due to overprinting of money by the fed. But most importantly they feel vilified by the current administration. They have been portrayed by the left as the source of all that is wrong and this had led them to respond by inactivity. This is their weapon by which they can respond to such attacks. The irony is that the administration needs these entrepreneurs to become active, to grow the economy, to produce jobs and generate tax revenues to support government expansion.

Market psychology is perhaps the most important factor when it comes to economic trends. As long as the sentiment remains that government is anti-business, the economy will continue to stagnate. The entrepreneurs must feel that the potential reward gained is worth the risk taken. BO thinks the government can replace the private market in expanding the economy. He also believes he can continue to drain private business to support his government expansion while vilifying the golden goose at the same time. Sadly this is only a recipe for further deterioration of the economy which then leads to more safety net expansion of the government. And the cycle continues downward.

Monday, December 14, 2009

BO Surfing TV

I was wondering when BO was at the end of his day, sitting on the couch in some room of the white house with a remote control flipping through the channels what he watches. I have a strange suspicion he lands on Fox news and watches Beck, O’Reilly and Hannity. One might think he would select NBC, CBS or MSNBC, which are outright supporters of his, but I do not think he goes there and I will explain why.

BO is a narcissist. He truly believes he has the answer to all of our problems and given time he can solve them all. This is why government will expand dramatically under his watch as he views it as the solution to our woes not the problem itself. He also believes he is smarter than all the presidents before him which is why he travels around the world apologizing for previous administration’s actions and decisions. Of course, he has the benefit of hindsight. By apologizing for previous policies he elevates himself personally at the expense of the previous decision makers and the historical record of the country. The apology confers the idea that if only he had been the president at that time, a better decision would have been made. It’s all about him.

As a narcissist BO cannot understand how people exist that do not agree with his policies. This probably eats him up inside and is eager to understand why there are dissenting opinions if he already has all the answers. This is why I think he is obsessed with Fox news, the main TV outlet for opposing opinions. He doesn’t care about MSNBC where they are all Kool Aid drinkers and cheerlead for him regardless. He dwells on those “crazies” who can actually disagree with him and he tries to comprehend why.

Fox news can thank BO for his loyal viewership. But he should not feel alone because as the ratings would indicate millions are tuning in to Fox over NBC, CBS, and MSNBC. He wishes it were for the same reasons.

Monday, December 7, 2009

Timing is Everything

It is now clear why it took so long for BO to come forward with his Afghan plan. Call me conspiratorial but I think he was waiting to use the issue as a way to deflect attention away from the health care argument. This administration is extremely calculating and as Rahm says never let a major issue go to waste, but use it to advance your agenda even if it involves a failing economy or sending kids to war.

The popularity of the health care plan was dropping on a weekly basis. The more people knew about it, the more they disliked it. They had to get this issue off the front pages and talk shows. They successfully deflected the attention of the media and the American public away from health care and onto the Afghan war.

The GOP has to be just as calculating and prepare for the Dems maneuvering. For example, the Dems are waiting to bring up the immigration issue to coincide with the next election cycle. They are well aware of the polarizing nature of this matter and the power of this issue to bring out the all important Hispanic vote. They are using immigration reform as a tool to manipulate the electorate and extend their power. The GOP must prepare the counter argument that will not alienate the Hispanic vote but attract the vote to the Republican side. They have plenty of time to come up with a platform that would appeal to the Hispanic voter.

They have to send a positive message to the Hispanics that they add a great deal to our nation and are critical to our future. Stay away from the often negative statements of illegality, deportations, and draining society’s resources. The vast majority of the Hispanics want their chance at the American dream not a replay of the socialist state that they escaped from and which the Dems are creating. This along with their high percentage of religious devotion should make them natural allies of the GOP.

The Republicans need to be just as cunning and manipulative as the Dems. They have to predict the timing of issues and plan their counterarguments. Most importantly they need to keep their messages positive. Negativity is not a recipe for success.