Tips for Beating Automation: Organizing is the Future!

Puerto Aventuras   I have trouble getting my closest living relatives to take the issue of resolutions seriously as we enter a new year. My son tried to stump me by arguing that, “resolutions are reminders of how many things you fail to do repeatedly.” Well of course there’s that, so I had to concede the point even as I rejoined that, “resolutions are a small attempt at organizing the future within the structure of your life.” At best it was a draw, so I found myself reading The New Yorker at dawn on New Years’ Day on the small balcony hanging over the suddenly quiet street in this small Mexican town.

Elizabeth Kolbert of course rehashes the Oxford research piece that within ten to twenty years half of the jobs in the United States might be automated, which is pretty mind boggling. She notes other work by MIT scientists that sort all work into “four boxes: manual routine, manual nonroutine, cognitive routine, and cognitive nonroutine.” The lowest pay will be found in the manual routine jobs, particularly on assembly lines, while the highest paid will be cognitive nonrouotine, she argues with examples being “managing a hedge fund, litigating a bankruptcy, and producing a TV show….” Taken to the farthest extreme we have a dystopian society of the super-rich who own the technology and the robots, some folks scratching a living in the middle, and a vast army of the unemployed.

So, where is the middle ground where we can create work that is meaningful, compensated, and long lasting? It must be found in skills and occupations that are people-facing. Even Kolbert’s example of managing a hedge fund is questionable. A recent article in the Times had one hedger trying to duplicate all of his decision making into a computer list of requirements for his employees to mimic. On the other hand, the more that is run by machines, the more we are going to need people to be the bridge between the machines and other people. I’m not just talking about people to fix the machines, though there will hundreds of thousands of jobs created to do just that, but I’m talking about people who can work with people. There’s still no “app for that” or machine that can substitute adequately for person-to-person contact. The trick will be finding the seams where tens of thousands of jobs can be created to provide that service, and to successfully compete with corporations that automate without understanding service as something more than a sunk cost that they can avoid.

Take Amazon for example. The people-facing experience is all automated and very difficult to operate when there is a problem, but they get around that with a very liberal return-and-replacement system which mitigates customer unhappiness. Walmart on the other hand after devaluing service for years has been surprised to find that giving workers higher wages has improved same store sales because morale, cleanliness, and service has improved. AirBnb beats VRBO because it allows you to get out of mistakes the public chose on misleading information, while VRBO let’s sellers use its platform and takes no responsibility, thereby eliminating service and accountability and putting customers at risk.

Things may be changing, but the way many who own the changes think about shortcuts and profit margins will create opportunities for people who like people to be organizers, navigators, advocates, and interpreters. Forty years ago, a young ACORN organizer named Charlie Best wrote a song at ACORN’s annual year end/ year begin meeting which — to some outcry — was always held on this very weekend when one year ended and another began. The original song written by Ed and Patsy Bruce and recorded by the great Willie Nelson was “Mamas Don’t Let Your Babies Grow Up to Be Cowboys,” but Charlie creatively composed different lyrics and changed the title to “Mamas Don’t Let Your Babies Grow Up to be Organizers.”

Mamas and papas. I’m here to tell you, Charlie was wrong, though of course he knew it then, just as we all did, you all need to let all your babies grow up to be organizers, so they have a chance in the brave new world, and because the people will demand them.

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Doctors Can’t Be Trusted About Healthcare

Cancun   Of all of the bad nominations coming our way, the notion of Georgia Congressman Tom Price running the Health and Human Services has the most impact on millions of people because of the impact of his virulent opposition to the Affordable Care Act and the jeopardy it places not only on 30 million beneficiaries there, but also on millions more because of additional threats to Medicare for the elderly and cutbacks in Medicaid for the poor generally. Some hold out a sliver of hope because Price keeps saying that he’s a doctor, and he wants that to mean something along the lines that he cares about peoples’ health. He’s taken the Hippocratic Oath, so he’ll “do no harm.”

James Surowiecki points out in the current New Yorker, that in fact the record of doctors and the American Medical Association has been to oppose virtually every governmental medical program providing health security for Americans for a century now. Doctors organized to oppose universal health care when it came to the ballot in California in 1917 during the First World War, claiming it was a “dangerous device imported from Germany.” The AMA in the 30’s opposed pre-paid medical groups where customers paid a flat fee in exchange for care and was fined for anti-trust violations. The AMA campaigned against the creation of Medicare, and hired Ronald Reagan to go on the air and warn us about so-called “socialized medicine.” The AMA was in the thick of the fight to oppose the Clinton health plan during his first term and only supported Obamacare after the so-called “public option” was off the table.

Ten thousand doctors have already organized in opposition to Price and his plan to scuttle the Affordable Care Act, and though the AMA has endorsed his nomination as a former member of their delegate board and a long-time friend in Congress, there is a schism mounting within the AMA over its stand as harmful to patients. Most hospital associations have been silent over Price’s nomination, but have come out strongly in opposition to the plans to end Obamacare as catastrophic in terms of patient care, hospital closings, job loss, and economic ruin within the healthcare industry. Nurses’ unions have been pretty unanimous in opposing the end of Obamacare.

Price is likely to hide behind the public’s assumption that as a doctor he’s an expert on healthcare. Reading Michael Lewis’ new book, The Undoing Project: A Friendship That Changed Our Minds, might take away any notion that doctors should be seen as our modern day priests. Experiments conducted under the influence of work by Daniel Kahneman and Amos Tversky found that fairly simply algorithms outperformed doctors in making diagnoses of many medical conditions, largely because of the unchecked biases of doctors for the way they are used to seeing and working. That’s scary, but true.

And, as Surowiecki points out repeatedly, the AMA is little more than a very effective special interest group, a closed shop union for doctors, if you will, and their own reports indicate repeatedly that their primary purpose is protecting the income security of doctors. Putting money in doctors’ pockets should never be confused with providing basic healthcare for Americans. We don’t need an algorithm to know the facts about that.

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Beware Website Rental Car Scams for Foreign Travelers in Canada and Mexico

Merida   I’m not a rookie traveler. I’ve been on the road, literally all of my life. My dad’s job would pack us out all over the American West, where I was born and partially raised, in motels and kitchenettes from Billings to Fargo to Rangely and Denver, Cheyenne and Laramie, and every place in between, where there was a pumping station or tank farm that his job as a field auditor with an oil company required him to hit. In my work United Airlines sent me a “thank you” note for more than a million miles, and I logged another million or so with the rest of the airlines over the years. I’ve driven all over Canada and Mexico and tested the road in a bunch of other countries as well. Sadly, none of this protects anyone from rental car rip-offs.

When you land in the Cancun airport, as my family did at midday on Christmas Eve, you are greeted by a wildly efficient industrial tourism machine. Vast crowds are deplaning from multiple gates and a small army of custom agents processes the horde in amazing speed, disgorging you from the doors into a maze of rental car booths. You get to your chosen company, purchased at an amazing bargain of $15 per day online, and are walked out to a scrum of white vans lined up and moving in a seemingly endless conveyor belt of people, baggage, and rolling stock until you are deposited at your rental company, one among many.

We felt lucky to find only a short line and four or five agents working. I had seen a post the day before from Cancun of an hour and a half wait, so standing in the warm, Yucatan air, it all seemed a good omen. And, then we heard the crying, gnashing of teeth, and rending of clothes all around us as the agents of the company explained the exorbitant, rip-off costs of additional insurance that they were claiming was mandatory. Insurance cards were being shown. Purchases via American Express cards were being touted. It was a horror, for some worse than for others, as charges for liability and collusion were being routinely added on to every car contract and people, friends and families, were stepping away to caucus and see if they could come up with the money or fathom a way around it.

The agents all pretended empathy and mouthed words of apology, since this was a common and usual scam for them. To avoid the charges a customer would have to provide a copy of their insurance policy from the United States covering both liability and collision insurance. They would also have to provide a letter that specifically mentioned Mexico (and I’ll add Canada, but I haven’t gotten to that yet). If they don’t have it with them, they have to have it emailed or faxed while they are waiting. Even if they have it, they would have to put $6000 on their credit card and another deposit that was too painful for me to hear clearly, because any accident would mean a repair in full on their credit card, and they could work out the refund with their company in the states. Or, they could pay about $35 USD a day extra and drive away. Purchasing separate liability insurance in Mexico, at least from what I can now tell, seems to be legally required, but that’s worth checking.

As you can tell, I listened carefully while waiting in line and occasionally queried my fellow travelers as they angrily interrogated the agents, but when our turn came, I was already a beaten man, and simply shrugged at the price with my family in waiting, signed, paid, and went on my way on my vacation. Why? Because I had been through the same hurt dance at a rental car office in Toronto only three months before at 1230 AM in the morning, where a similar premium was also required by a cheapo online deal someone had found for the ACORN Canada training and staff meeting where I was tasked with picking up the rental.

This scam seems broadly popular across North America, and a minute’s research indicated it was popular in the United Kingdom as well. Like any scam, there’s a kernel of truth in the shell of the lie. It isn’t hard to imagine why rental car companies, even reputable ones, try to transfer the problems of an accident to the customer. It is also possible to reasonably understand why countries, like Mexico, might require purchase of some kind of liability in-country. I’ve had to do that driving my own truck into Mexico at the border, and have watched them put a sticker on my window indicating I paid to bring the car into the country. But, the bait-and-switch is inexcusable, since the websites allege they are giving you the total price, and, if these charges were legitimate, why not disclose them on the front end?

See the world, my friends, but caveat emptor all the way!

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Healthcare Pricing is More Proof that Transparency Isn’t Enough

New Orleans   It is amazing that big companies and governments continually believe, despite the outrageous costs involved, that simply creating apps and information packed websites will change the public’s ability to make choices and decisions. Criminals and scammers fully know the tricks of the predatory trade are such that information is unable to immunize the public, and for some companies this is a business model as well. Payday lenders and tax preparers in negotiations with ACORN were always more than willing to be totally transparent about excessive interest rates and charges, because they knew full well the customer sitting across the desk from them is desperate for the money, and is more than willing to pay whatever it takes to get it. Healthcare is usually the same.

Healthcare policy makers, providers, and insurers in this critical, multi-zillion dollar industry are now expressing surprise as they find out that all of assumptions about the value of their apps, website data dumps, and comparisons of pricing on drugs and quality of healthcare services are not lowering costs or modifying consumer behavior. Once again, similar to payday lending and other predatory schemes, the providers and the industry are trying to ignore the desperation and powerlessness of the consumer by pretending she is a free agent of some sort, rather than a victim. They are also ignoring increasingly well settled economic understanding that people are not rational economic agents, especially when it comes to change and their reliance on trusted intermediaries, like their usual doctors and hospitals. Looking at this mess, we almost want to say, if you are so rich, why aren’t you smarter?

The New York Times reported on the failure of many of these tools. Of course the rule continues to be, despite the actions of many states, that hospitals and healthcare professionals are hiding information about the comparative value of their services and the pricing in the market. But, even where efforts by some companies and insurers to offer price and value comparisons, people aren’t using them. Researchers compared the decisions of 300,000 workers who didn’t have access to a website cost calculator with 150,000 that did and found that only 10% used the site the first year and 20% the second year, and that it didn’t reduce outpatient spending. Aetna offers a price transparency tool but only 3.5% of its commercial market participants use it. A similar price tool in New Hampshire is used by only 1% of residents. Robert Wood Johnson did a 10-year study and found that doctor quality comparisons had only a “modest effect on the awareness and use of the information.” Duh.

Let’s skip the digital divide and the millions of lower income families without access to any of this information, and get right to the point of how difficult it is to either find this information most places or understand it. Why isn’t there a recognition that we need ubiquitous healthcare advocates, navigators, sherpas, assistants, or whatever we might want to call them? During the Affordable Care enrollment in Texas for example families who had never had insurance were asked to choose between more than 35 plans, each with multiple permutations, without our navigators, who were forbidden to offer any advice to these novice healthcare customers. Who would be surprised if decisions defaulted to nothing or self-interested agents and professionals?

Of course some of the industry believes that education can only be administered by the blunt instrument of punitively making people pay the cost of decisions they were unable to make well without assistance by adding consumer pain to their delusion. Others advocate outreach, and, eureka, finally someone gets it. People need help with all of this to offset the predation, whether it’s door-to-door or through ubiquitous health care centers and advisory facilities so that they can get the information in a user-friendly way with full explanations from someone committed to their best interests. Furthermore, the cost for funding such outreach and facilitation would be minuscule compared to the daily explosion of health related costs that are based simply on the principle of the buyer beware and keeping suckers born and nurtured by the system every minute.

If we really want to make change and lower costs, people need to help people, not websites, applications, and fancy tools.

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What Happened to the Push for More Nonprofit Community Development?

New Orleans    Community development corporations, once seen as an important tool for neighborhood revitalization, may not have fallen on hard times, but it has become increasingly invisible in many cities. Partly the strategy, heavily funded and much-touted in the late 1960’s and 1970’s, shriveled as the huge federal funding programs diminished and the ideological dominance of private sector and market-based development suck the money and air out of the development space. Partly the strategy receded as studies like those by David Rusk, former mayor of Albuquerque and something of an urban expert, could not prove that CDCs, as they were called, had been successful enough to make a difference in deteriorating areas, especially compared to gentrification. Many CDCs became more service operators than jobs or housing developers. There were, and are, of course huge exceptions some of them very successful, but there numbers are no longer legion and their record more mixed.

When CDCs were ubiquitous, community organizations were often pushed, carrot and stick, by funders and their own search for stability and institutional status in this direction, building grocery stores, small businesses, community centers, and housing developments. Unions like the Teamsters in St. Louis and the AFL-CIO local federation in San Antonio became known for their senior housing and other services. Churches, as anchor institutions in many cities, tried to take on the task. Not so much anymore. It was hard work, requiring significant resources and managerial skills often stretching organizations far outside of their missions and expertise.

I was thinking about this while in Buffalo and talking to my friend and comrade Bill Covington and hearing about his church and how much they have continued to buck this diminishing trend of abandoning community development by doubling down in Buffalo’s predominately African-American east side and creating something rare, a buffer zone protecting the community from the expansion of the medical center. St. John Baptist and its social conscious isn’t a new thing. They pride themselves on being in the Martin Luther King, Jr. wing of the Baptist Convention and having committed civil rights Reverends Jesse Jackson, Fred Shuttlesworth, Ralph Abernathy, and Al Sharpton speak and preach to their congregation. They started down this trail of community commitment first by creating a credit union, but more recently they have expanded to a community center and school projects, including a charter school, and, most importantly, a clutch of community development corporations focuses largely on reviving and creating affordable housing in the East Side Fruit Belt area.

Their community development corporations consist of McCarley Gardens housing complex which are 150 unit 2, 3 and 4 bedroom tri-level apartments and St. John Tower a 150 unit Senior Citizen unit. The St. John Fruit Belt Corporation is the producer of a $54 million combine of single-family, subsidized housing units and town homes. Listening to Bill Covington on Wade’s World, it seems that they are continuing to break ground on additional affordable housing projects, including more desperately needed rental units. The financing, not surprisingly, largely comes from state, federal, and local pubic sources.

Community development is not for everyone, and it is not a magic bullet for curing poverty and turning around deteriorating neighborhoods, but it makes a difference, and it’s encouraging to see a success story in some faith-based institutions that are still committed to making community contributions and playing a leadership role benefiting everyone, regardless of theology and ideology.

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Labor and Community Collaborations Digging in to Fight Forward in Buffalo

Graphic from Open Buffalo

Buffalo    Richard Lipsitz, the head of the Western New York Area Labor Federation of the AFL-CIO, sits at an interesting cross section. With the call to revive manufacturing he notes that his area may have less manufacturing jobs than it did, but, interestingly, he argues that the overall economy in metropolitan Buffalo has about the same percentage of manufacturing jobs as it ever did, between 15 and 20%. A headline in the morning paper bolstered his case as General Motors announced a several hundred million dollar investment into improving and expanding its plants, once feared on the list for mothballing. Visiting with the staff of ACORN Canada at our Year End/ Year Begin meeting, he made the case that there would be resistance to turning back the clock and that labor was deeply debating the issues.

At the same time, Lipsitz was balancing on a slender beam. He argued for patience. He argued for finding a way to pull all of the pieces together. He admitted that some unions would salute revival of pipelines and all would support more infrastructure investment, but it couldn’t divide labor. He was clear that Governor Cuomo’s investments in the Buffalo area were also a key reason for low employment and a rising population, fueled partially by immigrants, in a rare rust-belt comeback. The expansion of the medical corridor and its 26,000 jobs made a huge difference. On his tightrope wire, he wanted to commit labor to the fight, but didn’t want any high winds blowing with dissident movements or factional fights. He had no patience for the Working Families Party in New York, but was open to Bernie Sanders and Our Revolution being part of efforts to move the Democratic Party left. He was categorical in advocating that the only way forward for the Democratic Party was a headlong commitment to being more progressive.

We also met Franchelle Hart, the executive director of an interesting formation called Open Buffalo, the product of a funding competition run by George Soros’ Open Society Foundations that had been won by Puerto Rico, San Diego, and Buffalo. Open Buffalo describes itself as “…a Community Movement for Social and Economic Justice” and “… a civic initiative to make major, long-term improvements in justice and equity in the City of Buffalo.” They are committed to building civic capacity in the areas of restorative justice, leadership development, arts, and innovation. That was the top-line of her remarks, but what clearly moved her most personally were efforts to force the police to be more sensitive to the community, especially African-Americans, “without a Ferguson,” as she argued, although she seemed skeptical from the work thus far that that might be possible.

Open Buffalo had also supported a campaign to win inclusionary zoning in the city opening a dialogue with the ACORN Canada organizers, who are involved in a number of campaigns in different communities on this issue. Hart reported without satisfaction that they had at least gotten a commitment for a study. Some of the Vancouver organizers comforted her that that was farther than some of their campaigns had gotten.

The Trump Era, as she called it already, was much on everyone’s minds. Lipsitz was clear in the commitment to resist, and Open Buffalo was still digging in to fight forward, so both offered the beginnings of a consensus for the future.

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