Health Care: A Business Perspective

How do we get health care costs down, while still maintaining high-quality medical care for as many people as possible?

It’s a question that politicians have been dwelling on for months, culminating in yesterday’s historic passage of new health care legislation.

Stefanos Zenios, a professor at Stanford Business School, has made it his life’s work.

A Cypriot math major who is now an operations professor, he’s researched new ways to coordinate doctors, patients, and healthcare systems to improve health outcomes. His mathematical models have helped revamp the kidney transplant waiting list and introduced more affordable HIV testing for developing countries. Now he’s looking into ways that hospitals serving under-insured patients could become more efficient–allowing them to treat more people each day.

Read more about it in my article on Zenios in Stanford Business magazine.

“It’s” Rampant

OK: time for the grammar police.

In the last two weeks, two articles in the Wall Street Journal—most noticeably, on the covers of inside sections—committed the same terrible grammar faux-pas. Both used “it’s” as the possessive form of “it,” which should always be written as “its.”

 “It’s” is only a contraction for “it is.” While it may be tempting to write “it’s” as the possessive of “it,” it helps to recall that we don’t write “he’s” for “his” when using another common possessive.

While reading the paper’s May 15 edition, I saw one “it’s” used this way on the cover of a weekend real estate section and chalked it up to a single minor oversight. (“This Sunday on the season finale, the plot involving Mr. McDonough’s character finally reaches it’s wildly dramatic climax.”)

This Sunday on the season finale, the plot involving Mr. McDonough’s character finally reaches it’s wildly dramatic climax.”)

But then, on Thursday, this second example popped out at me. In an article on the cover of the Marketplace section from Thursday, May 21, 2009, “Industries Are Grappling With New Bill On Climate,” slightly below the fold, I saw this (in the paragraph beginning, “The bill has been put forward by U.S. Reps. Henry A. Waxman…”):

“It’s prospects look good in the House, but it could face a tougher time in the Senate.”

Argh!

What are the writers thinking? And where in the world are the editors? 

I will not take this opportunity to upbraid this particular author, since it could have been an error introduced by an editor (I know the sting of that!), but I do hope someone is paying attention at the WSJ!

The Future of Journalism

The other day, listening to Talk of the Nation on NPR, I heard a featured guest, Gustavo Arellano, deride his chosen profession, journalism, to a caller whose son wanted to pursue a writing career. To study writing or journalism, he said, would be a waste of a college education.

Sad.

(A little background: This comment came from a guy who’d just published a piece in the LA Times about how his Mexican immigrant father, a truck driver and jack of all trades, is in some ways better off than he, a writer with a master’s degree.)

Then I took a look at the Pew Project for Excellence in Journalism’s “State of the News Media” annual report for 2009.

Its introduction begins: “Some of the numbers are chilling.”

Subscriptions down. Ads plummeting. Staffs cut down to bare bones. Newspapers folding, or going online-only. It reminded me of another recent radio story about papers ceasing delivery some days of the week.

What is the future of journalism? And what’s to become of any kind of investigative, thoughtful or complex writing?

Will it be relegated to academia, where it’s not read or even understood by non-experts?

Will everyone get their news from cable TV or TV-related news websites or blogs?

If you think that this kind of coverage will be just as good, you ought to think again. The truth is, many, many news outlets get their story ideas from newspaper reporting. They sit around newsprint-strewn offices, poring over morning editions of local and national papers with inky hands, trying to come up with something new to say, some unique trend in business or law, or an unknown, up-and-coming leader, or a disease no one’s heard of yet. That’s where news is born most often—and then it moves up the “news food chain” from there to TV, magazines, other websites, blogs.

In another NPR Talk of the Nation episode, I heard veteran ABC newscaster Sam Donaldson admit that his TV news ideas came largely from reading the newspaper. He, like everyone, complained about the downward spiral of newspapers today.

It’s the same thing with today’s blogs—that is, the ones that aren’t just pure rumor or opinion. Most of them are commenting on other people’s reporting. (Like this post!)

In other words, it’s not the newsprint paper itself that we’d be missing if newspapers all died. It’s that quality reporting that a good newspaper fosters and supports.

So now what?

There’s begun to be more talk of a new model for funding news reporting. We need to do some serious thinking about that. One of the most interesting recent proposals is to create some sort of public trust for journalism, some non-market funding for writing hard-hitting, investigative pieces that give insights into our political, financial, and social worlds. This model makes the argument that journalism does matter, because it offers a look behind the curtain and the PR façade—a means of testing that people really mean what they say, and that politicians or CEOs or anyone in leadership roles are not pulling the wool over the public’s eyes.

And that’s definitely a public service. Certainly, more heavy, critical reporting could have done a lot to uncover the weaknesses in our financial markets and the risks that large banks were taking with money they didn’t have. And that’s just one (very big) problem that really good reporting could reveal.

Even though many charitable institutions are suffering today, there will always be a thirst for supporting ways to keep our country a vital, well-informed, and honest place. And just as listeners give money to NPR, which is also government-funded, a similar combination of private and public funds could sustain news reporting.

Perhaps a new foundation for journalism as public trust could be the next big way to give back? And perhaps a new stimulus plan could find a little room for supporting the fourth estate?

The Pitfalls of Complexity: The U.S. Financial Crisis

We are embroiled in a very serious financial crisis. Banks are failing left and right, loans have dried up, and confidence in the economy is sinking fast.

Now it turns out that many of the problems at established firms were caused by complexity–driven by the use of complicated derivatives and schemes involving credit-default swaps that even many executives of financial firms didn’t really understand.

An article by Nelson D. Schwartz in the International Herald Tribune put it this way: “unlike the financiers 100 years ago, the people in the room did not fully understand what the institutions they run actually owned and were trading back and forth – at immense profit. Neither did they fully grasp the speed at which their world had changed since the last financial crisis a decade ago…”

Schwartz’s sources suggest that some company directors did not know what their companies were doing, nor did they understand the sophisticated financial tools their employees were using to trade credit. These execs signed off on schemes that they did not comprehend.

Which leads again to the importance of understanding complex ideas. It’s not enough to hear a short briefing or read an executive summary. If the math whizzes and finance gurus behind these schemes can’t explain them clearly, we need someone who can.

And above all, we need much more transparency in all realms of business. Today, we’re paying the price for not asking enough questions—or understanding the answers.

Treasury Secretary Henry Paulson’s three-page plan to “rescue” the economy—a document that asked for as much as $700 billion but contained no details on oversight of its spending—is now getting the pushback it deserves. The American people want more clarity, explanation, and accountability. And that’s the way it should be—and the way it should have been all along.

Are We Missing Something? Online Research’s Role in Writing and Editing

Is the Internet “making us stupid?” That question, asked of Google and the entirety of the web, was the focus of a recent Atlantic Monthly article that has stirred a lot of buzz.

I don’t think “stupid” is the right word, but I do think the Net is having a huge impact on the way writers and editors work today. And we should take a step back to look at how that change affects our written product.

I began my writing and editing career when the Net was really taking off as a source of information, not just a means of marketing or a techie meeting ground. More and more publications were going online. Amateur websites about obscure topics were being created on a daily basis, then overhauled by experts who added accuracy and legitimacy to their information.

Today’s writers can glean much of what they need from the web without ever setting foot in a library.

It’s fun detective work, trolling the web for that oddball quote in a trade publication, or uncovering a debate you didn’t know existed, or finding out your profile subject is a champion Frisbee-thrower.

But my academic experience doing research in the field of European history—reading primary sources in the bowels of an old library, visiting foreign book collections and archives, scrolling through reams of microfilm and fiche, straining to read handwritten notations, wearing special gloves to handle 200-year-old cartoons—taught me how to dig beneath the surface of things.

Scrolling through the Net doesn’t always yield a full picture. Not everything is there, especially if it’s more than a few years old, or requires more than a few paragraphs of explanation. You have to ask yourself what you’re not seeing online, and you have to go to the source—whether that’s a research paper, a book that references older books, and those books too, or the people at the heart of an idea or project.

Net-only researchers are missing out. There are decades’ worth—dare I say centuries’ worth—of relevant information crammed away in libraries’ troves of books, magazines, microfilms, special collections, and more. Some of this is starting to crop up online through sources like Google News Archive, but many, many gaps remain.

Writing that exclusively relies on the Internet without any other sources of information reminds me of those book reviews some students wrote in high school after watching the movie version of the book—or just reading the Cliff’s notes.

So if a research topic piques your interest, go to the page, not just the screen. And then go to the person, too—that’s still the most important source. (One reason I did not become an academic historian was that my interest in learning from other people, rather than just paper sources, was so strong.)

One more thought: Another side effect of the Net is that it may someday impede research into our own era. The Internet may have replaced much of our culture’s paper ephemera—the broadsides and fliers of old, and increasingly, the muckraking and the opinion-shaping, will now live on computers. And that will certain be a barrier if our servers and hard drives crash without leaving backups behind. And what’s more, that will be a problem for future historians unable to track down hard copies of just about anything.

Paying for College– New Ideas Apply Here

Today’s financial woes have created a new crisis in student lending at a time when college costs have risen up to 40 percent in the last five years. The average college grad owes around $19,000.

Higher education creates opportunity. But we need new ideas on how to pay for it.

Read more on this topic in my op-ed piece in the San Francisco Chronicle.
http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2008/09/11/EDI912RKK6.DTL&hw=kunz&sn=001&sc=1000

Five Keys to a Great Story about a Complex Idea


Communicating complex ideas is what I love to do. While these stories are never formulaic, I try to incorporate five basic elements that make for a good story. Here are my keys to an informative, engaging piece of writing about a research topic of other complicated subject.

What is the idea or research topic?
After first boning up on the field, I spend some time with the source of the idea. Usually that source is a person, though sometimes, the idea may be expressed in a research paper, book, or website. Either way, I try to talk to the researcher or another expert in the field who can explain it in the clearest way possible.

When interviewing experts, it’s important to underline the fact that the written product will be for an audience of nonspecialists. I prefer to meet with people in person if I can, but if geographical distance is a barrier, a phone conversation can work well.

Even if I feel silly asking a very basic question about the topic, I don’t hesitate to do this if there’s something I don’t fully understand. Since the writer has a fresh perspective on a topic that may be very familiar to the researcher, new questions can lead to new approaches to the subject—ones even the specialist may never have thought of before. Once I asked a researcher who’d created a computer model for walking whether changing the dynamics of the model’s gait would make the walker move faster. He replied he hadn’t considered it before, but that it would be a good idea for future research.

Why now, and why does it matter?
The “why now” question is essential to any good journalism or promotional writing because it explains the idea’s urgency and news value. In other words, it gives busy people a reason to care—and therefore, to keep reading.

Explaining why a topic matters is vital even if the subject has a technical nature. If it’s research that could lead to curing a deadly disease, there’s very little to explain here. Or the subject may be highly topical. For instance, people are more interested in renewable energy now that gas has topped $4 a gallon. If it’s a topic that’s more esoteric—like the politics of ancient Greece—the writer has a bit more work to do. But most good research bears some important relation to today’s world and people’s needs. For example, ancient politics can shed light on today’s political struggles by showing the limits of empire or the dangers of dictatorship.

Who is behind it?
Here’s the writer’s chance to portray the researcher(s) or inventor(s) with a human face. Everyone wants to know how smart people work. Maybe the person’s work methods or style will inspire the next discovery, or maybe the person’s quirks are just interesting because they’re odd.

We’ve all read the clichés about the brilliant academic working in isolation in some far-flung archive, or the genius scientist laboring alone in a lab at 2 a.m.—and just happening upon the discovery of the century. These notions may sometimes have a grain of truth, but I try to look beyond them to find the source of the person’s passion. Did she get interested in the topic or field because of her parents, a teacher, or a book or even a movie? What lengths did she go to to gain her expertise? What sparked her discovery?

Who disagrees or offers a competing point of view?
In most cases, it’s important to present the other side of the story—are there other researchers who disagree? Or is there a competing theory out there? The venue for the writing and the topic itself dictate how much time one should spend on this. Among scientists, there’s a feeling that often, too much time is spent trying to show both sides of a controversial issue such a global warming, when enough evidence exists on one side to make the answer clear.

What is the future of this idea?
Before ending the piece, I try to add some thoughts about where this idea or research area is headed. Most experts will be glad to share their predictions about the direction of their field or what they plan to do to further their research. This opens the story up for a broad conclusion that may pique readers’ interest for my next endeavor in communicating complexity.