"The price of incivility [at work]"

http://hbr.org/2013/01/the-price-of-incivility/ar/1

This builds on our past discussion on stress and health. These authors suggest that a disrespectful culture at work (often promulgated by a manager, who learned it from his boss, and so on and so forth...) can infect an entire dept of previously nice people, and cause health issues. We follow our leaders, right?

And here are the costs to employers and the economy: intentionally lower effort/output/creativity, reduced productivity worrying about the issue, complaining, and avoiding the culprit, HR costs of turnover (firings, recruiting costs, etc. can be $10K's per head), taking frustrations out on customers/clients, and of course the intangible reduction in team spirit and camaraderie. The effects of bad behavior may eat up 13% of a manager's time, which is also $10K's of costs per head. Cisco (generally regarded as a good place to work) did a conservative analysis and the total ran up to $12M/year. This led them to start a global workplace civility program. But of course many employers don't, and even pretend the issue isn't there. Maybe they will send out some BS employee satisfaction survey, but not act on the responses. That is even more demoralizing.

Simple fixes for bosses (though problem bosses are unlikely to try): walk the talk, show appreciation (so feedback is not always negative), ASK for feedback in a way that the worker is protected and comfortable to be honest, and change hiring/training practices to encourage civil behavior and keep out jerks (but of course asshole bosses may hire assholes who are like them). Also everyone is responsible to speak out when they see bad behavior, but often we keep our heads down for fear of retaliation. Changing culture takes time (if it ever happens), but when people see the "right way" to behave and people getting rewarded for it, they may follow. And similarly, bad apples have to be called out just like any other form of underperformance - even if the culprits are your rainmakers. In this sense, a jerk can be even more costly to your org than an underperformer, because at least others can cover for a slacker. A jerk often affects everyone, and in hard-to-measure ways.

Lastly, monitor that things are getting better (or if not, why?). Google does this fairly successfully with its manager metrics program where they have gotten horrible bosses to improve, but of course they are more data-driven and cutting-edge.

http://www.nytimes.com/2011/03/13/business/13hire.html?pagewanted=all&_r=0

Health care reforms

http://www.interfluidity.com/v2/4013.html

Thought you might appreciate this. The author is a pretty intense econ blogger (much of it right at or beyond my ability to understand the arguments), but here he just unloads in response to the recent Time article about health care costs.

---------

I haven't read the Brill article yet, but based on the blog post - I get his argument for collective action. But as with most market failures, the public is just so ill-equipped because of asymmetrical info and influence with policymakers.

We've chatted about this issue during the Obamacare debate and other times, but as you said, most of the "proposals" are marginal improvements - and even those are unlikely to pass because of entrenched interests. You probably have thought about more comprehensive fixes, and I'd love to hear about them. From what little I know about healthcare economics, here is my initial list and let me know what you think:

1) Shift from fee-for-service to fee-for-outcome - and along these lines, empower consumers to refuse unnecessary or excessive care. Just as we are constitutionally guaranteed to legal defense, maybe we should be guaranteed a health advocate who represents our personal interests vs. the healthcare providers (who also care about us, but also care about other things)

2) Related to (1) is tort reform because medical malpractice much more lucrative and widespread in the US, compelling some providers to over-prescribe. But along those lines, there should be lawsuits and penalties for over-prescribing too.

3) This one is the most controversial and hardest to achieve (if it's even a good idea), but change the nature of demand - it's amazing that people can live longer and enjoy life more. But we are part of a society with some zero-sum aspects. Keeping an elderly person on life support for a year affects other needy patients. We are constitutionally entitled to pursue our happiness (which usually involves avoiding death), so no laws can apply here. But maybe people should reconsider their life expectations and their resource allocation impacts on society. It's OK to get sick and die when you're old. It's OK to "tough out" non-critical issues. A "good life" does not mean being top performing and discomfort-free all the time. Unless you have a high-deductible crappy plan, over-using resources doesn't hurt the patient, but at scale it does to everyone else. In other words, tragedy of the commons. 

4) market-based pricing & more buyer power - there has to be a supplier out there who is willing to sell us gauze for less than $77/box. And for medicare, the VA, or even Blue Cross with thousands of members should be able to negotiate better rates (the whole point of HMOs according to Kaiser and Nixon). But providers and vendors have local monopolies so there is little to no market. Also switching costs can be high, especially for employers choosing insurance. The health-care exchanges won't help much (if at all) because the pools are small and some of the most high-cost customers.

5) Harmonize state laws and health benefits admin - a lot of waste, bureaucracy, and delays regarding the different laws relating to privacy, insurance, benefits payout, taxes, etc. As part of this, there has to be more layoffs and pay cuts in the industry. It's ridiculous that health is 15-20% of the economy (just in the US, and maybe sub-Saharan Africa). It doesn't really make sense today to have >5 major airlines in the US, so why would we have dozens of insurers?

6) Incentivize hospitals and providers to have excess capacity, not fill empty beds with less sick people. Pay them to NOT treat people (when appropriate), because treatment also increases the risk of medical error and infections. This may free up resources to help underserved areas. Like with public schools, shut down or take over poorly performing hospitals and reward the good ones (measured by health outcomes per $ spent, not revenues).

7) Shift medicare spend from end-of-life emergency treatment to daily maintenance and preventative care (do this for younger patients too). Seniors sometime go to the doc mostly because they're lonely, yet we're cutting in-home services. If they feel socially connected, there is some data to suggest that their health improves too. And there will be someone there to take care of the small things before they get big, and take pressure off the elder's family.

8) Change the research grant structure - those who financially benefit from the research should pay back the gov't (at a low interest rate), even nonprofits. Along those lines, shift the emphasis from public-subsidized medical high-tech research to efficiency & outcomes research. Yes, future innovations are sexy and amazing, but probably not cost effective and affordable to many. It's better to focus on using our current proven tech in better and smarter ways. Even improving IT and data collection/analysis would be huge, and much cheaper than the next specialty drug that extends a sick person's painful life for 2 more months. Many docs and hospital admins are notoriously horrible with data. Again, this will cost jobs, but will save lives for less $.   

Why is China such a bad global citizen?

This is coming from an Asian-American, so there is a certain level of obliviousness and hypocrisy here, but I am tired of Chinese BS like this: http://www.businessweek.com/ap/2013-02-20/a-look-at-mandiant-allegations-on-china-hacking

I know in their society, stuff like hacking and currency manipulation isn't seen as dishonest cheating, but instead a clever and necessary part of competition. Morals have nothing to do with it; it's about winning. I guess China does use soft power, but their antics are just so annoyingly passive-aggressive: spying but denying everything, cracking down on peaceful dissidents but calling them terrorists, stealthily building up their military, laying claim to new waters, and buying up raw materials all over the globe. And of course they manufacture unsafe, defective, and poisonous products just to shave a yuan here and there. Surely the US is guilty of all of that too (and worse), but at least we cowboys are more brazen with our bad deeds (part of that is due to our freer political system and press). And at least the US does help some people around the globe (Americans are some of the most generous in terms of foreign aid), our inventions/actions have reduced illness and poverty, and we did fight global threats like Hitler and the USSR.

In almost every arena, the Chinese government is playing a negative role (note that I am criticizing the Chinese GOV'T here, not Chinese people). Apart from the unique economic relationship with the US, I don't think any other nation can say that they are so grateful for what China is doing for them - maybe with the exception of Iran, Myanmar, etc. No other state is coming to China's defense and singing its praises. I know I am misinformed and exaggerating here, but there is just case after case of bad news. Uncompetitive behavior with their solar industry and fears of stealing IP have probably set back global green tech innovation a decade. They are the #2 consumer and #1 polluter in the world now (not per capita of course). They don't respect property rights and trade laws. They are usually one of the last states to condemn crimes against humanity (except for America's shielding of Israel), and they commit plenty of atrocities themselves. Their system is rife with corruption and injustice. Their wealth gap is even larger than ours.

Like Israel, China almost "gets a pass" for its poor global citizenship because of its meteoric rise and tragic history. Only the USSR had more dead from WWII. Maoism was taking them in the wrong direction, but then Nixon and Deng shocked everyone and started a new partnership that changed the world. China went from Third World to #2 economy in a GENERATION. Many people got rich and many new products/jobs were created in Asia and the West. Many want China to be a feel-good, zero-to-hero story. And some may like a powerful China to counter-balance Russian and US imperialism. Previously ignored, poor African nations enthusiastically welcomed Chinese development and merchants. But they "overstayed their welcome" and caused major resentment by displacing local businesses and "scamming" naive African governments (trading the rights to precious resources for shoddy infrastructure projects made with crappy materials and imported Chinese labor). China has been an impediment to Western interests on Darfur, Iran, North Korea, Syria, etc. They really don't have much of a stake in those conflicts, and have little to lose by cooperating. But they don't (maybe they still fear Western domination, or have a chip on their shoulder and want to be respected?). They have made little to no serious effort at conflict resolution over Tibet, Taiwan, and democratization. They don't volunteer troops or resources for peacekeeping missions or natural disasters. A poor, developing nation may deserves a pass for that, but China always wanted to be a global power and now they are. So they are held to a higher standard, which they are not living up to. I know the #1 priority of any gov't is self-preservation, as well as maintaining harmony and growth. But a global power should think bigger. They have to make friends and work with others if they want major, mutually-beneficial accomplishments - which will better ensure the continuation of their gov't than repression.

I guess China has its 5, 10, and probably 50 year master plans for development. What are their plans for getting along with the rest of the world, and maybe making the world a better place? Some Chinese people are working selflessly and tirelessly on those issues, but what is the gov't doing? Because even those rooting for China will eventually tire of their egocentrism and more-or-less sociopathic behaviors (= inability to empathize with and care about others). China was so successful since the 1980's partly due to its soft power and peaceful cooperation. Yet they seem to be straying from that now, flexing more hard power and possibly losing friends (empire syndrome?). Some businesses are tired of Chinese corruption, inflation, and IP theft, so they prefer to set up shop elsewhere in more democratic, cooperative places like India and Malaysia. The global economy will be "dependent" on China for decades to come, but clearly the winds are changing and we are coming up with substitutes and strategies to wean ourselves off of China. The West has known about Chinese hacking for years, but maybe it has finally reached the tipping point. Nations are collaborating and deciding what to do about it. But the problem is, how will it escalate? We can get together and tell China, "Hey, stop doing this crap or we will ____ you." But what will the stick be? What will get them to desist without making matters worse for everyone? Because no one wants a cyber, trade, or conventional war with China - especially because China would probably prevail in cyber and trade (and can hurt our allies militarily). I don't know, what else can we do to peacefully encourage them to change their ways? Because it only seems to be getting worse. I think China is loathe to succumb to outside pressure, especially when we have so little leverage with them. Change has to come from within, but how much support can we covertly funnel to dissidents and reformers? China clearly won't tolerate what we did to Iran and Qaddafi.

The tragic part is, China can have awesome socioeconomic growth and global admiration without engaging in these annoying, ultimately mutually harmful antics. The gains they can reap from transparency, trust, reforms, and lawfulness vastly outweigh the fleeting benefits of cheating. They can win fair. But this is the side-effect of a one-party system. There is no check or balance to say no and act as a sanity check. Their state-run enterprise system is now an impediment to innovation and growth in my opinion. China may be the #2 economy, but they are like the #10 creative economy (or worse). Maybe they make up for that with stealing and cheating, but it can't last forever. Some are concerned that China's economic model has run its course and plateaued. I am not sure yet, but clearly they will have to move towards a more democratic market and society in order to have the free flow of ideas necessary for entrepreneurship and economic success in the 21st Century.

Glock's rise and gun control

http://www.npr.org/2013/02/01/170752391/how-the-glock-became-americas-weapon-of-choice

This is an older interview, but related to the gun control debate now. Technically speaking Glock is an excellent firearm vs. its early peers, but its marketing was leaps and bounds ahead:

- They fed on the negative press that Glocks were the weapon of choice of terrorists and bad people (if those hardened killers choose Glock, maybe I should too!).

- They made overtures to Hollywood armories to make sure Glocks got exposure in big time TV/movies like "Law and Order" (and unintentionally in many rap songs).

- Around the time the Glock was invented, cops were using old S&W revolvers and the military was using heavy Colt 1911-like automatics. The Glock was futuristic looking, with a sensitive trigger, made of plastic, and with no external safety. People were skeptical about using it. The genius of the Glock is that it is super-reliable, super-simple design, and made in a very efficient manufacturing process. Their original idea was to leverage that cost advantage to sell cheap and undercut rivals. But then they decided on a premium price, in order to signal to customers that it wasn't a flimsy plastic toy gun - it was in fact a premium, high-performance, superior gun. Though for hesitant police departments, Glock basically had a "name your price" + trade-in policy (subsidized by superior margins to the public). Cops were also motivated to get Glocks because they were tired of being outgunned by criminals with them. So this strategy got them impressive market share, and got the gun double exposure from the "good guy" cops and the "bad guy" crooks.

Here's the gun control side of the story. Glocks were made to accommodate a variety of magazines, some as high as 30 rounds. The gun control community were very opposed to Glocks, and looked foolish after they claimed that the plastic gun would get through airport security (half of the gun is still metal, and its outline would be obvious in an X-ray). But they got momentum after the Killeen, TX mass shooting (the worst in US history at the time) where the perpetrator used a Glock and other firearms. So capping magazine capacity was part of the assault weapons ban, though not retroactive (i.e. existing guns would be grandfathered). Legislation is slow and Glock anticipated this change, so for years prior their plants were pumping out a ton of Glocks and large mags. They sold like hotcakes leading up to the ban, in some cases at 3X higher prices than before Killeen. I guess like the AR-15 now. 

Glock was also the punching bag for many police departments, despite being their supplier. They employed a controversial practice of "trading in". In order to drive more sales, Glock reps would reach out to PDs and offer to buy their old guns in exchange for new, better Glocks (sometime every 1-2 years). PDs agreed, and then Glock would sell those used guns on the secondary market. Of course some of those guns got in the hands of criminals. Cops were blaming (and even suing) Glock for "flooding the streets" with guns, but where did those guns come from - the holsters of cops! If PDs resisted the urge to get the latest-and-greatest guns (subsidized by their current guns), then the problem could have been much reduced. They could have mandated that Glock melt down their old guns and sell them as scrap instead.

Obama's bad bet on the sequester strategy

Jack Lew [BHO's Chief of Staff and possibly next Treasury Sec.] said we have an idea for a trigger. And Harry Reid, the Democratic leader asked skeptically, what's the idea. And Lew said, sequestration. Reid bent down and put his head between his knees almost as if he was going to throw up or was having a heart attack. - Bob Woodward on NPR (he wrote a book about the budget battle)

http://www.npr.org/2013/02/11/171737558/republicans-push-to-rebrand-automatic-spending-cuts-as-deadline-nears
http://www.npr.org/2013/02/15/172078615/automatic-budget-cuts-near-as-democrats-gop-stand-firm

The Dems really need to read The Art of War and Game Theory stuff like this: http://artofstrategy.net/, because their strategy continues to suck! As you probably know by now, contrary to our assumptions the idea of sequestration (mandatory across-the-board budget cuts) originated in the Obama White House, from Jack Lew (and was later passed in a bipartisan vote by Congress). Their belief was the seq. would be so repugnant that even the most intransigent Republicans would agree to some tax increases to cut the deficit. Gross miscalculation! It shows they don't know the other party (or their own) very well.

Rule #1 of making good threats/punishments is to actually make sure that your threat/punishment is the absolute worst thing imaginable among your rival's plausible outcomes. Otherwise why the heck would he/she be motivated to avoid it by making a deal? Now for *sane* Republicans, the seq. is a nearly worst choice due to its harsh cuts to defense and loss of federal funds for their districts (FYI the seq. is constitutional and not a new idea, but it just has never been implemented in modern history, if ever). But the House is not totally comprised of sane, conscientious GOPers. Due to GOP-led gerrymandering, you have even more ultra-safe ultra-red districts. While the constituents there may be a mix of deficit hawks and people who might get mad about less federal dollars flowing in, their representatives have great job security and no reason to be less conservative. Much of the TP and many safe GOPers actually WANT the seq. to happen. So Obama served it up to them on a platter, and now they have all the leverage because they have no "stick" to fear from the seq. This has also caused a problem for Boehner and less-extreme GOPers (the few of them left), who may face a lot of voter (and corporate donor) ire if they let these cuts happen. It's a disaster for the Dems obviously. Yeah another lesson in punishment - make sure your idea hurts your rival more than you!

The folks in DC made matters worse by the fiscal cliff deal they crafted - which was mostly tax "increases" (and some tax breaks/pork to get the required votes - like the NASCAR and tuna industry exceptions), with no major spending cuts. That further motivates the pro-seq. crowd to stick to their guns because they haven't been appeased with major spending cuts so far. It's a cluster F.

When negotiating with folks whose #1 priority is to irrationally cut taxes and spending as much as possible, you can't scare them with spending cuts (a 3rd grader knows that). What do they fear instead - losing their jobs, losing their pay, and tax/spending INCREASES. What Obama and Lew should have done instead of proposing the seq. was to replace it with a "stick" like this: if they don't come up with a budget deal that is a mix of "reasonable" spending cuts and tax increases, then the following will happen:

- Irreversible loss of pay to Congress and their staff
- Irreversible loss of future benefits and pension
- Garnishing of their re-election funds and party PACs towards deficit reduction
- Expiration of tax cuts and maybe some tax increases
- Increases in as much legal, extra-Congressional discretionary spending as possible

That stuff should make any deficit hawk and teabagger quake in his/her boots, right? Probably a lot of that is unconstitutional, but come on, they can come up with something that could actually scare. Brinksmanship is getting you and your rival as close to oblivion as necessary in order to force a compromise. It is even more effective when you are not quite sure how close to oblivion you actually are (so you are forced to play it safer). The "stick" would be even better if the amounts of tax and spending increases was determined by a random-number-generator (over a reasonably large and painful range of #s), so there would be no way for the deficit hawks to zero in on how bad it could be. Of course it takes a lot of cojones to pull this stuff off, and there is a chance it will blow up in your face. But at least it's better than giving your rival exactly what he wants.

The biological consequences of stress

Ironically I saw this program while on vacation in a very stress free place (see attached photo):

http://www.pbs.org/programs/killer-stress/

http://en.wikipedia.org/wiki/Whitehall_Study

Maybe some of you have read into this stuff already. I wish I took a class from that Sapolsky prof. - his beard is badass (and he's super smart of course). Recently science has found a simple way to measure how much your body is aging - the length of your telomeres (structures connected to your chromosomes). The more times your cells divide, the shorter the telomeres get, and the closer your cells are to "death" (cells can only divide a finite # of times). Not sure how that relates to physical death, but older cells generally don't perform as well. As you would expect, stress increases the rate of telomere shortening. The doc is from NatGeo, but I think they were a bit fast and loose with their conclusions based on what limited data they provided. However, they did a study of Marin County moms who take care of disabled kids vs. moms with non-disabled kids. The former group had shorter telomeres (on average 6 years older than their calendar age) and complained about more health issues. We know that conception is less likely for couples under stress, but apparently stress can also affect fetal development. This part was a little sketchy, but they did a survey of Dutch children born during a terrible famine under Nazi occupation. Their moms were likely under a lot of stress. The kids are now elderly, and they reported higher incidence of chronic illness and emotional problems. I am not sure if that difference is statistically significant vs. peers, but I do believe that an expecting mom under stress probably isn't a good thing.

Also related to stress and health outcomes is your work environment. The UK performed a study on public workers and found that the mortality rates of low-level workers were 3X higher than upper managers (mostly driven by cardio health). Of course job level may correlate with amount of vacation time/financial security, and a multitude of factors are likely at play (socioeconomic background, education, diet, etc.), but not sure if they controlled for those. The theory is that the stress imposed by lack of empowerment & control, and managerial pressure have negative impacts on your biology. So yes, your boss may in fact be killing you. :)

The workplace and social hierarchy stuff ties into Sapolsky's research on baboon colonies. They are evolutionarily fit creatures (despite having bright red faces and butts), so they have about 9 hours of free time per day when they're not hunting and sleeping. They use that time to either torment each other or build social bonds. The "alpha asshole" baboons were dominant and often harassed the others to maintain their social positions. The beta baboons were marginalized. Just like middle school or the office. The alphas get first dibs on food of course, but for one colony it was bad because they happened to dine on diseased meat in the garbage of a human settlement. So all the alphas died. The betas then "took over". Did they become jerk alphas in their place? Nope, they maintained their submissive, "nice" ways. The colony on average spent less time fighting and more time grooming (a primate form of relaxation and bonding). They lived longer and looked healthier. And they propagated these traits to the next generation, so the colony continues to be more Utopian than others. If they can do it, what is our excuse? Maybe we need to get rid of all the assholes, for everyone's health? :)

Of course a lot of stress is self-imposed. So I think we have to say enough is enough and learn to let go. I definitely need to. It's not worth killing yourself over.

----------

conclusion:  we should take out all of the assholes?  do you think this cop in LA may be doing what is best for society?  maybe alot of these massacre killers are highly evolved and trying to move us to the next level by getting rid of what they perceive as the alphas? hey, someone had to say it.

----------

That is basically the plot of this Angelina Jolie movie from a while back: http://en.wikipedia.org/wiki/Wanted_%282008_film%29

These elite hitmen use a magic device to get the names of bad people that they need to whack in order for the world to keep going. But things turn south when the device gives them their own names. DUN DUN DUN!! (I could narrate trailers if I had a deeper voice).

Well, the mass killers in CO and CT targeted innocents, not "assholes". I am not sure what is going on with the LA case, but I am sure that cop had some legit injustices inflicted upon him. Civilized people are just not permitted to use violence for revenge, even if we're persecuted by assholes. Religions say that we'll be rewarded in the afterlife for our tolerance. I sure as heck hope so. Bullies are the worst scum of the earth, but we can't beat them with violence or we may become then. Some would say we have to make exceptions for people like Hitler, but it's a slippery slope (i.e. did we have to firebomb Dresden to stop Hitler, who was clearly going to lose by late 1943?).

LOL: "they also shot another guy they thought was dorner....he looked just like him, but he was about 100lbs. less than dorner and he was white." Yeah it gets bad when a guy targets cop families. They all get itchy trigger fingers and circle the wagons. It's interesting that they are making absolutely ZERO effort to resolve this peacefully. Some other mass killers surrendered when the cops came. Something can be worked out of they give it a serious effort. But they are out for blood now, even if it's unconstitutional. Hell that whole Constitution thing didn't stop Obama and his drones. And he was the "nice" choice for president.

Instead of resorting to violence to enforce justice, our societies need to learn to change priorities and incentives. Now we reward asshole behavior and basically punish nice behavior. We have to flip that on its head (some "primitive" societies already do - but we look down on them), but good luck when it's the assholes making the rules and the $. It's the human effing condition. But like Sapolsky said - ditch this BS and live in rural Africa. He felt truly happier and healthier when he was there and can't wait to go back. The French expats I met in Polynesia look happy and healthy too. They married nice island girls and take tourists on snorkel trips every day. Now who is the alpha dog?

----------

show me one supposed cop killer that is taken alive.  it ain't gonna happen.  also, there is no real evidence tying him to the killings of that cop's family members.  we'll never know the truth b/c this guy is dead.  they will never let him say another word and he sure as shit will not see the inside of a courthouse.

some north american native tribe used to react to antisocial behavior by bringing everyone closer to the person. it was the tribe's responsibility collectively for the tribe's behavior.  just seems the zero tolerance/punitive response isn't working real well....

and, i've seen those ex-pats.  certainly looks like a nice life....stress is greatly reduced.

-----------

Yeah I agree with that, it's Wild West "justice" for the LAPD and other such orgs when they feel the blue line has been crossed.

That is a good point about the Native American collective remedy to antisocial behavior. In the US, we celebrate some sociopaths (athletes, Hollywood, financiers, etc.), and ostracize others (to institutions, prisons, the streets, etc.). It's a billion-dollar industry to segregate people in America. Maybe it has to do with our ultra-individualistic mentality and culture vs. more "social" societies. Hehe I guess that makes us an antisocial society. Though a prof recently told me that the US is not the most individualistic culture... that is actually Israel. Not sure how it was measured, but in that study it was more about defiance of authority rather than collective problem solving. But clearly the East Asian, Latino, and African cultures are much more collectivist than ours.

PS - speaking of "Latino", with the immigration debate going on, I am just so tired of the word "Hispanic". That is the stupidest name ever - totally artificial and irrelevant to everyone but Columbus. I was told that the Reagan admin. popularized it, but not sure if that is true. To me it's worse than "Oriental", which personally I don't find offensive at all. It sounds exotic. :)