Message from the Regent - 2010

Hawaii/Pacific Regent's Message, 2010
Aloha Hawaii-Pacific Chapter members,
I've often wondered, even after 30 years in the healthcare field, "when and what were the good ol' days like?” Was it way back in the 1970s before DRGs and managed care and RACs? Was it even before that when new therapies were being discovered like antibiotics, antisepsis, and open heart surgery? It is natural as human beings to long for something in the past. But I suggest that, as Carly Simon said, "These are the good ole days!" (Of course she sang that song about 30 years ago, so you could argue that those were the good ole days, but that defeats my point!)
Why is TODAY the good ole days of healthcare? Well, if you look at some of the signals, you'd think I'm crazy! Considering the rising cost of healthcare, the number of uninsured, the unbelievable burden of regulation, it might seem a little bleak. But, consider these facts too. We are riding the wave of unprecedented quality and safety improvements. Through projects like core measures, IHI 5 Million Lives Campaign, national patient safety goals, surgical care improvement program, we are saving more lives than ever before. Our current technology leaves the processes of the past in oblivion. I remember (yes I've been around that long) when a heart attack was catastrophic almost every time. Before thrombolytics and stenting you either died on the spot or suffered for weeks on drips and ventilators only to hope for survival. And then, you were on high powered antiarrhythmics, needed an AICD or both, and were still likely to suffer lifelong heart failure. Not to mention amazing advances in cancer treatment and minimally invasive surgery. And, what about genomics? We barely know what promise that holds for the future! 
Yes, it is a privilege to be a healthcare leader in the 21st century. I just hope that we keep up the momentum so that we hand off even better quality and safety to our successors in the future. Yes, these ARE the good ole days!

Kevin A. Roberts, FACHE
Regent, Hawaii-Pacific

Hawaii Congressional Candidates Speak On Healthcare Reform

(Taken from an article by Derrick DePledge, Honolulu Advertiser, March 4, 2010).

Former congressman, Ed Case and State Senate President Colleen Hanabusa are enclined to support President Obama's healthcare reform plan if elected to Congress, but Honolulu City Councilman Charles Djou believes the president and federal lawmakers should start over with a clean slate. The three candidates in the May 22 special election in urban Honolulu's 1st Congressional District discussed healthcare reform last night at a forum sponsored by the American College of Healthcare Executives Hawaii-Pacific Chapter at the Hawaii Prince Hotel in Waikiki. Obama...asked Congress to vote within weeks on a reform plan to expand coverage to the uninsured, contain rising medical costs and waste and reduce the federal deficit.

George Greene, president and chief executive officer of the Healthcare Association of Hawaii,...asked the candidates if they would vote for the plan if it includes, as expected, three provisions that could benefit Hawaii:

   *$100 million over 10 years to help local hospitals treat people under Quest, the state's version of Medicaid, the federal health insurance program for the poor and disabled.

   *An exemption for the state's Prepaid Health Care Act of 1974, which requires businesses to provide insurance to employees who work more than 20 hours per week.

   * A study on the geographic variation of federal reimbursements under Medicare, the federal health insurance program for the elderly, which could lead to higher payments to healthcare providers in the islands.

     Case, a Democrat, said he supports all three provisions for Hawaii and Obama's recent suggestions to include ideas such as expanding medical savings accounts and funding state demonstration projects on medical malpractice insurance reform like health courts. But he said he could not say for sure how he would vote until he sees what is in the final bill. He also said he would reject the bill if he thought it was bad for the nation, even if it contained provisions beneficial to Hawaii.

    Hanabusa, a Democrat, said she also supports the provisions for Hawaii, particularly the preservation of the Prepaid Health Care Act, a landmark that has placed Hawaii among the leading states nationally in healthcare coverage. "We shouldn't lose anything in the process," Hanabusa said.

    Djou, a Republican, described the way the reform plan has evolved as "extraordinarily ugly" and said it should be rewritten without the incentives added for states to help win passage in Congress. "If this national proposal is so good, why does Hawaii need an exemption?" Djou said. "And if it isn't so good, then, of course, you need to push some form of exemption in there. But then, are you willing to stomach all the other exemptions, all the special kickbacks and favors, for all the other states that they want?"

     Case and Hanabusa also said they would support the U.S. Senate moving the reform plan by reconcilliation, a procedure used on budget matters that requires a majority vote for passage instead of the supermajority needed to break a fillibuster.  Djou said he opposed reconcilliation because it would confrlict with Obama's own goal that the reform plan achieve bipartisan support.

     The special election is to fill out the remainder of former congressman Neil Abercrombie's term.  Abercrombie campaign in the Democratic primary for governor. 

Make Listening a Key Component of Your Leadership Strategy

Successful leaders don’t talk all the time; they pay close and constant attention to the people they want to influence. If you want to do a better job of leading people, start by becoming the kind of leader your staff feel comfortable talking to. Here are some guidelines:

  • Ask good questions. The best questions generate detailed answers and thorough discussions. Instead of telling people what you want them to do, ask them what they think they should do and why. Listen before you speak, and then ask more questions that explore their thinking.
  • Don’t solve problems for people. Your staff will bring you problems and ask you what to do. Resist the impulse to tell them, or to handle the problem yourself. Instead talk about what caused the problem, explore options, and—again—listen to ideas. Even if the solution ultimately comes from your head, people will feel better about putting it to work knowing they had a fair chance to share their opinions.
  •  Pay attention to feelings. You don’t have to be a psychologist to understand and take into account the emotions of your employees. Let people vent when they’re upset. Acknowledge their anger when they feel they’ve been treated unfairly. Smile when they make a joke. You may not agree with their feelings, but you do need to validate them.
  •  Look forward, not back. Always steer your discussions toward the future. Avoid dwelling on past mistakes or last year’s triumphs. Don’t ignore the lessons of experience; instead, take a long-term perspective that motivates people to move forward.

Adapted from Communication Solutions, July 2009, (800) 878-5331.

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