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What's in Store for Obamacare?

November 11, 2016
The election upset took most of us by surprise. Given the tenor of the lead up to the election and Republican control of Congress, the healthcare space sees Obamacare squarely in the crosshairs.
In the broader public’s mind, Obamacare or the Affordable Care Act is viewed mostly as the individual mandate, exchanges, and certain provisions that impact coverage like pre-existing conditions and adult children remaining covered through a parent’s insurance. The ACA is much more than just these items. It was intended to be a massive shift in how healthcare is financed and managed. And like any public policy, especially one that is trying to manage $3T or so in spending, the ACA was in need of serious adjustments. The high profile problems with the exchange business would have to be tackled regardless of who was elected. 
While it’s impossible to predict how it will ultimately play out, here’s my take.
Some modifications to individual insurance, but mostly status quo What will…

A slightly dated list of places to check out in New Orleans

All of these distances apply if you are staying in or around the Marigny, which I believe is an ideal location to experience the city.
Marigny – Triangle(very close to you) Spotted Cat – great music club, little or no cover, great dancing Dba – cocktail lounge with cool New Orleans bands La Peniche Horn's – a fine update of an iconic location with good breakfasts by the Slim Goodies people. Snug Harbor – Burgers as big as your head
Marigny – Rectangle(a cheap cab ride/Uber away - <$8) Mimi’s in the Marigny (Bar-upstairs they serve tapas and have great bands play in an intimate setting)1 Orange Couch – Great coffee shop and an easy walk from Royal Street Inn.  During the day, the neighborhood is a visual delight2
French Quarter Coop’s – Dive bar with a great kitchen of classic food.  Oyster po-boys.3 Cosimo’s – What a bar in the French Quarter should be.  Local, chill and affordable4 Molly’s on the Market – bar with a great jukebox, people watching.  Check out the frozen Irish Coffee.  This…

Managing Through Plateaus and Disappointment

This is the hardest thing I struggle with. And I struggle with many things. I'm constantly amazed at how feedback (or the lack of it) drastically impacts me. I'm very motivated by positive feedback in general and very demotivated by a lack of feedback. I’m actually slightly less demotivated by feedback poorly given. 

So, I take this as a challenge to me. Of course, I can complain about the delivery or quality of the feedback, but it seems more constructive to inoculate myself to it, especially when it comes from those with whom I disagree with or don’t share their perspective. The best feedback comes from those who a) have actually viewed what I've done over time and don't rely on one sample, b) give me meaningful points to build on and finally c) have struggled to build skills themselves versus having some degree of natural aptitude or demonstrating that they indeed need to practice. 

But the problem is being too driven by feedback, good or bad. That means you are looki…

Autonomy

I read an interesting study the other day. I say “interesting” in this case because it confirmed my instincts. The study was a way of measuring how much people crave power and exactly what they want from it. In sum, the study found that most people don't want to control others, but rather they want power so they have autonomy, i.e. they get to control themselves. I've thought about this for years.

While I would love to have a VP title to round out my resume, I have not wanted to be anyone's boss in a long time. I like the prestige that can be conferred by the title, the possible perks and greater autonomy, but I don't necessarily want to tell others what to do. My experience managing 50 people when I was in my 20’s was a lesson I learned well. In fact, I am now suspicious of anyone who actually wants to be a boss. That's not to say that I don't like being a coach and helper to my colleagues. I often enjoy these types of positive engagements with people and I cr…

Know Yourself

Here are some things that I know about myself. I learned them through some type of quantification, either formal or informal.


My average weight over the past three years has been 151 poundsI can subsist on 24oz per day of water, assuming moderate physical activity and 80-85 degrees temperatureI can survive for 3-4 days with no food with minimal impact to my energy or mood.I typically sleep 7.5 hours per night. I almost always wake up at 5:30 AM. My mental state suffers at less than 6 hours of sleep. The result is typically slower reaction time, mild depression and irritabilityWhen I travel, I sleep less. I am also more depressedMy stress behavior is typically to want to connect MORE, rather than less with others
What do you know about yourself? How do you use this information to be more self-aware and manage yourself more effectively?

Know your limits. Know what you can do with yourself. Test yourself before you're tested.

Focus

Yesterday was the last day of a weekend of baseball tournaments for this guy. Unfortunately, the team was bested by their opponents in a three hotly contested games. 

My son is a pretty good ballplayer. He makes up for his average athleticism with a good mind for the game and incredible powers of observation. 

What really amazes me is his absolute love of the game. After playing a hard game, his only wish besides eating the sandwich he had stuffed in his gear bag was to watch some other teams play. It wasn't watching the team he had just played, it was ANY game. So, after a long day, we sat in the stands and watched more games played by teams we've never heard of. Then we walked to another field where he could watch a team in his league play for the championship.

Hunger and baseball overload finally got the best of me and I made the suggestion that we go get some dinner. 

On our way out of the fields, a homerun baseball came flying over a fence. Santiago shagged it and ran it to t…

Sleep

Last night I tried to stay on top of my "sleep hygiene," namely turning off screens and going to bed on time with an appropriate amount of winding down time. While I didn't execute it perfectly, I did get seven and a half hours of some of the most blissful sleep I've gotten in a while. That makes for a good day all around. I have already banged out a workout and I'll do another one at lunch. Plus, my mood is so much better automatically. When I think of how chronically under rested we Americans are (and maybe all of us modern people - my sleep app shows that a lot of countries get even crappier sleep), it's pretty amazing we can get anything done.

Now, I will say that I think we want to avoid a slavish devotion to doing the same thing all the time. While generally getting a good nights sleep is good -and when you're in your late 40's, it's a freaking blessing every time it happens- I also think that we need to break patterns every now and again to …

Listening

In keeping with my alarmist postings about people being "checked out," I am thinking about the lack of good listening that goes on in my world. Probably yours too. How many times do you feel like someone is just keeping quiet while you are talking, waiting for the chance to insert what they were going to say, regardless of your point? How many times have you done this, if you're being honest with yourself? I'm a major offender myself. Oftentimes, I've thought up something witty and likely very relevant...to what was said five minutes earlier.

This week, along with practicing good sleep hygiene (damn you, Words with Friends!), I'm going to practice listening more and talking less. The challenge I have right now is that we're all competing for airtime and people are so used to being interrupted that they talk and talk and talk if no one busts in. My experiment will be to see how long it takes for someone to finish what they have to say and then hold my tongu…

Attention

Lately, I've been very alert to people who are checked out while doing their job. It's fairly obvious with people who have service jobs, or office workers. It's not always so apparent when I'm observing professionals with high requirements for safety: doctors, first responders, truck drivers, etc. But if at least some percentage of these folks are checked out (or distracted by their phones, their own thoughts or otherwise not fully present), this has incredible ramifications for the people they serve, i.e. all of us.

There is so much competing for our attention all the time. I'm certainly not immune. I'm one inch of finger movement away from checking Facebook RIGHT NOW. What if I'm driving a car at the same time? What if I should be making an important decision at work?

Pay attention.