Paul S. Cheng 1932-2015

Paul Cheng Obit

I felt compelled to write something given the swirl of emotions recently.  When a mentor passes on, how can one not?  For most the 1980's, I worked in an IBM Advanced Office Technology group in the Washington DC area.  This was an amazing growth opportunity for me in several ways.  This was a small group that basically wrote our own rules and determined to a high degree what we worked on.  The leader of this group, basically was running a startup within IBM.  The early 80's was the boom time for IBM PC and applications.  This group had produced a best of breed dictionary technology.  All the IBM platforms wanted this, but we couldn't "sell it" to them, but, they could sponsor headcount and that would be used to supply the technology.  So, we would ask for like 4 headcount, but it would only take .5 to do the work.  So, suddenly, we had this extra headcount to work on, well, stuff.  Unfortunately, when the first PC crash happened in the mid 80's, we found out those authorizations weren't worth the toner used to print them.  Funky accounting in IBM, headcount only mattered at the end of the year.  So, using these authorizations, we could push the books during the year even with our core division gave us 10 headcount and we had 20 working.  But, when the books closed, the numbers had to balance.  When the books closed, the other divisions, especially PC, refused the authorization, and basically ended up with, can you spell audit?

We were doing touch screen hardware, advanced graphics, image decoding, and of course our bread and butter, linguistics. As they grew, I was a bit of an experiment for them.  I was the only one without an advanced degree, and the only one with a lower IBM title at the time.  But, this was the arena where I did my first real professional growth.

Ironically, our management chain was the group that produced the old mainframe terminals (3270's for all those with real morbid curiosities), and since they were kind of our boss, and they could see the future with PCs, they were fighting tooth and nail to preserve their business case (and I was the one without the advanced degree?)

So, in another great pursuit, we were instructed to produce an application that would showcase our technology and exploit the features of  every terminal, scanner, printer, etc in their arsenal.  The result, we produced a WYSIWYG (what you see is what you get) word processor for these devices.  Never mind that we really couldn't do this explicitly, but we did a really good job and our print previews were stellar.  We also supported every font, and had image and graphics when most pc's had neither the hardware, memory, or applications support for these.

So, a small cadre of us were starting this up and then one day, this guy shows up (Paul) and after a few repeats we understood he was our new boss.  Things were never the same.  To this day I still don't know how he was found or found us, but it was to our advantage.

Paul had been around the block with IBM, and he know how to exploit (re circumvent) every IBM process known.  He fit right in, and we learned a lot about how to get things done with a minimal staff doing things this way.

Paul is the only person I ever met who said they were from Formosa (look it up).  He never really lost his accent, so it was a bit before we all really understood each other.  Took even longer for us real tech types to get the hint on how he could work the politics. But that was one of our advantages, and disadvantages.  As I said many times, the best thing about Paul is that he could go into a meeting with a bunch of execs who might not have been real happy, and they left thinking they heard exactly what they wanted to hear.  The disadvantage, Paul could go into a meeting with a bunch of execs who might not have been real happy, and they left thinking they heard exactly what they wanted to hear.

For those who have worked with me over the last 20 years, you may have wondered where all my absurd sayings came from, it all started with Paul.  His best one, which he repeated many times was on strategy.  He compared it to how a China-man (there were lots of China-men examples) eats from a rice bowl.  He doesn't have the bowl on the table, he brings the bowl up to his mouth and pushes the rice in, while all the time looking beyond the bowl to see what else in on the table.  Always look to the future, have you next move ready.

Chinese new years was always a special time. He would round up a large group and we would meet a some obscure Chinese restaurant.  He would order, and we didn't have a clue, but the staff sure did and they hopped on like he was a general in the military.  He was at the height of his game, you could see it in his face.  Those were the moments I saw where he enjoying on what he had built of his life, and that was the moment, family, friends, and success.  Not bad for a guy from Formosa.

I had to leave the DC for personal reasons in the late 80's and lost touch with Paul.  Not too long ago, thru the joy of Facebook, his wife and I became friends and started communicating again.  By this time, Paul was rather ill and as said, recently his time came.  Even thou it had been some time since we last talked, when the word of his passing came, I felt the loss inside of me, a part of me was always with what he gave me.  And as such,  I felt compelled to write something given the swirl of emotions recently.  When a mentor passes on, how can one not?

Ken's Rule #2 for Controlling Health Care Costs

With many of the organizations I have volunteered with, significant focus is on  the Triple Aim regarding Health Care Reform.  These are:

1. Improve the experience
2. More cost effectiveness
3. Improve the overall population health.

This second item has been the focus of much debate over the last 6 years, and from my experience, here are my top three to address costs:

1. Personal Responsibility
2. Address last 6 months of life
3. Providers must come to term in understanding their costs.

So, lets talk about addressing the last 6 months of life.  We all are mortal, and no matter how advanced our medical knowledge is, everyone's time does come.  So, how do we address our final days?  Part of the background of this country is so much based on the personal aspect, by default we expect opt in vs opt out.  All you have to do is look at the ACA debate on how dare the government force me to have insurance, that is my choice.  Not focusing on the discussion here, but think about provide for the common good.

But, part of that debate focused on Medicare to reimburse doctors to discuss end of life options with patients.  IMHO, a great disservice was done to this country with the inflated death panel label. Reason being, since we have to opt in, the percentage of us who have medical directives and wishes, very low.  Therefore, hospitals must do everything they can to keep patients alive.  Additionally, since no plans were put in place, there is then confusion as to who has the right to make decisions for the patient who at that point, can't.

That is why this article caught my eye.  Tackling tough decisions end of life scenario  We spend way too much money in these end of life scenarios without helping to patient with quality of life and dignity.

If you have not setup your directives, hopefully after reading this article you may change your mind.

Ken

Get the best people on the bus ...

In my MBA program, the very first class was on Leadership and company greatness.  In that class, the very first textbook was Jim Collins Good to Great. ( Jim Collins Article) The concepts presented in that book were reiterated over and over again during the MBA program.  OK, got the hint, and the challenge to take it out of the classroom and into implementation.

This would not be limited to corporate, but is generic in nature and can be applied really to any organization.  The base concept:

The executives who ignited the transformation from good to great did not first figure out where to drive the bus and then get the people to take it there.  No, they first first got the right people on the bus and then figured out to drive it.

I have been working with AARP Minnesota for several years as a volunteer on advocacy issues.  This was mainly driven from what I learned the hard way about our health care system over the last 9 years.  This year, the interviewed many people for an Executive Council and, I have been asked to join.

AARP Minnesota appoints executive council

When I look at the other members, this is rather humbling, and exciting.  I can't wait for us all to moving this forward.  So, by acclamation, sure looks like we got the best people on the bus !!!

Works for me ...

HBR: Meditating Helps Make Better Decisions

Well, surprise surprise surprise.  Actually not really.  One of the smartest things I did in my early college days (aside from actually making it to graduation!) was to learn how to meditate.  This has also been presented as TM (Transcendental Meditation)  I still meditate today, although never as much as I should.  I have been through a lot in my life, meditation has been one way I have managed to cope. However, this actually is rather simple, natural with no smoke and mirrors involved as this table shows.

	Physically Awake	Physically Asleep
Mentally Awake	Conscious	Meditating
Mentally Asleep	Day Dreaming	Sleeping

 

You can be physically awake or asleep.  Your mind can be either awake or asleep.  When both are awake or asleep, the result is rather obvious.  It is when they differ things get interesting.  We all have experience with daydreaming.  We know we are not physically asleep, but from a mindset standpoint, who knows where we are.  Meditation is just the converse of daydreaming, mentally awake and physically asleep.  Ever had the situation where you are trying to fall asleep and feel as though you are sinking into the mattress but your mind is very active?  You have then found the natural state of meditation. 

In this stressful lifestyle we have found ourselves in, is it asking too much to find 15-20 minutes twice a day to find a quiet comfortable spot and let a natural healing aspect take over your mind and body?  As shown by the study cited above, this will also make some good business sense.  You Type A people out there, are you listening?

For more information, see  http://en.wikipedia.org/wiki/The_Relaxation_Response

No Direction Home

My apologies to Bob Dylan, but need to drive the point home.  I noticed this reporting on NPR:
 
NPR: doctors hesitate to ask heart patients about end of life plans

This flies in the face of everything I have encountered and learned over the course of personal and professional knowledge regarding Health Care Reform.  #hcr

Here is Ken's top 3 actions we need to take to get control of costs and efficiency for Health Care in the US:

1. Personal Responsibility
   Whatever happened to us as individuals that we no longer take responsibility for our actions and stand up to fix them?  I will expand on this topic in a future blog post, but here is something to think about.  We know that people who are obese over their lifetime will cost on average $13K/year more in health care costs than a non-obese person. 
   
   This is not very hard to understand.  Consider that likelihood of Diabetes, Health Disease, and increased need for hip and knee replacements.  These cost add up fast.  However, people who fall into this category do not pay more in premiums, that cost is distributed to all of us.  Therefore, all costs are driven higher unnecessarily.  So, a lot of talk these days, but we have not come to terms with the impact of this issue, why not? 
   
   Another example, we know in the state of MN, the cost the state pays dealing with smoking related illness comes to $554/year per person.  Not voter, or taxpayer, per person.  Yet, for all the progress made in this area, there was great opposition recently when the legislature wanted to raise the cigarette tax.  The reason, it would cost jobs at convenient stores and gas station?  How many jobs are being lost because living within our budgets, we can't invest appropriately in infrastructure and other items to create more jobs in the state because we give medical welfare to smokers? 
   
   Get my point?
   
2. Dealing with last 6 months of life.
   Bingo, this is why the NPR article hit home.  Unlike many other countries in the world, in the US we have to opt in to things rather than opt out.  If someone does not have a living will or other plans, then by default we go to extraordinary efforts to keep them alive.  We increase the quantity of life while throwing out the quality of life in many situations. 
   
   Remember during the ACA (ObamaCare) discussions the whole scar tactic of the government wants to kill Grandma?  Yep, keep fear alive, and by the way, we won't compensate via Medicare for Doctors to have the up front discussion for people to plan their end of life with dignity.  The costs here are staggering, for example: CNN Cutting the high cost of end of life care
   Therefore, time to us as a society to grow up and deal with death.  Hello, news flash we all are going to die, accept it and stand up how you want your final days to be.  Tubed up in a hospital, or, maybe at home with family?  If we don't opt in and put plans in place, prepare to tube up.  We can't tip toe around this anymore with the "Silver Tsunami" coming down the pike.  The important aspect here is for our politicians to step up on this topic before they just blindly go and pull back on benefits and cut these budgets.  Like many businesses out there, afraid to resolve the process issues to save money, just cut travel budgets, headcount etc.  Short term fixes because the core issue on whats wrong has not been addressed. 
   
3. Hospitals need to address their costs
   I have spent over two years working in the arena of Activity Based Costing for health care providers.  Wow, what a shock this was to me.  Go ahead and ask a hospital a simple question like, what is your cost for a CT of the abdomen?  They don't know.  They might know parts of it, but not the total cost.  Ask a car manufacturer in Detroit what was their cost for a car, you will get an answer to tenths of a cent. 
   
   Now, calm down, I'm not saying people are just a manufacturing line, but there is a corollary here.  Back to the CT, a simple workflow process would be Schedule-Checkin-Triage(maybe contrast or IV)-Scan-Interpret-Document.  It is a process ending up with a specific outcome of an interpretation of the scan.
   
   Now, for all these steps, consider the costs for labor, equipment, supplies, overhead items, the providers can't put their fingers on all of these components.  Bottom line, they don't know the actual cost.  All of that data is manged through a plethora of IT systems that don't talk to each other.  So, how do they know if they are making a profit or losing money?  That aside, the hospitals don't control reimbursement for these events, the government (Medicare) & Insurance companies do. 
   
   By the way, Medicare reimbursement will be declining at the same time patient numbers will be increasing.  Simple question, if we want to be more efficient to manage our resources better while not effecting outcome of procedures, why don't we understand this? 

Humbly submitted as food for thought ...

"This is so simple an 8th grader could figure it out. Go find me an 8th grader I can't make heads or tails out of it" Groucho Marx

http://knowledge.wharton.upenn.edu/article/corporate-tax-avoidance-can-the-system-be-fixed/

So, I stumbled across this article and figured, gee, this should be simple enough.  I have a lot of business experience, have a MBA,  fairly intelligent person, no problem.  For a while I understood it. But as more and more borders were crossed things became fuzzier and fuzzier.

I can understand this much, lots of US Corporate money is not being invested here.  From this article, it appears there is a lot of money that needs to be repatriated, which can only be a good thing.  The other item I understand is the tax rate.  I have heard so many times about the US having the highest business tax rate.  That is not good.  I also hear that few if any corporations pay that rate because of the loopholes and things such as outlined in this article.

From my research and statements by some of my MBA professors, Hong Kong is simple.  19% tax on profits, no games.  Gee, maybe even an 8th grader could figure that one out.

Therefore, here is another item for our do nothing overpaid congress, most of you act like you are in 8th grade, so why not make it simple enough for all of you to understand.  If you can get it, I'm sure the rest of use will do just fine ...

Not A Positive Trend

From the Harvard Business Review:

December 26, 2013

Students Get Lower Grades in Online Courses

Although students who take online courses in community colleges tend to be better prepared and more motivated than their classmates, a study by Di Xu and Shanna Smith Jaggars of Columbia University shows that the online format has a significant negative impact on students’ persistence in sticking with courses and on their course grades. For the typical student, taking a course online rather than in person would decrease his or her likelihood of course persistence by 7 percentage points, and if the student continued to the end of the course, would lower his or her final grade by more than 0.3 points on a 4-point scale. Before expanding online courses, colleges need to improve students’ time-management and independent-learning skills, the researchers say.

SOURCE: The impact of online learning on students’ course outcomes: Evidence from a large community and technical college system

Personally I have never been a fan of online or even remote classrooms.  I first encountered this concept back in the early 80's taking some Master level Computer Science classes thru the U of Minn remote hooked that IBM supplied.  That never really worked for me.

Blogging and online forums do have their place, obviously ☺.  However, when I went for my MBA a few years ago, to me there was no compromising on having classroom instruction.  The level of discussion in a classroom cannot compare at all to that which occurs in an online discussion.  I also have made friends and professional contacts that would be much harder to accomplish online.

Of course, with this study good to see that I also achieved much more than online as well ...