Category Archives: Business

Good Idea Faeries

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Some of the most dangerous statements begin with the words, “All you have to do is . . . .”

This is the mark of a Good Idea Faerie. Their approach has a number of advantages:

  1. I get the responsibility off my shoulders and onto yours (sometimes referred to as “the monkey on your back,” or more crudely, “flipping a booger onto someone else.” If you’re disgusted–good.
  2. If you do it, I can take credit for it being my idea.
  3. If it doesn’t get done, I can say that I told you, but you wouldn’t listen.
  4. If it gets done, but fails, again I can say that I told you, but you wouldn’t listen.

Good Idea Faeries never lose.

There’s only one way to handle them. Respond with, “That’s a great idea!” as you take a notebook or smartphone out of your pocket and ask, “How long will it take you to do that? I’ve made a note of it for my calendar and will check with you periodically to see how you’re progressing. This will be great, and I can’t think of anyone better to make it happen. Thank you so much.” Look at your note, “How about I check back with you on [fill in the date].

At the first available opportunity, announce loudly to the rest of the group, “Hey, everybody! Let’s have a round of applause for [Insert Good Idea Faerie’s name here] who is going to [fill in their idea] and has committed to having it done by [insert date here].”

A word to the wise–don’t let them interrupt you while you’re doing this. If they try to, feign deafness, and just keep on talking.

Twenty-First Century Bare Knuckle Fighting

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The big thing today is bare-knuckle boxing–a throwback to the days when women were expected to stay home, and prohibited from voting; when horse manure in the street was normal and every house smelled like stale cigars, and brass spittoons (or tin cans for the less affluent) were standard furnishing.*

As a philosopher-at-large, I should claim that this was fully expected, but unfortunately, I was blinded by my faith in the human species. Sorry about that.

Honest disclosure–I never thought two people trying to beat each other up was entertainment. I was never a fan of schoolyard bullies, bar fights, gang fights, or boxing. I never watched professional wrestling–even though we all know it is choreographed ballet for muscle-bound males.

In any case, at a time in which everyone over the age of three has their own smartphone; when cars drive themselves with the same skill as humans (“Lookout, we’re gonna crash and die!”); we have suddenly become fascinated with 19th century sports.

Don’t get me wrong, The 19th century gave us many things, including, including some of the best paintings, sculpture, and literature. Fisticuffs, on the other hand, is not on my list of positive accomplishments.

However, we seem to have an overdeveloped fascination with beating one another senseless.

How weird is that?

* I remember the tin can behind the couch at my grandparents’ house—–yuck—–never mind.

An Appeal for Donations

 

Photo of a Collection Plate

CNN reports, “Jesse Duplantis, leader of Jesse Duplantis Ministries and the owner of three other private jets, is asking his followers to chip in so his ministry can purchase a brand new Dassault Falcon 7X, which runs about $54 million.”

I thought that televangelists were on the television, which would seem to mean that their physical location was immaterial, so long as a television studio was available. I believe that, in a pinch, this would include the camera and microphone built into most computers.

But then what do I know?

As the only world’s only Philosopher-without-Portfolio–to the best of my knowledge–I believe I am just as entitled to a personal aircraft as anyone else. However, my needs are far less prestigious. I’d be more than happy with a used Cessna 182, which is available for less than $500,000.

I expect everybody to give this their best effort.

However, if that proves to be too difficult for you, a boat–say a 30 foot cabin cruiser, might be more achievable. Again, used is fine. I can engage in philosophical thoughts in a used airplane or on a used boat without any difficulty.

There is one problem.

Jesse said that God wants him to have the new jet.

I asked God if He wanted me to have people collect money to provide me with a plane or a boat. He didn’t exactly say, “Yes,” but He apparently enjoyed a good laugh.

Magic with Numbers!

SONY DSC

Albert Einstein and Stephen Hawkins were rank amateurs because they were handicapped by their pathetic math skills.

The real math pros are accountants.

As the old joke goes:
A businessman needed to hire someone who knew math. For the interview, he had written on a white board “2 + 2 =.” The mathemetician wrote “4,” as did the physicist. When an acountant arrived, he looked at the whiteboard, locked the door, checked to make sure the window was locked, and pulled the curtains. He leaned close to the businessman and whispered,
“What do you want it to be?”

Creative accounting requires more mental gymnastics than figuring out how the universe began or will end. Here’s a great example:

Forestt Gump, the movie, cost $55 million dollars to produce. It earned nearly $680 BILLION, but according to the accountants, it lost money. Some of the contributors (like author Winston Groom) had agreed to a percentage of the net profits. However, since it never made a dime, their share was zero.

Let’s review the math:

$679,850,637,000
–        $55,000,000
             ZERO*
* After depreciation, marketing, amortization, title, and dealer preparation charges–and other “Generally Accepted Accounting Principles”.

I didn’t include taxes, because if it “lost money,” I’m not sure whether or not they had to pay any.

Albert Einstein and Stephen Hawking, eat your hearts out!

 

 

History Doesn’t Repeat

I heard a great comment on NPR’s Fresh Air the other day. I believe it might have been Jake Tapper, but since the quote is wrongly attributed to Mark Twain (Samuel Clemens nom de plum), if I attribute it wrongly, so be it.

The comment was, “History doesn’t repeat itself, but it rhymes.”

A day or so later I read that Ford was no longer going to manufacture sedans, but would focus on trucks and SUV or crossover vehicles that look like this:

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Ford Expedition 2019

It’s kind of interesting that Henry Ford’s vehicles started out looking like this,

 

Ford-Model-T-1

Ford Model T 1907-1927

eventually evolving into this.

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Ford Model A – 1927-1931

Notice any similarities in the body shapes? He might have been onto something a century or so ago.

Maybe Henry Ford’s design

Would repeat again, after a time.

The shape of his car proved to be fine,

And history, does–once again–rhyme.

Thought for Today

At times I think I would prefer to be a gentleman, in the old English sense, born into wealth and privilege with lands and a stately old home with gardeners taking care of the outside and an entire staff keeping the inside neat and tidy (including my teenagers’ bedrooms and bathroom).

estate 1

Maybe a little over the top, but you know what I mean.

I’d have to juggle my tennis match with other elites and various social engagements in order to make time to sign important papers to increase my wealth or to meet with important peers awaiting my sage advise.

No such luck. That is not how my day will unfold.

However, today I will not hide behind a spoofed telephone number on your caller ID to try to sell you a time-share condominium. I will not go around my store and relabel all the appliances, automobiles, or canned goods with a higher “Regular Price” so the same old “Sale Price” looks like a better deal. Nor will I be sending you an email to steal your money, your password, or your identity. I won’t pretend I’m a Nigerian Prince who needs your help to rescue my fortune or try to convince you that, based on a single poorly performed experiment, I can cure you of your chronic ills.

I’ll just go to work, then come home to my family.

Not to bad, really.

 

Teenagers Are Cheap?

As a newly acclaimed Philosopher-without-portfolio, I have taken my responsibilities seriously, to think about whatever needs to be thought about–without restrictions. I recently completed and submitted my income taxes. Naturally, that involves a great deal of thought, usually such things as, “I need something for my headache,” or “I don’t usually drink hard liquor, but it’s beginning to sound better and better.”

I use TurboTax, which is causes mixed feelings. Yes, it is helpful and yes, it’s about 1/10 the cost of having someone prepare it for me; however, it’s parent company, and all the companies that have anything to do with tax preparation, were the ones who lobbied (a polite term for hiring and unleashing high paid but unscrupulous experts) to prevent the simplification of the tax code. After all, if taxes were simple enough to submit on a post card, these people might have to get honest jobs.

But I digress (it’s a philosophical thing).

One of the many oddities in the tax code is the child tax credit. This is means you can reduce your federal tax by up to $1000 per child. The criteria include that the child lived with you, is your dependent, you paid for their support (food, clothing, etc.). It also requires that the child be younger than seventeen.

Now, I’ll reserve my opinion about politicians, the Internal Revenue Service, lobbyists, etc., but do they have any idea as to how costs change as a child gets older. I could clothe both my kids for a year for the same amount of money as I now spend on their shoes. Once they hit that magic age to get a driver’s license, auto insurance increases.

With two teenagers with drivers licenses I spend as much on car insurance in two years as what my first house cost. One of them is away at college, can’t have his car on campus, but since it’s less than 100 miles, the price stays the same. Add in the class photos, yearbooks, formal dances, etc., and those incidentals for college, like books, tuition, room and board, and you get the picture.

But someone has decided that kids must be cheaper after they turn 17 and included it in the tax code. They must be in one of those states where recreational marijuana is not only legal, but can be written off as a business expense.

Goodbye to the Newspaper

When I was growing up, almost everybody took the local newspaper. Many cities had several competing newspapers, although Toledo’s two papers–one morning and one evening–were owned and operated by the same company.

Journalism is dead, having given way to commentary. Many newspapers are moribund. In my area, so few people subscribe to the actual news that the newspaper distributes a free weekly printing of advertisements. They probably copied the business model of the US Postal Service, which became a model of financial success when junk mail became their most profitable business.

Many papers already rely primarily on the wire services for their content, which means that in the morning paper you’ll see the same articles you read online the day before. With reliance on wire services–of which there are basically two–the entire nation receives the information as perceived by one writer. While I don’t like this, I must admit that it is an approach that has worked well for Vladimir Putin.

News is framed so as to attract everyone’s attention–in other words, it must be sensational or salacious–ideally both. This results in the media altering our perception. Travel by airplane, for example, is very safe, which is why an emergency landing on a highway with no injuries is considered nationally newsworthy and causes some people to perceive airplanes as dangerous. On the other hand, automobile accidents are so common that it must involve a self-driving vehicle, have a dozen or so fatalities, involve over 50 cars.

It’s sad that most people don’t want journalism because it requires readers to think. It’s easier to find some online source that reinforces their existing position and biases than to have to think and possibly change their minds occassionally.

The CES and Other Illusions

Every year I read about the great new products at the Consume Electronic Show, this year held 8 – 12 January in Las Vegas. The products are marvelous. They’re amazing. They’re introduced amid a glamor of models, cosplayers, and celebrities. They represent the cutting edge of technology.

Unfortunately, most of us will see, much less be able to use most of them. Like, where are the flying cars?

Driverless cars, domestic robots, virtual 3-D that’s adult—NOT porn (I’m not kidding, that’s what they say), and (wait for it) the ability to see INSIDE YOUR HAIR! Now, given that I have much less hair than I did in my younger days, that just might be important to me. Can I stop by WalMart, BestBuy, or even Brookstone and pick one up? Not so much.

There are the latest video games (yawn)—but—wait! Here’s something special— a smart kitty litter box! Something practical—but it’s for the show, not the store.

Oh well.

I’d write more, but I need to go sweep up around the plain, old-fashioned, low-tech kitty litter box.

Memorandum

FROM: THE BIG BOSS

TO: Subservient Middle Managers

SUBJECT: Appropriate Attitude

It has come to my attention that some of our middle managers are not only talking with employees, but even (and I’m embarrassed to admit this) asking them for advice. This behavior must stop immediately. As the Good Book says, “Do not cast pearls before swine.”

I have had some managers insist that sudden improvements in productivity and/or quality are due to ideas from the workers who actually perform the jobs that improved. This is pure, unadulterated balderdash. No employee below the level of supervisor has the brains or ability to impact our standard operating procedures. We must continue to do things the way we always have done them. Let me be perfectly clear; the end does not justify the means. Don’t tell me that things are better because a member of the working class came up with an idea.

It has been scientifically proven that the earth is flat and only management personnel have the ability to think.

Effective immediately, do not interact with workers, do not speak with them, and unless ABSOLUTELY NECESSARY, do not acknowledge their existence. I hope I do not need to say anything further on this subject; if I find someone is so infatuated with workers, I will arrange for you to join them.

Inferior Garbage

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At our house, we repurpose by donating things to Goodwill or K4AMG—a charity that helps kids learn electronics. We compost. We recycle. Some places I’ve lived, we had one bin for paper, one for cans, and one for bottles. Here, we have one giant container for everything, with the sorting done elsewhere after it’s picked up. A few years ago the paper included a story that two weeks after scrap cardboard was sent to China, it was headed back as packaging for new merchandise.

But wait.

The Chinese are complaining that there are too many imperfections in the material we recycle. (Please note that “we” refers to more than just my family).

The approved recyclables include bottles, cans and cardboard, BUT NEVER, EVER INCLUDE A PIZZA BOX BECAUSE THE GREASE FROM THE PIZZA RUINS EVERYTHING! However, some people have included more than what is on the list—bowling balls, deer heads, and——-you really don’t want to know.

Once American products set the standard for the world, but no more. Now we’re known for inferior recyclables.

So, how do we improve the quality of our recyclable garbage? Maybe the White House should appoint a recyclable garbage Tsar, but that would mean bigger, more complicated government.

On the other hand, there’s one group that knows garbage better than anyone—politicians. So, let’s make it one of the duties for any politically elected or appointed position to spend a couple of hours a week down at the recycling center separating the good recyclables from the bad recyclables. While they’re down there, sooner or later they’ll start talking among themselves, which would be a marvelous improvement.

The Studio Boss’s Advice

“Thank you all for coming to this important meeting on such short notice, but this is extremely important after all the allegations of sexual misconduct. I’d like to correct it, but since this is Hollywood, we’re going to make people feel—almost believe—we corrected it. Hey, perception is reality, we’re going to give people the perception that we’ve corrected it.

“How? First, we all know that there are only a handful of plots that we keep recycling. A few of them are going to have to be put into suspended animation, at least for a while. ‘Boy meets girl’—forget it. It’s poison and no venture capitalist would touch it with a ten-foot pole. I spoke with Art Stanslawski—the former basketball legend—well, he’s a 7 foot 1 ½ inch Pole, and he said he wouldn’t touch it either. It’s going to be a hell of a long time before Harry meets Sally again.

“Next standard plot, at least for the 21st century, ‘Boy meets boy?’ Trust me, it’s just as dead after some of the big name actors who say they were molested.

“Boy doesn’t meet girl?” There might be a few possibilities, but the planned sequel to Sleepless in Seattle with a female playing the Tom Hanks’s role and a male playing Meg Ryan’s? That’s deader than another remake of Baywatch or The Dukes of Hazzard.

“And as far as I’m concerned, if you want to do ‘reality TV,’ more power to you. Me? I’m going to wait and do real reality TV It will feature the exposes about the shenanigans that went on behind the scenes on reality TV. I can cover the allegations, arbitrations, trials, and appeals. I’ll make a ton of money from the shows AND even more from the lawsuits.

“So, where does that leave us? Anything with lots of explosions, computer-generated effects, car chases, and spaceships. We might want to bring back Westerns.

“If we can’t computer generate actors who aren’t real people, we can always use puppets or maybe we can hire some Jesuits. Can Jesuits join the Screen Actors Guild? Maybe not a good idea because of some of he Church scandals. Scratch that.

“Anyone with a better idea, let me know. Don’t come to my office—we’ll meet in some heavily trafficked public place that’s loaded with security cameras. It’s not that I don’t trust you, but one can’t be too safe, you know.”

Spreadsheets

If you’re reading this, you probably have at least a basic understanding of computers—whoa! Don’t leave! Bear with me for a minute.

I used to communicate with others on NetZero dialup and write articles on a DOS (that’s disk operating system—pre-Windows for you youngsters) word processor. The first spreadsheet program I recall was Lotus 1-2-3, once a powerhouse, but now an answer to some stupid question on Jeopardy. We’re so used to spreadsheets that we have no appreciation as to why they were the first “killer apps.”

No, really! That’s how it was done!

Prior to the 1980s, complex production was tracked on the manual equivalent of spreadsheets. Seriously. We’re talking about blackboards (yes, real chalk boards—not whiteboards; you never got a buzz from chalk dust, just a nasty cough). Businesses would have huge blackboards mounted on the walls and/or wheeled stands—not one blackboard, mind you, but many. The blackboards were set up with grids, and if a change occurred in one variable, the person tracking it would go from blackboard to blackboard, updating the appropriate sections.

Maybe it’s easier with an example. If chairs usually cost $10, but the price changed to $12 and the company had orders for 15 rather than the usual 10, the human Excel operator would go to the place on the blackboard where chair costs were written and change it from $10 to $12. He (the male to female ratio of geeks was even worse back then) would then go to the place where quantity was tracked and change the 10 to 15; it could be the next blackboard or one in a different room. Next, he’d replace $100 (10 chairs at $10 each) with $180 (15 chairs at $12 each). A small mistake (is that 180 or 160? I can’t read my own handwriting) in one part of the blackboard jungle would cascade throughout, and might take days to correct.

Today, almost every computer seems to have Microsoft Office, which includes Excel, an extremely powerful program. I’m told that over 80 percent of Excel users are only able to utilize about 5 percent of its capabilities, but still are able to accomplish almost everything they want to do.

All that on one screen with no chalk dust.

The Brain? Abby Normal

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Aaron Hernandez (the late football star) is in the news because he committed suicide while in prison after he was sentenced for murder. His dead body provided shocking information that medical science was not able to discern; his autopsy showed chronic traumatic encephalopathy.

Now, let me get this straight—it’s the twenty-first century, and instead of having flying cars (dammit!) we are just beginning to realize that if you hit someone in the head, over and over, it affects them. It impairs their judgement, causes mood swings, and inappropriate behavior.

Well, we’d better stop that—unless getting hit in the head is part of a professional sport that generates millions of dollars in revenue.

Sounds curiously like the justification for the gladiators fighting to the death in the Roman Coliseum. That, of course, pleased the crowds, but was barbaric.

We’d never stoop so low today, but, if it has major network coverage, instant replays with everything coordinated to accommodate commercial breaks, and attractive cheerleaders, it’s okay. Hell, we’ll have a dedicated section of the newspaper every day!

Hmm.

Being surprised that repeated head trauma causes problems is kind of like the medical logic that “if you shove an ice-pick up somebody’s nose far enough so that it reaches the brain and you wiggle it back and forth, they act differently afterward.”

Is it just me, or are we missing the blazingly obvious?

Maybe I should just shut up and bang my head against the wall repeatedly, until it makes sense.

From Whence Comes the Disaster?

So, with Hurricane Irma headed my way, I drove my Wells Fargo financed car to the airport, and with my Wells Fargo credit card, I bought a ticket on United Airlines.

Anyone want to guess where things went awry?

(Hint: My car was repossessed, my credit score demolished, I got dragged from the airplane, and never got to my destination. Those are only hints.)

Labor Day

According to the US Department of Labor, Labor Day was first celebrated in New York City in 1882, although there is some disagreement as to whether the machinists’ union or the carpenters’ union can claim credit. It was a municipal holiday, and other cities were invited to follow suit. After 23 states recognized it in 1894, the US Congress passed legislation making it a national holiday.

As one trained in management, it was repeatedly pointed out to us in college that the real job of management is to remove the roadblocks that prevent workers from being productive. Except in very small businesses, managers and owners produce no products nor do they provide services to the customer. Everybody’s paycheck comes from the efforts of the workers.

In many ways, we seem to have forgotten that and tend to believe that the people in the big offices and the expensive suits are the producers. Meetings don’t generate revenue. PowerPoint slides, slickly bound and printed reports, consume a lot of resources, but belong solely to the Expense side of the ledger.

Even as automation takes over many jobs, reports are that the demand for workers is increasing. The workers may perform different functions, but they are still critical to the process, no matter how much the elites may wish to believe otherwise.

Today there are many industries that produce nothing. Instead they move money around, mix it up, and in so doing make a profit. Some of this “profit” is virtual—it exists on paper, but may never translate into cash. Other profits occur when money is moved from one owner to another; this is a transfer—profit means that there is more, not that we’ve moved it around.

We are becoming a banking and finance nation, which is one of the places where a nation moves when it ceases to be great. The great nations of only a few centuries ago—The Netherlands, Spain, Portugal, France, Great Britain, etc. are only a shadow of their former selves.

So, to those of you who build, grow, design, or otherwise create, thank you. It’s your day—enjoy.

Football In the Future

Football Hall of Fame Re-opens

Newly remodeled Football Hall of Remembrance opens to celebrate Traumatic Brain Injury.

SATIRE AFFILIATED PRESS
CANTON, OHIO 11 September 2035

Although American style football has been banned, the Football Hall of Remembrance—formerly the Football Hall of Fame—is still a popular tourist attraction. It’s remodeling was recently completed and the familiar football roof is now surmounted by an artist’s conception of traumatic brain injury. Over the front door, the entryway features a bronze relief of a player being carted off the field after, as they used to say, “Having his bell rung.”

While the exhibits still include trophies, helmets, jerseys, and other game paraphernalia, it’s the preserved brain tissue and MRI scans that are today’s favorite. Visitors can view the pathology, then try to guess to which famous player the brain once belonged. Pressing a touch screen, the player’s name, teams, scores, and number of concussions is displayed. Original plans included videos of interviews with former players, but many could no longer communicate, being content to babble incoherently, or stop mid-sentence with, “What did you just ask me?”

Taking a page from big tobacco’s playbook, the industry insisted for years that football was not dangerous; eventually there were too many injuries at the high school, university, and professional levels to ignore. Professional teams found that medical insurance costs exceeded revenues—even if the revenue from sale of team products like hats and jerseys are included. With the profits gone, most owners took their investments elsewhere. Unfortunately, this left many cities with substantial debt for stadiums they built. Many are crumbling and have been condemned because of the degree of deterioration; there’s reason to repair them and no money to tear them down. Universities initially expected a huge financial crisis, but found that the sport had actually not been a money maker, in terms of real cash, but a huge annual loss. Without football many universities were able to improve facilities and pay teachers better.

Football, is gone, but not forgotten—except by those who played the game and had their bells rung too many times.

It’s Good to Be the Tsar!

putin

Vladimir Putin, according to reports, is wealthier than the next two richest people combined with a net worth of $200 billion. Pretty good for someone who grew up as Communist with enough commitment to work for the KGB.

His career with the KGB was unremarkable (his highest rank was lieutenant colonel), but once he got into politics, he found his niche. Trained as a lawyer, he adopted the Don Corleone business model (“One lawyer with a briefcase can steal more money than 100 men with guns.”–The Godfather). When the Soviet Union fell, various Russians began to acquire wealth. Putin apparently made many of them an offer they couldn’t refuse.

It might be good to keep that in mind before considering doing business with Putin.

Goodbye to an Old Friend

Long before my time, Theodore and Milton Deutschmann started a business to cater to the new field of wireless—specifically, amateur radio. They called their business Radio Shack.

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Why? Ships were among the first to adopt wireless communications, and since early transmitters created a signal by generating a huge spark, there was the risk of starting a fire. To minimize risk, the radio equipment was placed on the main deck, in a separate small building, which came to be called the radio shack.

Ham radio operators (no one knows for sure why they’re called “hams”) tended to call the place where their radio station was located as the radio shack, or ham shack. Amateur radio was shut down during both world wars, but hams returned to the air as soon as it was legal to do so. The end of the Second World War provided an added advantage with huge selection of inexpensively priced military surplus radio equipment.

When I was a youngster, there were a few radio stores around town where you could buy components or tools. However, periodically the mailman would deliver a catalog from Lafayette, Allied, or Olsen Electronics. The Sears Christmas toy catalog couldn’t compete with these for the pure lust they generated. I remember building a set of Knight Kit walkie talkies, purchased from Allied.

In the late 1960s, Allied began opening stores in malls, outcompeting most the other companies, which gradually faded away. Allied purchased Radio Shack, but the combined Allied-Radio Shack was determined to be too monopolistic, and the two companies were split up. Allied became the industrial supplier while Radio Shack stayed as the retailer in the malls. Radio Shack sold things that you couldn’t find elsewhere. The TRS-80 computer was one of the first personal computers. They introduced a pocket-sized computer and one of the first laptops. Radio Shack had a niche market—the nerds—but nerds were paying $2,500 for a radio shack computer before the general population knew personal computers existed.

You could find all the parts to build a stereo from tuner to speaker wire. How about a multimeter and a soldering iron? They sold CB radios, of course, but also some ham radio transceivers. Most everything was manufactured by someone else, but carried one of Radio Shack’s brand names.

If you were working on a project and need a 47 ohm resistor (usual price, 10 cents—Radio Shack price, two dollars) you could drive to the mall on a Sunday and finish your project before dinner, even on a Sunday afternoon. Yeah, their components were overpriced, but the convenience made it worth it.

Then, one fateful day, the brainless
pencilnecks management of Radio Shack decided to sell the same products (e.g., cell phones) that you could buy for less money at Best Buy, WalMart, RiteAid, etc.

I’ve been told by Radio Shack managers that the really profitable part of the store was the parts section with those overpriced resistors, capacitors, and semiconductors. You know, the ones you could buy whenever you needed them? The parts selection went from a large section of wall to a metal cabinet with multiple drawers. I think the cabinet got smaller, but in any case, there were fewer and fewer parts available. Cell phones—no problem. Parts? Sorry.

I hear that Radio Shack is still sort of, kind of, in business, but you couldn’t prove it by me. The last local store is now empty. Like Bigfoot or the Loch Ness Monster, you only hear about someone who knows someone whose brother-in-law saw one. It’s too bad—they could have coasted a few more years just on what I spent there.

Fixing Healthcare – Part Three

Physician’s Assistants (PAs) and Advanced Registered Nurse  (ARNPs) are helping lower costs and increase access. While some nurse practitioners, can operate relatively independently; other nurse practitioners and most physicians’ assistants, cannot. Why?

Physicians are adamant that they maintain a high degree of control over these and other healthcare workers. This is a throwback to the nineteenth century—which is kind of interesting in a weird sort of way. The story, and I cannot vouch for its accuracy, although all my research seems to support it, is that the country was besotted with traveling medicine shows hawking patent medicines (You’ve seen it in the movies—“One for a man, two for a horse”). The physician industry supposedly promised to get things under control if they were put in charge of medical practitioners, i.e., physicians and surgeons (MD). It, at best, minimized, if not blackballed, osteopathic physicians (DO), chiropractors (DC) and chiropodists, now known as podiatrists (DPM).

A physician, at the time, could authorize any hireling under his license to perform any duty under the concept that the doctor was “the captain of the ship” and was responsible for everything. Therefore, he had authority to authorize any employee to do anything—hopefully, but not necessarily, after some training.

Today, many non-physician healthcare workers are licensed in their own right; in most states this includes nurses (of all levels), therapists (of all varieties), and technologists (ditto). These people are trained and possess technical skills that physicians do not. Generally speaking, only television doctors leave their practice in order to operating high technology devices. It’s good theater but bad economics.

Many of the other healthcare careers such as nurse practitioners, physicians’ assistants, etc., have made significant advances Unfortunately, old attitudes die hard, and there are too many physicians who try to maintain an inordinate control over everything, including these other professionals. Nurse anesthetists and physicians’ assistance must be “supervised” by a physician, although such supervision does not require actual observation or even the presence of the supervising physician.

Efforts to keep others under control have led to some bizarre arrangements. In radiology, for example I’m told that the technologists are now required to periodically retake the examination that initially proved their competence even though there has been continuing education requirements for 40 years. If true, I believe this is a unique requirement, but a warning to all others. Of all the physicians’ assistants, only those specializing in radiology are not permitted to interpret x-ray or other diagnostic images.

Why?

Some blame the American Medical Association, a very powerful organization with effective lobbyists. However, it apparently speaks for a self-selected group of physicians. Out of 923,308 practicing physicians, the most recent numbers available indicates that only 228,000 belonged to the AMA. If you don’t round, that’s just less than 25 percent.

Nobel Laureate Milton Friedman and his wife, who wrote the book Free to Choose, asserted that the AMA functions more like a guild with the goal of increasing physicians’ wages and fees by limiting both the supply of physicians and the competition from non-physician groups.

This is yet another issue that must be addressed if we are truly interested in fixing healthcare.