This article was originally published the The Health Care Blog (August 24, 2013) – http://www.bit.ly/open-letter-to-the-president
Dear Mr. President:
I served in your White House; to do so was among the highest honors of my life and an incomparable professional opportunity.
Since 2009, I’ve sought to return the favor by building on a decade as a journalist to write about the unsung innovation I saw happening beneath the public’s radar. (The federal government has never been great about describing its positive achievements, but this unintentional “humility” is worsened by too much media reliance on muckraking to generate cheap content.) The prize for some of your Administration’s improvements will be billions of dollars’ worth of process efficiency and an ability to retain social-good programs while slashing redundancy and phasing out archaic ways of doing business. All politics aside, I watched these mechanisms with my own wide eyes.
But if one is to deliver praise like I just did, then one must also be willing to highlight dangerous errors in the path ahead, especially when the potholes are avoidable. As a subject matter expert on emergency medical technologies, I have a patriotic duty to point out correctible overstatements and oversimplifications that, if left uncorrected, could undermine your Administration’s objective to bolster the public’s senses of safety, security and comfort—especially as it simultaneously emphasizes the danger of man-made and natural disasters.
On July 9, 2013, your White House sent out a “marketing” email entitled “President Obama’s Plan for Using Technology to Make Government Smarter.” The email contained the following three bullets:
- Increasing efficiency and saving money. CHECK: A worthy goal, and one that I had the chance to see put in action from the inside-out, as part of the project team that relaunched USAJOBS.gov—the so-called “face of federal hiring.” The White House email cited cost reductions of our $2.5 billion; that seems reasonable, considering how extensive an effort went into collapsing duplicative data silos and databases, and modernizing the federal government’s technical infrastructure. Vivek Kundra, the visionary former federal Chief Information Officer, should be a central figure in every conversation about government’s meaningful gravitation toward efficiency; he earned more credit than he gets (but that’s not why people work in government).
- Opening government data to fuel innovation and problem-solving: CHECK: The Administration claims that it is opening “huge amounts of government data to the American people, and putting it on the internet for free.” There are many ways in which this is true, ranging from Data.gov to the Blue Button Initiative, to a (relative) simplification of the grant-making process. (The latter is better than it was, but it still is eons from intuitive or fair.) Much controversy now swirls around actions that the government still keeps secret, but that cannot detract from the fact that a veritable cornucopia of information has been released, and it is indeed spurring creativity. Unfortunately, my own firm uncovered a challenging corollary problem that goes hand-in-hand with the release of oodles of data: at least some of those data are bad, faulty or incomplete, yet when we tried contacting the appropriate agency to close the gap and strive for accuracy, we were met with silence.
The last bullet in the White House’s email, however, does not deserve a “CHECK.” Rather, it is concerning and arguably more dangerous than whoever drafted the outreach piece likely realized. It also touches on something I know a bit about.
- Digitizing disaster recovery: According to the White House, “FEMA uses data analytics and internet/mobile apps to deliver better results in disaster areas.” It is possible that FEMA uses analytics and apps—that may well be the case. But do they “deliver better results in disaster areas”? No, they don’t, and therein lies a problem: to suggest that emergency responders should use popular technologies (like “apps” or even devices like iPad) to do their sacred work in the field puts both responders and the public at risk, for such suggestions fail to account for the vulnerabilities that those popular technologies present.
This is not a statement against the apps or the iPad; both have their place, but given their current physician and technical construction, that place is not in an ambulance or a fire vehicle. Technologies tempered for use during disaster require technical robustness and physical ruggedness beyond the bounds of an iPad’s current capabilities, regardless of what Los Angeles City Councilman Michael Bonin said. (In early July he suggested that the Los Angeles Fire Department should utilize iPads as a centerpiece of modernization. Very few people inside the industry agree.) As the old saying goes (here’s looking at you, Joe Friday), these are “just the facts”: To describe consumer-grade technologies as broadly insufficient for use during disasters is not to devalue those devices, but rather to recognize that high-stress situations require hardier equipment. Indeed, to called emergencies “special contexts” may be to understate reality’s harshness.
After all, the first and most obvious problem that practitioners on the ground face during disasters emergencies is the loss of communications capabilities. If the previous hyperlink seems a bit old, consider this one instead from 2013: “Oklahoma City Area Hit by Phone, Internet Outages After Tornado.” Or another piece I have written on this subject: “A Dangerous Distortion: Verizon’s Foray into Emergency Medical Services.” At the 2013 National Association of EMS Educators Conference, two medics from Oklahoma were perplexed and anxious when I mentioned Verizon’s advertisement showing that one of their largest regional EMS agencies supposedly uses real-time video in its ambulances. It is simply untrue. The EMS agency neither collects nor transmits video from an accident scene; and because it operates in the heart of Tornado Alley, to rely on video connections would be to burden it with unacceptable risk of reliance on network connections that are vulnerable to disruption by storms.
As a citizen-taxpayer, and a professional in the Fire-EMS technology arena, such overstatements both infuriate and dishearten me, because they make it seem as though emergency responders are doing less than they could be today. They also misconstrue the “manual” nature of so much of disaster response in the United States. Did you know that one of Silicon Valley’s famous “superangel” investors is creating an application tohelp police officers write tickets more efficiently…but that the police department lacks phones on which to operate the app?
Or how about this: Did you know that the San Francisco Bay Area is considering a social network for use ”during emergencies only.” This social network will rely on the internet…in earthquake country. Perhaps I take my experience in this regard for granted because I grew up in California, but do you know what happens to the Internet (or, say, cell phones) when an earthquake knocks down a tower, shuts down power to a tower, and scared citizens take to their phones to call loved ones all at the same time?
Cell circuits overload. Networks go away. Bye-bye social media app “for emergencies,” and we’re left feeling stranded. That’s an uncomfortable feeling that was captured with frightening intensity in the film “Live Free and Die Hard”: “What if you’re hurt and alone and you dial 9-1-1 and no one answers?”
But it gets worse: The emergency networks in and around San Francisco are among the least-sufficient in the country, despite that this region is considered the Mecca of technology innovation for Planet Earth.
There are glimmers of hope that the Bay Area Wireless Enhanced Broadband (BayWEB)—a network especially designed for first responders, which will operate exclusively of public communication channels—will go back onto the drawing board. But it could also be déjà vu all over again: just as a smartphone application for police officers won’t work if they don’t have smartphones, so too will a next-generation technology network failwhile “there have been about $206 million worth of citywide information technology upgrades requested by departments, but only $49 million is available,”per the San Francisco Examiner.
- Author’s Post-Script: The Examiner‘s figure was published just five days before the announcement of the potential re-invigoration of the BayWEB project. It is unclear whether the two groups have been in communication regarding resources.
Mr. President: You have challenged us – bolstered by circumstances such as extreme weather and tragic terrorism – to step into an era of innovation, a path begun as part of President Clinton’s “Bridge to the 21st Century,” and continued as part of your commitment to “Make Government Cool Again.” (That was part of my mandate when I arrived at your Office of Management & Budget in 2009.)
I know that “Digitizing Disaster Recovery” makes for an excellent sound bite, but if you see it as longer-term-beneficial, then we need to be implementing wise—not just so-called “smart”—technologies in a manner that befits their pertinence to America’s dire need for impactful emergency response infrastructure.
My opinions on what these technologies should be have been published elsewhere, but they start simply with a need for better information about modern technologies and how should they best be applied. They end with the disastrous effects of incumbency (anathema to progress), and the suggestion that we learn to buy based on usefulness, not just politics or price considerations (“low-bids”).
Medics, firefighters, and other emergency personnel do so much with so little; the public is scarcely aware of their willingness to go without, because the public-facing story is often skewed toward non sequiturs like pensions that have little to do with capabilities or courage. We can have substantive conversations about business and politics for sure, but first let’s get ready to respond to disasters and even everyday crises.
As the global model of public preparedness (for better and worse), we need a pipeline of tools that offer improvements beyond what is possible using “apps” that “digitize disaster response” and thereby tie us riskily to an ephemeral internet that may or may not persist when we need it most. Quick-fix solutions may score political points, but ultimately they do little more than clutter the faces of our digital devices.
I promised my friends at Startup Health that I would try to help them navigate the wily world of public relations (PR) and media relations (MR), in such a way that actually saves them time, money, and the pain of watching their messages take on a life unintended, with consequences to boot.
As I had a chance to tell one of my colleagues at the recent Startup Health summit, perhaps the most difficult truth to accept about publicity is that messaging is very hard to control – which is fine if what’s being conveyed is simple or innocuous. But in the healthcare world, nothing fits neatly into those categories, whether due to legal/regulatory or scientific reasons, or because our companies are solving complex problems that [no matter how diligently we try or how hard we're pushed] are simply not conducive to 140-character spurts.
The goal of this primer, therefore – which builds on something like a decade spent in various journalistic roles, from advocate to researcher to editor to publisher to critic to reporter to lecturer to (perhaps most distinctively, in the worlds of MediaPost’s Larry Dobrow) “adept schmoozer” – helps illuminate some “tricks of the trade” for entrepreneurs who aim to interface with professional reporters in a fashion that is at once conducive to relationship-building, by illuminating the road to common ground, and also productive with respect to generating good and meaningful press.
(After all, one might be amazed at just how pointless it is to have one’s name featured offhandedly in the press…being quoted doesn’t mean anything if it doesn’t tie back to one’s ultimate business objectives. EXCEPTION: If one’s business objective is to be quoted, and there are people for whom that is a priority.)
It’s amazing how much similarity there is between being a startup CEO and a reporter: both are vocational jobs, both are very lonely at times, both involve deadlines not necessarily within one’s own control, and both are helped by a broad base of knowledge and a general curiosity.
I may add to this primer as time goes by, but to start, here are the “Three Keys” to good press: caffeine, alcohol, and tobacco (I don’t advocate for cigarettes, but a good cigar on a special occasion serves as sweet dessert and exclamation point.) Within the journalistic community, certain addictive characteristics are long-known (and even heralded) and seen as “par for the course,” given the amount of time that journalists spend at their very isolated, often lonely craft that includes long hours. That said, off the cuff while on a plane back to the Bay Area, here are my top tips to securing solid press…consider this a mini-tutorial.
Lisa Suennen has to be commended for her excellent overview of the fun and optimism we participants in the Skolkovo conference felt (I was honored to be among the speakers) while learning about the states of entrepreneurship, health IT, and telemedicine across the Russian Federation. But as some of my former professors might have said, one element absent from this discussion — in the interest of keeping it “non-meta” and sticking to journalistic reportage – was the “normative” question.
That is to say, what some might call the “moral” question (though I think that word carries too much baggage). In short, would we be wrong to ask-and-answer the question of whether entrepreneurship in Russia is progressing as it “should”? If the country is indeed striving to inculcate a culture of innovation, is that even a “good thing”… or perhaps not?
I’m not being comical or rhetorical; there is no latent James Bond-style reference here, nor the silly intimation that intrepid business-building across the former USSR will lead to missing nukes and hidden undersea fortresses. Rather, it’s a question of cultural readiness, and that one that seems fair: Everyone knows that the Old World’s universities remain among the world’s best. But have Russia and her neighbors instituted the informational (read: transparency), financial, legal and regulatory, security, and even human-collaborative, etc., structures that are conducive – if not critical – to the growth of a self-sustaining entrepreneurial ecosystem?
Lisa asks, “Was the vibe and smell of innovation present or was it really the vibe and smell of entrepreneurship—a bunch of guys trying to answer an already defined question that many are seeking to answer similarly, but willing to take significant business risk while doing so?”
Let’s push the question further: If the “bunch of guys” is indeed willing to take the business risk, are mechanisms in place to reward their gumption…or will they be, in effect, outlaws who bucked the system and unexpectedly (or not?) find themselves on the outside looking in on a system that cherishes the idea of disruptive innovation but actually prizes the equivalent of “mass intra-preneuership”? That is to say, might they be cast as “mavericks” within a dominant operating system…and isn’t such a paradox anathema to the big, World-Changing Ideas that turn into fortunes for founders and societies alike?
Here’s an ironic corollary: Americans flatter ourselves to think that “we would never be so closed-minded” as to the color and shape of innovation. But is that true? Do two investment bubbles during one decade of the 21st century—first, the dot-com / new media frenzy, then the app explosion that is more recently but not necessarily more profitable or long-term healthful—suggest that we in the U.S. look for ideas that fall far from the central mean…which is to say, of course, the common and rabble-ish average? Do we prize and honor innovation as much as we think we do…or again, as we should?
Or do investors and entrepreneurs alike prefer to huddle on a cliff’s edge, pending one charismatic Lemming with a Powerpoint and a Profound Professional Pedigree who points toward the Next Big Thing (which turns out to be, in this admittedly gory example, either the ground or ocean tide)? Continue reading →
There are two “two sides” about 20 children being murdered. The 21st century gun debate in America smacks of obfuscation and dodgery and misplaced priorities. What do we have to show for it? Murder. The lives of bright-eyed dreamers too soon snuffed out.
I’m furious. Passionately pissed off. The principle of “mutually assured destruction,” which held a cold war at bay so long ago (or so it seems by measure of modern memory) has given way to actual mutually assured destruction. Guns over here and guns over there has led not to stalemate, as the Second Amendment likely intended: the guarantee that Americans could defend themselves against tyrants has not made us safer, but rather, placed us all at greater risk. Theory does not matter here – reality trumps all.
Certain business leaders said, “You cannot argue with success.” By similar logic, you also cannot argue with repeated mass slayings, as the President noted: “Can we honestly say that we’re doing enough to keep our children — all of them — safe from harm? Can we claim, as a nation, that we’re all together there, letting them know that they are loved, and teaching them to love in return? Can we say that we’re truly doing enough to give all the children of this country the chance they deserve to live out their lives in happiness and with purpose? I’ve been reflecting on this the last few days, and if we’re honest with ourselves, the answer is no. We’re not doing enough. And we will have to change.”
When those who claim the right to be blind (and then some…) wake up to their tragic folly? I’ve never agreed so strongly with my Israeli friend Kfir Catalan: he’s right. In England, for example, where guns are illegal to everyone but a few specialized police teams, the murder rate is at a 30-year low in 2012.
But let me throw a bone to my conservative friend Greg Vaslowski, and the senator that perhaps best encapsulates his view, Senator Lindsay Graham of South Carolina.
- Here is Greg’s opinion on gun control, as explicated in a Facebook post: “Guns have been here for hundreds of years with the majority of citizens having no problems with them. It’s the proliferation and acceptance of certain types of behavior or some bleeding heart need to somehow assimilate parts of society with serious illnesses or dark thoughts is the problem.”
- Here is Senator Graham’s opinion, as told to CNN’s Piers Morgan on December 11, 2012: “I enjoy shooting. I hunt. It’s something me and my dad did together. And in the South, it’s part of growing up. Now when people abuse a weapon, I think having additional penalties for a crime committed with a gun makes perfect sense.”
Let it be said, for both of these Gentlemen, that if the one’s concerns it that one will be unable to go out hunting with one’s father – as Senator Graham clearly enjoys and that, as Greg rightly points out, has been going on for a long, long time – then I believe one would be hard-pressed to find a cogent, reasonable excuse for disallowing citizens to hunt using traditional tools of the trade. There is not a good reason that a hunting rifle or shotgun should not be used to do what humans have done for so long. Continue reading →
Here’s a post that’s short-and-sweet: as much I dislike the conservative perspective on how our country – government, business, society as a living, breathing, vivacious entity sui generis – nevertheless it’s hard to argue with the Christian Science Monitor‘s point about the absurdity of President Obama’s recent statement about the origin of business and taxation:
“As Representative Labrador pointed out on Thursday, taking the president at his word – that he meant not that government built American businesses but instead that government built and/or fostered the roads, Internet, and public safety necessary for business to flourish – is still ripe for conservative attack.
In other words, the money the government used to build the roads and develop the Internet came from somewhere. That somewhere was private enterprise – and some say that Obama’s inability to recognize that is his fatal flaw, economically speaking.”
The fact is, they’re absolutely right: somewhere along the lines, business of some kind has generated taxable earnings that are paid to government to affect the Greatest Good. (My late professor Lester Lave is smiling down from somewhere now, even though his “Iron Law of Government” said that “When government gets involved, everybody loses.” I disagree, but today he may have won the skirmish.) Mitt Romney got this one right: “The taxpayers pay for government. It’s not like government just provides those to all of us and we say, ‘Aw, thank you, government, for doing those things.’”
BUT – and this is crucial – the present politically tinged reports have left out a critical fact that we would do well not to ignore: without government funded projects and resources (such as the firefighting teams that the President spoke about), or the roads / bridges / tunnels necessary to transport goods, business wouldn’t have much of an infrastructure to leverage into profit. This is the backbreaking flaw in the Tea Party / Republican worldview as much as it is the toxin in the Occupy Wall Street well: if we seek extreme views on either side of the aisle, we’ll get it wrong every time.
The answer is somewhere in-between: government needs business for funding, and business needs government for tools to do business. The late Rodney King asked the often-recast question “Can’t we all just get along?” In our modern society, we ultimately have to anyway – America has to function, and it also has principles – so why do we fight so hard to play at the poles, rather than seeking a centrist stance that would empower us to be so much more efficient?
We Cannot have Liberty without Taxation – An Argument Using Only Conservative or Academic/Neutral Sources
I confess that my use of Karl Rove as a statistics’ battering post here is largely superficial: it’s been said that he is the boy-wonder pollster who jimmied President Bush II into his victories, but especially the second one. It’s been said that he somehow “sees the Matrix” of the American electorate – and if someone can get George W. Bush elected twice, one has to think they may be onto something…how else to explain it? (Twice?)
- Personally, I think the fellow is a bit goofy, and I can’t wait for his predictions for 2012 to prove off-kilter.
If Mr. Rove here is as smart as folks say he is, perhaps it’s high time he explain to his party the problem of a bifurcated constituency: .
The Republican Party is split between the wealthiest and poorest Americans. The former quite understandably want to pay fewer taxes, and the latter quite understandably want to pay fewer taxes.
- If it sounds like I’m sympathetic to this point, it’s because I am: I would seriously challenge anyone who stand up and say “I want you to take my money, please.” People often refer to Warren Buffett’s admirable pledge to pay more taxes and donate the bulk of his wealth; that is a wonderful offer indeed, one that hearkens back to Andrew Carnegie’s belief that “The man who does rich dies disgraced.” But (a) Buffett – one of my business idols; his authorized biography “The Snowball” is on my desk, and I learned at least as much about finance from it as I did from my MBA, if not more… – is far from your average American, and (b) even Buffett doesn’t want his money simply taken away. He still wants it used wisely.
The problem with this split is the latter: poor individuals who want to pay fewer taxes….but who need social services the most. Where else will such monies come from but taxes – or those that reduce their taxes by paying out of what would otherwise be profits (or “net income,” when the earner is not a company) to support social programs instead of requiring the government to do so?
NOTE: To avoid the ire of my unabashedly conservative friend Greg Vaslowski, who would (rightly, by the way) take me to task for relying on biased sources inclined to my position to make my points in this post, I have made a commitment that turns out to be more challenging than I expected: in this piece I will only from cite sources that are either (a) conservative-friendly media, (b) academic, or (c) neutral. I will assume and stipulate (hopefully Greg will permit) that while academic materials may not in fact be politically neutral, they at least aspire to rise above the fray in the interest of credibility.
Yet the continued success of American society depends upon government’s ability and willingness to tax. Why? Thanks to logical syllogism. For support, as promised, I’ll look to a most unlikely ally: an evangelical Christian organization. In a post on November 17, 2011, Sojourners declared: “Contrary to popular belief most opposed cutting federal funding for social programs that help the poor (67%), and cutting federal funding for religious organizations that help the poor (66%).” The “federal funds” that support these programs come from somewhere.
I’m an entrepreneur, husband, and passionately centrist Democrat. This page – my soapbox of sorts – will I hope become a rallying point for conversation about issues that aren’t getting the attention they deserve from today’s Democratic party…which certainly means they’re getting next-to-no attention from the Republican party!
I hope that the moniker “Enterprise Democrats” – and more specifically, the functional description “Democrats for Business” – will gain some traction among those who realize that liberalism in the face of economic reality is unsustainable (read: We’re not a Socialist country, so MOST people in American will get jobs working for companies. Welcome!); and conservatism in the absence of a social conscience is a recipe for broad-based socioeconomic disaster (read: ANYONE can become handicapped, injured, unemployed, bankrupt. Safety nets are important for all our sakes.)
Those of us with a passion for politics – and the dream of a political future, someday – have heard time and again that to align with the center is to lose an election, but you know what? So be it. I don’t pander. I don’t do it personally (ask my wife, parents, and friends); I don’t do it professionally; and I’m certainly not going to start doing it where I care about the issues.
Here’s the reality we face: having begun my career as a media type (reporter, editor, publisher of independent magazines), I’ve long been in love with words. But especially since earning my MBA (before too, but admittedly more so since), I’ve come to truly believe that certain topics of popular discussion and political import cannot be explored in 30-second sound bites. It’s simply not possible.
- It’s not possible to meaningfully lay out a tax reform plan in a 30-second response during a televised debate.
- It’s not possible to meaningfully discuss (and a discussion it deserves!) American global interventionism in the space of a Twitter feed.
- It’s not possible to negotiate a responsible balance between environmental protectionism and energy independence – both positive ends unto themselves – between commercial breaks.
Yet we must have meaningful conversations about what it means to levy taxes on citizens (they’re critical once your population grows beyond the size of a village), and what it means to spend tax monies responsibly. My late esteemed professor Lester Lave once said that, “The Iron Rule of government is that ‘When government gets involved, everybody loses.’”
I began my career as a reporter-editor, and long worried about the journalistic doom on the horizon as column lengths shrank and with them so did readers’ attention spans. After all, how can one capture the heart of a complex discussion—say, a debate in which “smart people disagree”—in a one-inch paragraph, a 140-character newsfeed, or a 30-second highlight reel?
Now, as Treasurer of the California Democratic Party’s Business & Professional Caucus—and founder of an informal group called the Enterprise Democrats, or “Dems for Business,” that will use this site [for now] as its home—I find myself again torn. This time not just between the step toward simplicity and the flight from detail, but between ideological double standards: On the one hand, my conscience demands that I uphold the Democratic Party’s commitment to social equity, access to opportunity, and progress. But at the same time, my MBA keeps slapping me in the back of the head, telling me that we as a country, like every family and every company, need to pay for that progress. Market forces are important checks on rampant government—and in turn, social programs and government involvement are important checks on profit motives.
Of course, a third argument overshadows both of these perspectives: no matter how friendly and collegial we would like to think we are, a country is not a company, or a family. “E Pluribus Unum” (“Out of Many, One”) is an aspirational motto, not a literal description of events. And because we have so many mouths to feed, children to educate, buildings to build, lives to save, we have to cope with dynamics that companies and families don’t: they don’t pay for military readiness, or healthcare research, or space exploration, or power plans. They don’t have to keep the lights on for the poor, and keep seniors and the disabled out of hospitals.
The leadership of the United States has to cope with over 300 million individual stories — and that’s just citizens, not including illegal aliens, students, and tourists — whereas the typical family only has one: its own. That has to change the calculus. What doesn’t change, however, is that we still have to pay for things. Economics isn’t rocket science; it’s a social science — a science of people, and people (for better and worse) behave with some predictability. That’s why so many economists become talking heads, and why we can extrapolate from the factors that led up to the Depression, relying to some degree on Mr. Bernanke’s expertise to steer us from the abyss.
After all, economics is a complex subject for one reason alone: those 300 million stories.