I am currently battling the health insurance companies. It is a hard fight and here is the back story: This past summer, I had the fun experience of having a pneumothorax or spontaneous lung collapse. It was actually my second one (lets hope that third is not the charm). I don’t view the ailment as very serious. All it means is a four-day vacation at the hospital—doped up on western medicine’s finest medley of painkillers. I return home for a week of excruciatingly painful bed rest and in a month’s time, I am more or less in decent form.
I have health insurance--thank god for Massachusetts and its progressive health insurance legislation. However, the real inconvenience is not the missing essential organ; it is the mountain of paperwork and arm wrangling by the health insurance companies that drives me to insanity. At first, the insurance company flatly refused to cover any of my $25k medical bills. Then, realizing that they have a responsibility to cover people who pay premiums, they fight tooth and nail to pay as little as possible.
How did health insurance get to this point? How did the US medical system become one where the patient feels victimized? Although I complain, I know that the health insurance/medical system in developing countries is 10x worse. I remember one situation where government doctors in India routinely took exorbitant bribes from the poorest of the poor for routine medical procedures.
Health remains one of the key challenges when overcoming poverty for those living at the bottom of the pyramid and those living in the US. This begs the question, how are US development consultants qualified to advise developing countries about health policy? If we can’t figure it out for ourselves, what gives us the authority to push a broken system?
Wednesday, December 10, 2008
Sunday, December 7, 2008
4-Hour Workweek
I recently started reading a book by the title of The 4-Hour Workweek. It is definitely one those self-help/become rich quick guides, which I enthusiastically devoured back in the college years. It has the smooth undertones of a Rich Dad, Poor Dad and the earthy hues of a E-Myth Revisited. I just began reading it, so it would be unfair for me to begin making any definitive assertions, but it did get me thinking. How would it be possible for anyone to work a 4-hour workweek for a non-profit or microfinance institution?
It was standard procedure for a person to put in at least a 12-hour day. The worst part is that people working in development are often paid much less that peers working at equivalent skill levels but in higher paid industries. I don’t think the 4-hour work week would cut it in the developing world. What if you were inoculating children against hepatitis? What would you say to them? ‘Sorry, my 4-hours are up…I will see you next week’.
There are some types of work, which requires people to devote themselves to the cause. These are the people who work in the remote regions of the world, who are paid at poverty level rates, who do not even have the luxury of indoor plumbing and who work 12+ hours. However, it is interesting to find that many of these people are satisfied with their lives. They have a mission—a worthwhile goal—that sustains them through the physical harsh realities.
Then there are those living in the western world. The people who have all the physical amenities—the car, nice apartment, 9-5 routines. However, these people seem to have an emptiness. They lack purpose, meaning and motive. They work to sustain their physical comfort.
What I came to realize is that when working in development, it is necessary to balance these two worlds. I realized that I am not able do the extreme all or nothing development experience. Furthermore, I would go insane if I worked the mindless 9-5 grind. There needs to be a combination of both experiences. I want a comfortable home and to be compensated appropriately, but I also want to be helping people and making lasting impact. Of course, finding where these two worlds meet is the real challenge.
It was standard procedure for a person to put in at least a 12-hour day. The worst part is that people working in development are often paid much less that peers working at equivalent skill levels but in higher paid industries. I don’t think the 4-hour work week would cut it in the developing world. What if you were inoculating children against hepatitis? What would you say to them? ‘Sorry, my 4-hours are up…I will see you next week’.
There are some types of work, which requires people to devote themselves to the cause. These are the people who work in the remote regions of the world, who are paid at poverty level rates, who do not even have the luxury of indoor plumbing and who work 12+ hours. However, it is interesting to find that many of these people are satisfied with their lives. They have a mission—a worthwhile goal—that sustains them through the physical harsh realities.
Then there are those living in the western world. The people who have all the physical amenities—the car, nice apartment, 9-5 routines. However, these people seem to have an emptiness. They lack purpose, meaning and motive. They work to sustain their physical comfort.
What I came to realize is that when working in development, it is necessary to balance these two worlds. I realized that I am not able do the extreme all or nothing development experience. Furthermore, I would go insane if I worked the mindless 9-5 grind. There needs to be a combination of both experiences. I want a comfortable home and to be compensated appropriately, but I also want to be helping people and making lasting impact. Of course, finding where these two worlds meet is the real challenge.
Friday, December 5, 2008
Hemlocks and Beetles
A little aside from the usual discussion of development, but I have been thinking quite a bit about a Ted talk. Richard Preston talks about the Redwoods of the pacific northwest. I have always held a fascination with those behemoth wooden monsters, and on a recent visit to the west coast, I even had the privilege of seeing some of them. What stood out for me about the talk was a piece about the East Coast Hemlock trees, which are a distant relative of the Redwood. Currently, the East Coast Hemlock's are being threatened with extinction by an invasive beetle. In some areas, the beetle has destroyed 90% of the population of Hemlocks.
What struck me as interesting was an earlier part of the Preston's talk, where he discussed how only 4% of the Redwood population still remains from just 50 years ago. Intensive logging and human contact have destroyed the majority of Redwood forests. Now, I was just thinking, if I was a beetle, reading this information for the first time, wouldn't I think that humans were the more invasive species?
What is worse is that humans have the ability to make a choice. We can decide whether or not to destroy or save a species. For the hemlock situation, we view the beetle as invasive and the hemlock as the victim. We feel obligated to help the hemlock, to rescue it from the threat of extinction. However, what if in the process of saving the hemlock population, we bring the threat of extinction to the beetle population. The situation is further complicated because most likely, humans were the ones who inadvertently introduced the beetle population into the eco-system!
In a sense, the battle between beetles and hemlocks is very similar to development work. In any given country, there are the powerful and powerless--the poor and the rich. Cultures around the world are threatened and face extinction. For example, the culture and knowledge of Ayurvedic medicine has faced near extinction at the hands of western medicine. Tibetan culture faces extinction at the hands of Han Chinese. When is it our role to choose who wins and who loses in these battles? Are there any real 'winners' or 'losers'?
What struck me as interesting was an earlier part of the Preston's talk, where he discussed how only 4% of the Redwood population still remains from just 50 years ago. Intensive logging and human contact have destroyed the majority of Redwood forests. Now, I was just thinking, if I was a beetle, reading this information for the first time, wouldn't I think that humans were the more invasive species?
What is worse is that humans have the ability to make a choice. We can decide whether or not to destroy or save a species. For the hemlock situation, we view the beetle as invasive and the hemlock as the victim. We feel obligated to help the hemlock, to rescue it from the threat of extinction. However, what if in the process of saving the hemlock population, we bring the threat of extinction to the beetle population. The situation is further complicated because most likely, humans were the ones who inadvertently introduced the beetle population into the eco-system!
In a sense, the battle between beetles and hemlocks is very similar to development work. In any given country, there are the powerful and powerless--the poor and the rich. Cultures around the world are threatened and face extinction. For example, the culture and knowledge of Ayurvedic medicine has faced near extinction at the hands of western medicine. Tibetan culture faces extinction at the hands of Han Chinese. When is it our role to choose who wins and who loses in these battles? Are there any real 'winners' or 'losers'?
Tuesday, December 2, 2008
Recession
The recession is upon us. It is about time. I remember when the recession first started a year ago. At the time, I clearly remember my conversations with investment managers, mutual fund representatives and insurance people. They were all telling me that now was the right time to buy! They were so passionate and sure of themselves. They believed that the bull market would last forever and all I would have to do is give them all my money and all my troubles would be solved. I remember thinking that a year from now, the economy was going to be destroyed, but still they were adamant. It is good for me that I ignored their pleas.
Now we have the long struggle ahead of us. There will be no quick rebound. All we can do is wait and see. The virus of recession is already spreading around the world. Soon even China will be bailing out major industries as demand slows. Growth will slow and even contract. It is not a good situation but it is the only thing that can balance out the excess which we have had over the past few years. We have lived in a fanciful world where credit was free and easy. Now we need to pay back the world. For me, I am glad for the downturn. I have always believed that the world’s assets have been overpriced. Now, I will actually be able to afford investments such as a house or stocks.
Now we have the long struggle ahead of us. There will be no quick rebound. All we can do is wait and see. The virus of recession is already spreading around the world. Soon even China will be bailing out major industries as demand slows. Growth will slow and even contract. It is not a good situation but it is the only thing that can balance out the excess which we have had over the past few years. We have lived in a fanciful world where credit was free and easy. Now we need to pay back the world. For me, I am glad for the downturn. I have always believed that the world’s assets have been overpriced. Now, I will actually be able to afford investments such as a house or stocks.
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