Still a great rule: Trust but verify

Lessons from Madoff. Assessing the alleged financial chicanery of financier Bernard Madoff, Sempre Management cofounder Michael Feinstein tried to extract lessons for entrepreneurs and investors. In a post titled "Lessons from the Madoff Mess," he wrote:

"Trust but verify" is often attributed to Ronald Reagan. He certainly used it very often. And these are good watchwords for every entrepreneur. Some examples:

From the looks of it, Madoff's investors (and "friends") trusted him without verifying his results. It seems like no auditing of his transactions was done. When you are dealing with tens and hundreds of millions of dollars, you have to verify the results. A true friend or honorable money manager would never object.
thefeinline.com

Power of the status quo. The gravitational pull of the status quo is what keeps us from changing things that ought to be changed, writes Charlie Baker, the chief executive of Harvard Pilgrim Healthcare. To explore that idea, he compares the college football post season with the healthcare system.

Oh boy - what could healthcare and the so-called BCS possibly have in common? I pondered this question as I read, watched and listened to the discussion going on across every major sports news outlet throughout the weekend about how the Bowl Championship Series is simply a bad way to pick a national champion. This year, there are at least 10 teams that all have a legitimate shot at number one - Oklahoma, Texas (my favorite), Florida, Alabama, Texas Tech, Penn State, Utah, Boise State, USC, and Ohio State.

But in college football, a computer piles up points all year long for each team - based on wins, losses, strength of schedules, and the like - and the two teams with the most points at the end of the season play each other. That determines the national champion. This year, when there are still two undefeated teams, and a host of teams with one loss (most of which occurred against one another), the idea of a two-team showdown based on computational statistics seems simply nuts. But the keepers of the BCS flame have their reasons for retaining the status quo, and they have the power and the juice to keep things just the way they are.

But maybe there's another answer - the folks who participate in and benefit from the current arrangement don't want to change it, and as long as the fans, the alumni, the TV networks, and the schools themselves continue to show up and participate every year, moving away from the status quo is simply not going to happen.

Which brings me to healthcare. Anyone looking at healthcare from the outside in would have to conclude that it needs to be reformed. And the commentary from the various analysts, experts, and overseers on this question is quite familiar. There is too much utilization and service variation, too much focus on volume, not enough attention to outcome, too much administrative complexity, too much high technology, not enough personal attention, etc. The system, to anyone who's studied it seriously, needs to be reformed.

And yet here we are, twenty years or so into this conversation, and it still works under more or less the same terms it's always worked under. Why? Well, in some ways, it's a lot like the BCS. As long as everyone who pays for, manages and participates in the current system likes it better than something they either don't know or don't understand, it's unlikely that major change will occur.
letstalkhealthcare.org

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