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Single Payer Health Care will Work

Health Care Reform

Here's why I want a ONE payer system. Just got a BCBS statement (explanation of benefits - wait for it, we will come back for this). It was for a general checkup, I got a tetanus shot (they really push them - like drugs) and a small 'skin-tag' removed from my underarm.

Itemized:
Office visit $221
Preventive Service $242
Surgery-Skin tag removal $176

on the second statement - completely separate envelope for the same visit:

Drugs $65
Vaccine Admin $30
Treatment Room $120
Laboratory $12
Laboratory $74
Laboratory $22
Laboratory $43

Yep that explains it!

Would any reasonable person believe that being charged an office visit and a treatment room for the same visit is NOT redundant double billing. A phone call to the provider Virginia Mason assures me that this is standard procedure.

So how does the double speak of EXPLANATION of BENEFITS sound now? I'm confused, and just believe that a single payer system will make my life better! Sure a lot of insurance claims admin people will lose there jobs - but they are really smart can work computer systems like no-body's business - they can find another job.
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David's notes on "Drive"

- "The Surprising Truth about what Motivates Us" by Dan Pink.

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What I notice first and really like is the subtle implication in the shadow of the "i" in Drive is a person taking one step in a running motion.  This brings to mind the old saying - "there is no I in TEAM".  There is however a ME in TEAM, and there is an I in DRIVE.  And when one talks about motivating a team or an individual - it all starts with - what's in it for me.

Introduction

Pink starts with an early experiment with monkeys on problem solving.  Seems the monkeys were much better problem solver's than the scientist thought they should be.  This 1949 experiment is explained as the early understanding of motivation.  At the time there were two main drivers of motivation:  biological & external influences.  Harry F. Harlow defines the third drive in a novel theory:  "The performance of the task provided intrinsic reward" (p 3).  This is Dan Pink's M…

Exercise:: Definition of Ready & Done

Assuming you are on a Scrum/Agile software development team, then one of the first 'working agreements' you have created with your team is a 'Definition of Done' - right?



Oh - you don't have a definition of what aspects a user story that is done will exhibit. Well then, you need to create a list of attributes of a done story. One way to do this would be to Google 'definition of done' ... here let me do that for you: http://tinyurl.com/3br9o6n. Then you could just use someone else's definition - there DONE!

But that would be cheating -- right? It is not the artifact - the list of done criteria, that is important for your team - it is the act of doing it for themselves, it is that shared understanding of having a debate over some of the gray areas that create a true working agreement. If some of the team believes that a story being done means that there can be no bugs found in the code - but some believe that there can be some minor issues - well, …

What belongs on the Task Board?

I wonder about these questions a lot - what types of task belong on the task board?  Does every task have to belong to a Story?  Are some tasks just too small?  Are some tasks too obvious?  Obviously some task are too larger, but when should it be decomposed?  How will we know a task is too large?

I answer these questions with a question.  What about a task board motivates us to get work done?  The answer is: T.A.S.K.S. to DONE!



Inherent in the acronym TASKS is the point of all tasks, to get to done.  That is the measure of if the task is the right size.  Does it motivate us to get the work done?  (see notes on Dan Pink's book: Drive - The surprising Truth about what motivates us) If we are forgetting to do some class of task then putting it on the board will help us remember.  If we think some small task is being done by someone else, then putting it on the board will validate that someone else is actually doing it.  If a task is obvious, then putting it on the board will take vi…

Elements of an Effective Scrum Task Board

What are the individual elements that make a Scrum task board effective for the team and the leadership of the team?  There are a few basic elements that are quite obvious when you have seen a few good Scrum boards... but there are some other elements that appear to elude even the most servant of leaders of Scrum teams.









In general I'm referring to a physical Scrum board.  Although software applications will replicated may of the elements of a good Scrum board there will be affordances that are not easily replicated.  And software applications offer features not easily implemented in the physical domain also.





Scrum Info Radiator Checklist (PDF) Basic Elements
Board Framework - columns and rows laid out in bold colors (blue tape works well)
Attributes:  space for the total number of stickies that will need to belong in each cell of the matrix;  lines that are not easy eroded, but are also easy to replace;  see Orientation.

Columns (or Rows) - labeled
    Stories
    To Do
    Work In P…

What is your Engagement Model?

What must an Agile Transformation initiative have to be reasonably assured of success?

We "change agents" or Agilist, or Organizational Development peeps, or Trouble Makers, or Agile Coaches have been at this for nearly two decades now... one would think we have some idea of the prerequisites for one of these Transformations to actually occur.  Wonder if eight Agile Coaches in a group could come up with ONE list of necessary and sufficient conditions - an interesting experiment.  Will that list contain an "engagement model"?  I venture to assert that it will not.  When asked very few Agile Coaches, thought leaders, and change agents mention much about employee engagement in their plans, models, and "frameworks".  Stop and ask yourselves ... why?

Now good Organizational Development peeps know this is crucial, so I purposely omitted them from that list to query.

One, central very important aspect of your Agile Transformation will be your Engagement model.