On the road to sustainability

The ramifications of the credit crisis are/will be many.  Here’s one that’s good: sustainability.


A morsel of sanity comes from David A. Rosenberg, the North American Economist for Merrill Lynch. Instead of some horrible economic apocalypse, he forecasts a near future of frugality, where people concentrate on paying off their debts, and live a simpler life.

The meat, via Paul Kedrosky (and a few others):

As far as I know, there are only two ways to eliminate debt. You either walk away from it, which people obviously are doing, which is why we got these write-downs and these foreclosures, or you pay it down. I think people with a FICO score that they are concerned about are going to pay that down. That means that the savings rate is going to be forced higher. This, again, is going to be very, very disinflationary. It means that fashions are going to change. It means frugality is going to set in. We’re going to be living in smaller houses, driving smaller cars and living more frugally. It’s not going to be the end of the world; it’s going to be a necessary process to truly embark on getting the balance sheets down to more comfortable levels so that we can actually embark on the next cycle.

A question and a thought.  From the hospital’s perspective, what does a frugal America mean for health care spending?  Answering that question may be a good task for the planning departments in hospitals where capital projects have been pulled because of the credit freeze.

This, though, could also be a backdoor to sustainable health care.  A more reasoned America may very well begin to reduce health care spending at the “America’s health care system” level.  Slow and gradual would be the desirable approach to such thoughts of reduced growth.  Because if the financial crisis is any indication of how a requsite pullback in health care spending will occur, we know this: it will be long and painful.

Our Future: Moving Back Home?

Give or take a few years, the Millennial generation is roughly composed of those born between 1980-2000.  We number over 80 million (yes, that’s more than the number of Baby Boomers).

The eldest of this generation are starting to become parents.  Parents of Millennials are nearing retirement.

Explore this: in 15 years, the oldest Millennials will turn 43.  If they had children at 30, their oldest will turn 13.  The parents of those Millennials will largely be retired.

What’s the big deal?

From The Wall Street Journal’s Real Time Economics blog:

The study, by the McKinsey Global Institute, the think-tank arm of the consultants McKinsey and Co., carefully examined the saving behavior of various generations. The “silent” generation, the 52 million Americans born from 1925 to 1944, followed the classic pattern closely, with their household savings rate rising from below 15% in their early 20s to about 30% in their late 40s. But that pattern is almost absent for early boomers, those born 1945 to 1954; their saving rate tops out about 20%; and it’s completely absent for late boomers, those born 1955 to 1964, whose saving rate so far has remained stuck at around 10%.

Combine that with this troubling story from LifeWire via CNN:

When Stephen Leach gave up his Rockaway, New Jersey, condo at age 48 to move back in with Mom and Dad, it was out of need — his parents’, not his.

With his father suffering the ravages of Alzheimer’s disease and his mother struggling to remain in the large Randolph, New Jersey, home in which they raised five children, Leach stepped in a year ago to stabilize matters.


Such arrangements are becoming more prevalent as the population ages. An estimated 10 million American adults need help with daily activities, and family members are responsible for 80 percent of such caregiving, according to the AARP.

If the people who supposedly saved enough are having trouble paying for health care in retirement, what lies in store for the Baby Boomers who most assuredly have not?  What are the implications for their Millennial children who may incur the burden of taking care of both their parents and children simultaneously?

Expensive health care has ramifications (see above) far outside its sheer cost.  But money has the most prescient impact.  Our health care spending becomes more difficult to sustain every day.  It is expected (pdf) that there will be 2.9 workers for every Medicare beneficiary by 2020, down from 3.9 in 2003.

A sustainable health care future is desirable for all.  Eighty (plus) million Millennials will think along the same line.  The last thing we need is a parents vs. children struggle for government dollars.  Expensive health care could ignite just such a fight.

Another question…

In class we have been talking about quality–no doubt a needed discussion as we enter the workforce.

Six Sigma, Lean, Lean Sigma, IHI, Baldridge. And the countless other programs/iterations/combinations/mash-ups in existence.

But any quality program discussion necessitates other conversations. Importantly: 1) implementation and 2) sustenance.

No doubt any health care worker has been through some sort of the “flavor of the month” experience except for maybe a select, chosen few.

Seth‘s post gives it straight, “I don’t want to use a tool unless I’m going to use it really well. Doing any of these things halfway is worse than not at all. People don’t want a mediocre interaction.”

Partially implemented and poorly sustained quality programs damage the patient interaction.

Why don’t we ask, “are we fully, top-priority-like, completely committed to this?” when it comes to implementation…er, real implementation?