A Tale of Two Markets

You get up every morning from your alarm clock's warning
Take the 8:15 into the city
There's a whistle up above and people pushin', people shovin'
And the girls who try to look pretty
And if your train's on time, you can get to work by nine
And start your slaving job to get your pay
If you ever get annoyed, look at me I'm self-employed
I love to work at nothing all day

Bachman Turner Overdrive

Today’s blog inspiration comes from a couple of “close encounters” this week.  The first was inspired during a ski lift ride at Alta and the second by an attempt by my editor to deal with my Mom’s oxygen supplier.  She nicely volunteered to deal with it when I flipped out over a simple voice mail from them which, as I suspected turned out to be a nightmare.  I hope both of these tails may inspire some of your thoughts on the pro’s of free market capitalism, and the cons of some lowest common denominator capitalism.

Let me start by stating I am a “free market” guy. I am a firm believer in open competition and the capitalist system.  Furthermore, I am not “anti-immigrant” nor am I “anti-foreigner”.  I have always been skeptical of pure “buy American” campaigns.  Frankly the world wide spread of trade and the capitalist system have given billions of people a better way of life.  (There is a website called “Human Progress” that demonstrates in pure statistical terms the remarkable progress brought to the world by creative capitalism.  I strongly recommend you give it a look.)

So let’s begin with the ski lift story. 

Last week on a great bluebird ski day, Barbara and I caught a lift ride to the top of Alta with a “local”.  While chatting on the ride up he got a text message which interrupted our chit chat.  When he finished reading it I kidded him and asked if “work” was getting in the way of skiing (we retired people like to say things like that).  He responded, “no, just my middle school daughter looking for a lift from her unpaid “personal” Uber driver.  We laughed and I brought up a couple of personal Uber experiences.  I also told him I recently read an article about how 10 years ago “personal on demand drivers” were the realm of Warren Buffet and Bill Gates but now the average Joe can call for his personal driver at any time, any place and have them there in minutes.  He agreed and then told us his story.  He described how as a back country skier he can drive up a canyon, park his car, hike up, and ski over the mountain to a distant canyon.  He then summons Uber and they drive him back to his car!  There are even “specialists” locally that do this!  Cost is a lot less than a lift ticket…..unbelievable.  He does this a few times per week.

Now that is how creative capitalism can make the world incredibly richer, for all of us, and you know what, as long as the driver is on time, smiles and gets you where you need to go I really do not care how good their English is.

Now on to my Apria story but first a quick digression or two to my own real world management experience.

First story, while at AIG and as our division grew out in the “wilds” of Parsippany NJ I got some “pressure” to personally relocate myself and my management team to NYC.  I always prided our group for being the “bizzaro” world of AIG” in that we understood mass, efficient platforms and prompt customer service.  These concepts were frankly foreign to our Property Casualty Group that had always focused on huge commercial accounts. All of our transactions and business management were handled right there in Parsippany with the executive team an integral part of the group.  One day I was “summoned” to NY for some operational/financial reviews. During a break in the meeting the World Wide Operations Executive caught up to me while I was using the urinal in the Men’s Room.  While standing next to me he said “Hi Jim good to see you here in NY, you really should spend more time here, as your operation has gotten so big you need to be closer to where the “action is”.

 I looked “up” from peeing and said: “You know Neil, when I take a leak in Parsippany I often find myself standing next to one of our telephone customer service reps who is more than happy to share a problem or two with me.  When that happens I actually “know” how we are doing with our customers each and every day”.

He never suggested that to me again. 

A few years later our corporate financial people pushed me hard to relocate our “back room” to Subic Bay in the Philippines.  I argued that as a Company dealing with a unique US Insurance market why on earth would we want people who have no clue about this system and who had to communicate with American small businesses (lots of small contractors) in strained English be our customer contact point on day to day issues? Their answer but you could cut your customer service and billing costs in half! So I could save maybe a million bucks a year and jeopardize a Multi-Billion Dollar Business with dismal customer service?  No way.

 At the time I had enough “leverage’ to get away with comments like that but a few years later my successor succumbed to that corporate myopic thinking.  I think seeing that coming (coupled with Federal Oversight Pressure on management to repay Uncle Sam) helped me decide to retire (as well as my tax crusade).  Shortly after I retired many of our operations were “outsourced” to the Philippines.  My old group ceased to exist in 2012-2013, dying a slow death from poor service and a loss of a competitive pricing advantage we held, that is for another story.

Anyway this brings me to Apria, a healthcare service provider, which supplies my mother’s oxygen machine.

Now my first observation is that being in a primarily “Government Run and controlled” (as is most health care now) market the emphasis is on costs and “efficient” delivery. While there is one other competitor in this market (Utah) her original provider pulled out of this market a year after she moved here.

This old provider notified us (when we requested new replaceable hoses) that they were going to pick up her primary machine (A large floor model) and that we needed to find a new provider.  By the way (as an epilogue and to toss in another customer service tidbit) that large expensive machine is still in our garage, after several requests from us to get it that were left unanswered we gave up! It still works so maybe I can use for guests (altitude sickness)at our new home in Winter Park, meanwhile thanks Medicare!

Editor’s Note: I wish I could make this story shorter but perhaps by relating the WHOLE story we can make this a “Health Care” waste story as well.

Anyway, we took Mom to the Doctor and he prescribed a “new machine” but of course the fact that she has needed constant Oxygen for 3 years made no difference to Medicare so she needed to be stressed tested by a respiratory therapists.  One was ordered through Apria by the doctor and our relationship began.

Now in fairness to this company the local employees who came out and tested my Mom, delivered equipment and “trained us” were wonderful.  They arrived promptly, and even gave my mom a piece of candy before leaving. They gave us a new “portable unit” (my Mom already owns an older model but it works fine).  When I asked why they said that is what was proscribed so we got that as well as new big machine. 

My Mom’s machines need to put out 4 liters of oxygen per minute, or she kind of suffocates.  The floor machines we have do that no problem.  The portable she owns does it as well for about 3.5 hours (enough to take her to Doctor’s, shopping etc.) it has a spare battery as well.  Her new machine puts out 4 liters only for about 40 minutes.  We learned that on our first excursion to the store.  It was not pleasant.  We called Apria .  It took about 45 minutes to convince them that we

1.      Knew how to turn it on.

2.     Knew how to charge the battery

3.     Knew how to set Oxygen level

4.     Knew how to read a watch (Ok they did not ask us that)

(We now know why the customer service people all barely understand English-they are in the Philippines as my editor discovered Yesterday)

They sent a tech out and he brought a new portable.  He said it was a “newer model” but it looked the same to me.  We soon found that it was “better” it lasted 55 minutes.  Frankly since we had a perfectly good portable I said (like any rational guy would) “screw it” and tucked it away.

So now every month we get a bill charging us our portion of the Medicare cost, 7 bucks for that unusable portable machine.  I let it go for a couple of months but finally my Editor suggested we should tell them we do not need it.  I handled that call, which after 45 minutes (see prior call for why) I finally explained the story enough so that they understood. They told me I needed to get the Doctor to “un-proscribe”.

Last week, before taking my mom to her most recent Doctor’s visit, my Editor “gently” suggested I talk to Doctor about this.  Question: why on earth would a nice guy like me get testy with a wonderful woman like Barbara for simply expressing a simple, logical idea?  Call me clairvoyant.

Anyway I dutifully handled the matter with the Doctors receptionist and went home “proud as a peacock”.

Two days later I got a voice mail from Apria, “we will be out to pick up all oxygen equipment Tuesday”.  I flipped out thinking they will kill my mother taking away her machines!  Once again my editor calmly intervened saying how worried she was that I blow up over a simple voice mail.  She is likely correct but I get this Don Quixote inspiration sometimes.  She calmed me down and offered to call Apria to clarify so I could feel better.

Go for it dear!

Over an hour on the phone during which (via garbled English):

1.      She learned “no problem we see the equipment was already picked up”

2.     They did not need a Doctor’s order to take away machine

3.     They would reimburse us for that 7 bucks per month.  But first she had to talk to someone higher up…in Ohio USA

Being a calm persistent person Barbara was going to try to take care of that 45 or 50 bucks.  Unfortunately the Ohio person spoke clear English.

1.      OK equipment not picked up, they are coming today

2.     They did need a Doctor’s order

3.     NO MONEY refund.

Take that customer!

Anyway my overriding thought, how on earth does a company function that way?  How can management let it go on?  Why would anyone do business with such a company?  Here are some “free Market” thoughts, many for which I have no immediate answers.

1.     Health Care is not, nor has it been “free market” for years and years.  Medicare is monolithic and is designed to provide “decent” healthcare to seniors (I hope so I go on it in June).  Costs are controlled “in theory” by the free market but in reality the providers have little freedom. 

2.     To keep costs down there is massive outsourcing using the lowest common denominator for customer “non-medical” interaction.  As a result the system “charges” us all for this by costing us hours and hours on the phone.  It is low cost to them because well, think Subic Bay.  On our end all retirees have lots of free time!  I could go on with stories about dealing with other medical providers since taking on "Mom's Stuff", but I have said enough.

3.     Management has absolutely no clue nor does it care about that part of their operation.  I‘m sure they do not pee with the customer service reps, nor would they if they could.

4.     This company bombards me with auto text reminders of bills, email reminders of bills and phone message reminders of bills.  They all clog up my stuff and do nothing but to stick with a theme, piss me off.  I cannot fathom how many elderly people deal with it.  I do know how my Mom does, she lets us do it.

Anyway to wrap up this lengthy post. I now feel much better about all of this.  Unloading on you guys I find to be better than Prosaic!

Until next time

Adieu.