US HealthCare Issues Notes

1.  Low-Value Care: as opposed to more effective or less expensive alternatives, “overtreatment”
2.  Lack of Price Transparency – seems arbitrary; most insurances apparently base prices on a “cabal”, or private small group which determines price values of medical procedures and care
3.  Administrative Complexity =overspending on administrative costs 
4.  Mandatory Budget includes Social Security and Medicare, which is increasing deficit; however, it is political suicide to suggest cutting spending for the disabled (grandma, Veteran, etc).  One solution is to lower overall healthcare costs, which Obamacare (ACA) addressed by including coverage for preventive costs, catching illnesses and diseases before they become ER visits or cancer treatments, aka more expensive costs.

Leading With A Limp Notes -Dan B. Allender

On Leadership:

“Many a king misunderstands or abuses his calling and ends up devouring the flock – and then he blames the sheep for the dwindling numbers.  Such a leader solidifies his power by the use of fear and shame.  The troops cower and obey, but they do not love the leader and they are not loyal to him.  It is far more difficult to be a shepherd-king, one who must possess power and give it away until he serves as the balancing point of an inverted pyramid” (pg. 61)

“The leader will fail, so he needs to confess his anger, self-absorption, and cowardice and serve his people by being the first one who needs to be forgiven”  (pg. 62)

“And why worry about a speck in your friend’s eye when you have a log in your own?  How can you think of saying, ‘Let me help you get rid of that speck in your eye’ when you can’t see past the log in your own eye?  Hypocrite!  First get rid of the log from your own eye; then perhaps you will see well enough to deal with the speck in your friend’s eye” (pg. 71)

           –>  “A broken leader is a sweet paradox of confidence and openness.  If those I lead have already found out the worst there is to know about me- then the log in my eye is continually being removed in the midst of every crisis. The result is better vision and greater wisdom due to the freedom I feel to both live and die” (pg. 75)

On Courage:

  “…  He must not merely cling to life, for then he will be a coward, and will not escape.  He must not merely wait for death, for then he will be a suicide, and will not escape.  He must seek his life in a spirit of furious indifference to it; he must desire life like water, and yet drink death like wine” … this is the foundation for true confidence.  – G.K. Chesterton (pg. 74)

“Courage never takes away fear; courage simply redistributes fear to get the job done” (pg. 77)

“Do I know what to do but simply not want to do it?”  (pg. 81)

---

Other Thoughts:

“If the church is really about spiritual relationships, then why are they so hard to keep together?” 

          —>”‘ What lens am I using to read reality?”  (pg. 83)

Entire pg. 98 (not included here unfortunately)

^(Entire pg. 113)

“Groucho Marx wouldn’t want to be part of a club that would have him as a member” (pg. 116)

“Organizations are full of binds because there is not sufficient honesty between human beings to build caring, committed relationships.  Instead, everyone figures out how to put on the right face.” (pg. 117)

^(pg 156)

“Most people want to grow, but the price of growth is pain… it is the way of growth and excellence:  submission to pain through discipline is the only route to maturity” (pg. 194-195)

On Betrayal:

“Betrayal is a deep psychic wound that hardens the heart against grief and deadens is hunger for intimacy” (unknown)

Notes on “The Life-Changing Magic of Tidying Up” – Marie Kondo

• Tidy/organize all at once, INTENSELY and COMPLETELY, not bit by bit
• Tidying is just a tool, not the final destination (21)
• Two-Part Question for Criteria:
  • Are you keeping the item?
  • If yes, where are you placing it?
• Sort by category, not by location
  • Avoid duplicates, narrow down volume
    • “Can’t put it back” types + “Can’t discard” types
• Make tidying into “special event” day

Obtaining HAPPINESS

1.  Picture the lifestyle you want.  Ex:  “yoga?  why? for more relaxation? to lose weight? are you sure?”  <– repeat 3 x for each item
2. Examining what you own
   • Selection Criterion:
     • Cease being functional
     • Out of date – fashion, past event
   • Choose what you want to keep, not what you want to get rid of.  Look more closely at what is there (41)
     • “Does this spark joy?”
     • Touch each item to see how your mind and body reacts
3. One category at a time
   • Make subcategories of tops, bottoms, socks, etc.
   • Things can be stored out of sight
4. Do not start with Mementos or anything of memory first
   • Clothes, books, papers, komono (miscellany), mementos <– ORDER
     1. Functional value
     2. Informational value
     3. Emotional value
5. Don’t let family see
   1. The urge to point out someone else’s failure to tidy is usually a sign that you are neglecting to take care of your own space
6. What you don’t need, your family doesn’t need either
7. Tidying is a dialogue with one’s self
   • Form of meditation
   • Quiet space to clean, background noise should be ambient or environmental music with no lyrics or well-defined melodies
   • Early morning is the best time- fresh air, sharp power of discernment
8. What to do when you can’t throw something away
   1. Human judgment:
      1. Intuitive
      2. Rational “I might need it later” / “It’s a waste to get rid of it”
   2. To truly cherish things that are important to you, you must first discard those that have outlived their purpose
      1. “Thank you for giving me joy when I bought you” / “Thank you for teaching me what doesn’t suit me” much like the people we meet in life, each has a different role to play.  Free them from the prison, let them go with gratitude

Tidying by Category Works Like Magic

• Clothes
  • Tops, Bottoms, Clothes, Socks, Underwear, Bags, Accessories, Clothes for specific events, Shoes.
• Downgrading to “Loungewear” is taboo
  • Usually it’s not appropriate loungewear
  • Positive self-image at home is important too
• Arranging Clothes
  • Rise to the right (heavy items on left, dark in color:  coats–>dresses–>jackets–>pants–>skirts–>blouses
  • Never ball up socks /store in shoebox
  • Seasonal clothes:  Divide into “Cotton-like” and “Wool-like” materials
• Papers
• Credit card statements / Warranties / Greeting Cards / Used checkbooks (get rid of) / Pay Slips
•  Komono (Miscellaneous)
• Bath/Sink
  • Keep soap and shampoo products out of shower to avoid slime
  • Keep sponge completely dry and underneath sink or hang outside on veranda
• “When we delve into the reasons why we can’t let something go, there are only two:  an attachment to the past or a fear for the future” (181).
  • 3 approaches:  face now, face sometime, avoid until we die.  Choice is ours.
    • FACE NOW!!
  • Not needing to search is a stress reliever
• DETOX!!  Living space affects your body 😀
  • Feng Shui:
    • Yin + Yang
    • Five Elements:  metal, wood, water, fire, earth energy.

Notes on “Quiet: The Power of Introverts in a World that Can’t Stop Talking” – Susan Cain

These are mostly personal notes for me since I find this book super intriguing and enlightening, and I want to remember all the key points, research, and arguments she has written.

• Culture of Character:  integrity, modesty, reserves, quietness,  originated from farming, changed to Culture of Personality:  bold, outgoing, confidence, after the Industrial Revolution hit around the 1920s (at least in America) for business purposes.  Commercials encouraged confidence and more extroverted values… attracting other people and more about the image –>  amplified by social media
  • Women/men who were back  then seen as coming from an educated classy family background if more reserved, but then over time became perceived as too shy, maybe even prude?
• Reason why introverts haven’t been wiped out by Natural Selection is because even though high sensitive babies seem generally to take up 20%, low-sensitive 40%, in-beweens 40%, circumstances change to benefit one or the other.
  • Example:  hunter-gatherers benefit extroverts with the “go-getter” attitude, survival of the fittest attitude.  But settlers with more farming, calmer detailed systems benefit, and animals who are more cautious are less likely to take risks that could get them killed.
• Nature vs. Nurture:  studies following 4-month babies to high school age show that babies who have “high-reactive” reactions towards loud noises and other stimulants tend to grow up to be more susceptible to emotions, both negative and positive, and possibly more inclined to be introverts who study and are more academically strong
  • Two high school kids, the “low-reactive” student grew up to be a confident jock who admittedly flaws cheerfully and spoke to interviewer as an equal, not a person of authority.
  • 70% of more “sensitive” people are introverted
• Solitude:  studies show that open-floor plans are actually more detrimental… having places to work alone in the office can help boost up creativity and allow employees to focus more on the tasks
• Peer-pressure:  experiments have shown that people are more likely to succumb to majority influence, so in a classroom, they might even not be aware that their answer is more to conform, even if it’s wrong
• Asian-american culture:  Asians come from a background that value more Culture of Character, modesty, reservedness, speaking only when there is value.  This clashes with things in American culture, particularly in classrooms and in the workplace where teachers or CEOs respect them more for speaking up and vocalizing opinions and equalizing them to confidence, even if the answer is not always the best, or the employee doesn’t have the most experience or knowledge
  • Cupertino has 70% Asian students – their culture revolves around the library and grades rather than the football field and sports. But students have struggled to conform to more extroverted outgoing culture once entering college

Questions:  Since Asian culture treasures Culture of Character (introversion) over Culture of Personality (extroversion), what would the test results yield for the proportion of introverts vs. extroverts, or rather high-reactive vs. low-reactive in the amygdala?  Since genetics of that can be 50% hereditary, would Asians tend to conform to their culture and biologically/physiologically have more than 20% population of introverts in Asia?  Over time, would they adapt to American traits that are prized and have less sensitive information signals in the brain?

• Professor Brian Little:  Free Trait Theory – “born and culturally endowed with certain personality traits, but we can and do act out of character in the service of ‘core personal projects'”
  • Self-monitoring – good at adjusting own behavior in accordance to other people and surroundings/environment.  Introverts with high scores are better at pseuo-extroversion.
    • “more pragmatic than principled”
    • better at deception, conformist
• Career: 
  1. What did you want to be when you grew up, why?
  2. What kind of work did you gravitate to?  Goals in pro bono work, etc. what motivates you?
  3. What/who do you envy?  (Susan Cain said writers and psychologists, not Wall Street lawyers)  
• “Restorative Niches” -place to return to your true self.  Physical place, or brief time.  Evaluate presence/absence at new job as carefully as family leave policy or health insurance plans
• Approaching requests at work empirically rather than psychologically works well to appeal for extroverts 😀  “nature of work required quiet time to concentrate, two days of work from home”
• Extroverts:  “need people as a forum to fill needs for social impact; may influence how many friends you have, but not how good a friend you are” (pg. 227).
• Introverts:  sincere, meaningful conversations .
• Big Five traits:
  • Introversion-Extroversion
  • Agreeableness
  • Openness to Experience
  • Conscientiousness
  • Emotional Stability
• The Communication Gap between Introverts/Extroverts
  • Introverts have two gears:  overwhelming feelings and detached self-possession.
    • How to show emotions without losing control?
    • More prone to cooperation, minimize aggression aka “receding emotionally”
  • Extroverts:  “confrontive copers” up-front, argumentative approach
    • more prone to competition
  • Hong Kong vs. Israeli MBA students
    • Asians prefer friendly business manager rather than hostile
    • Israelis equally likely to accept either – view disagreement not as sign of disrespect but that opposing party is concerned, passionately engaged
  • “Anger:  The Misunderstood Emotion”- Carol  Tavris.  Bengali cobra should hiss, but not bite.
    • “You’re so antisocial” –> rephrase:  “Can we figure out a way to organize our weekends that work for us both?”  (extrovert to introvert)
    • Introverts are better at observing social dynamics than participating in them (distracted by multi-tasking efforts)
• Cobbler vs. General – providing space for introvert or extrovert to fulfill potential
  • ‘iatrogenic’ problem:  when the treatment makes you sick.