Just Be And You Are

As attention becomes more of a scarce resource, does it become a commodity for sale?

Marketing agencies must view attention in this way at times. The signals we’re bombarded with day-to-day are endless; tv, music, books, ads, and magazines are just a start. Everyone has an opinion too and they aren’t afraid to express it, the blogosphere being a great example.

Attention spans are only going to get thinner. Multi-tasking has a limit, so do you a) choose to scale back and unitask, b) limit the scope of what you pay attention to, c) don’t do anything and let yourself swim in the sea of messages?

It’s a tough choice, but no matter which path you choose, you are paying out something of yourself. Something much more valuable than the dollar in your pocket. If attention is the next scarce resource, buy-in is gold.

John Robb’s links alone would suffice in connecting you to the myriad future world. Here’s a recent link to predictions for the decade ahead by Kazys Varnelis. Reading it in entirety is worthwhile but draining. I left feeling potentially optimistic and assuredly pessimistic. Lots of “ifs”. Here are the highlights:

China will start slowing. The United States, EU, the Mideast and East Asia will all make up a low growth block, a slowly decaying imperium. India, together with parts of Africa and South America, will be on the rise. To be clear: the very worst thing that could happen is that we would see otherwise.

I disagree on most counts here. China’s manufacturing of inelastic goods is too entrenched for it to slow. East Asia is lower growth post-recession but they are also more recession-proof due to their “immateriality” (as mentioned in the post) and service good production. India and Africa are too rife with corruption and dependent on non-resident financial funding to thrive on their own. The reverse brain drain is helping them out, but for how long?

A greater divide will open up between three classes. At the top, the super-rich will continue controlling national policies and will have the luxury of living in late Roman splendor. A new “upper middle” class will emerge among those who were lucky enough to accumulate some serious cash during the glory days. Below that will come the masses, impossibly in debt from credit cards, college educations, medical bills and nursing home bills for their parents but unable to find jobs that can do anything to pull them out of the mire.

So much of this is self-created. The party of the 1990s and 2000s (again, credit goes to the author) and even the “progressive” consumer spending of the baby boomers has brought us to this point. Many went into debt willingly expecting a positive ROI in the end, unaware of the champagne glass tower their investments were built on. While trust in financial structures is all but gone, the mental shift from consumption to value still hasn’t occurred, primarily due to the “upper middle” class continuing with business as usual.

Some cities are simply doomed, but if we’re lucky, some leaders will turn to intelligent ways of dealing with this condition. To me, the idea of building the world’s largest urban farm in Detroit sounds smart. Look for some of these cities—Buffalo maybe?—to follow Berlin’s path and become some of the most interesting places to live in the country…

…These cities will not see real estate values increase greatly. The new classes populating them will not be rich, but rather will turn to a of new DIY bohemianism, cultivating gardens, joining with neighbors communally and building vibrant cultural scenes.

What struck me was the mention of Buffalo, where I lived for the past few years. Cost of living is certainly an attraction and if you’re not into global arbitrage, it’s a great option on the national scale (same language, same culture, no need to adopt/adapt). With dilapidated storefronts ready to be revamped, a large elderly AND student population and shoestring entrepreneurship on the rise, there’s a lot of promise. Fresh blood needs to pour in waves though because of the conservative, revisionist mentality that still holds these kinds of cities back.

The divisions in politics will grow. By the end of the decade, the polarization within countries will drive toward hyper-localism. Nonpartisan commissions will study the devolution of power to local governments in areas of education, individual rights (abortion will be illegal in many states, guns in many others), the environment, and so on. In many states gay rights will become accepted, in others, homosexuality may become illegal again.

Hyper-localism is happening right now in “green” communities, spa-like baby-boomer villages, and open-source networks (think small; journalism to blogosphere for example). In Gladwell terms, it’s 10-15 years away from achieving critical mass, and when it “tips”, the trending will drive away those who began it to either accumulate wealth quickly and estrange themselves from the crowds or go back to creating mini oligopoly-like systems of government to hold onto power. Early adoption will become a skill.

As Varnelis iterates several times cautiously, this is a fun exercise blogs like to get into. It does shape bias mindsets of readers to a certain degree so being involved signals the belief that your voice is your vote. The U.S., being beat up so often based on Rome-downfall analogies, trumps Rome on the spectrum of freedom of speech. The internet only enhances that freedom. Take a bath in information and you don’t know what you’ll come out with. Join the fun.

Sound is vibration that can be translated by the delicate structures of our inner ear, but it moves more than just those tiny receptors. It is part of the spectrum of energy vibrations that affect us on the mental, physical, and spiritual levels.

Good Vibrations – Sound Healing

It’s unnerving how some songs connect us to the deepest parts of our being and provide solace when we need it the most. To translate that into a holistic method of healing is fantastic and easily applied on our own to bring us in and out of the mode of thinking we want to be in.

Modern existence is so complex, and much of what we long to do is left to wait by the side. We know what is important but tend to let the weight of worldly pressures lead us astray. To get back on track, however, we need only take a moment to consider where our thoughts will be as we take our last breath on this earth.

Your Last Breath – Redefining Your Priorities

The rest of the DailyOM goes into the last moments being composed of family and loved ones and spending more time with them is what matters most. While we’re all somewhat inclined to this notion, it’s very relative, subjective to what matters most to that individual person. Bottomline, thinking this way lets you tap into that meaning for yourself and pursue it in the here and now. Better than reflecting on it as regret (a waste of time if you already do what moves you).

**A collection of inspirational DailyOM quotes can be found here.

1. Summer Tomato’s healthy habits for a new decade. Simple and sensible. More about long-term evolution than short-term sacrifice.

2. Jay’s eloquent explanation of the health care industry. Past, present and future. A must-read.

3. A wonderful find from HBR on patience, smartphones, and how we’re micro-processing life, minute by minute.

4. “What’s difficult is changing your attitude.” Seth on the meaning of Kevin Kelly’s first 1,000.

5. 10-step plan on how to gear yourself to implement a marketing plan by Robert Middleton via Philippa Kennealy. Translates to just about any goal.

John Robb does a fantastic job discussing bandh dynamics in this post. Bandh means “closed” in Hindi and in this case is used to describe various close-outs that occured in India over the last few weeks. In Punjab, it was a clear case of an “eye-for-an-eye”. The events go like this:

1984

2009

I was in India for the Punjab Bandh and it was a ghost town that day. I still went out to run a few errands and a couple of shopkeepers were open to take advantage of th situation. At tremendous risk though, since the bandh initiators could have easily called them out and made trouble for the long run. The scary thing was my parents were driving in that day from New Delhi (which suffered its own bandh a week later) and buses, trains, roadways and such were the first to be blocked off by the boycotters. They got lucky and ended up cruising the empty streets, shaving an hour off their trip.

Robb describes the impact the best:

In short, it is pure global guerrilla. For example:

It exacts “taxes” on local businesses and individuals.

It promotes and participates in a thriving black market (which is made even more important due to suppression of “legitimate activity”).

It can rent the Bandh to politicians and businessmen for their own purposes. Competitive Bandhs from labor and politicians (aka non-violent strikes), are disrupted and can often turn violent when the Naxalites enforce their monopoly.

The last point – especially in essentially corrupt political environments such as in the East – is the scariest. Politicians renting out the black market and disguising it as a mercenary force gives little control to a “democratic” populace. When everyone agrees the wrong thing is OK, change management is nothing but showmanship.

Richard Smith from Patients Know Best after finally getting online access to his medical record:

It was an anticlimax. My records contain almost no information about me. You’d have no idea from these records who I was, what I did, what I thought, or what I care about. You’d know more about me after two minutes on the world wide web than you would from reading everything in my medical record.

Even if the appropriate documentation were available, asymmetry of information – the gap of knowledge between patient and physician – would prevent meaningful understanding of what had been written. Perhaps wiki links, clinical translation services, or changes in the way medical students learn to document may help.

Medical records tend to be disjointed. Linkages between labs ordered, results, the reading physician’s assessment and the attending physician’s follow-up don’t flow as a stepwise event. Without sequential order it’s difficult to tell where the gaps are and who might have dropped the ball.

And some of the most important information was wrong. It said that I took no drugs, and I do: I take the five ingredients of the polypill. These were prescribed by a cardiologist not the GP, but he had written to the practice. Unsurprisingly the information hadn’t made it into my notes.

Currently, healthcare is in the adoption phase of simply getting medical records online. Data is sorely needed, though challenges still exist to make effective use of that data.

The New England Journal of Medicine’s perspective on payment reform:

Care management, with its cost-reducing potential, will not spread widely in the health care system without substantial changes in payment policy. If hospitals profit from unnecessary readmissions, they are unlikely to adopt effective hospital-to-home care-management programs. If primary care practices are not reimbursed for the work of a registered-nurse care manager, they will not hire one unless they share in the savings generated by reducing hospital admissions and emergency department visits. Other obstacles include nursing shortages and the paucity of training programs for nurses to become effective care managers.

Current financial incentives sometimes create less revenue for better care. In a fee-for-service (FFS) system, rework (i.e. unnecessary readmissions) can be profitable because providers are paid per visit, not a cumulative clinical episode.

The first line of the article cites a stat noted often that deserves reiteration:

In the United States today, 10% of patients account for 70% of total health care expenditures. Many patients who require high-cost care are people with multiple chronic conditions, many medications, frequent hospitalizations, and limitations on their ability to perform basic daily functions due to physical, mental, or psychosocial challenges.

Chronic disease, such as congestive heart failure, diabetes, and coronary artery disease commonly occur in the elderly (though in the case of diabetes that is quickly changing). This sector of the population is also growing faster than any other.

Cost reform must be strategic and piece by piece unravel the complex knot that now represents the US health care system.