HealthCare Voice

Kicking the Can Down the Street, DeFacto Style

We hear a lot these days -- some would say 20-30 years too late -- that Congress can no longer kick the deficit/debt can down the road.  Of course, the clear and factually accurate implication of this statement is that Congress has seen this deficit/debt train wreck coming for a long time.  In their wisdom, they chose to put off the inevitable with year after year of highly touted cuts in spending which were actually cuts in the rate of increased spending, not net reductions leading to lower deficits, so we kept slipping further and further into debt.

What is going to happen now?  Since Medicare is and will continue to be the single biggest driver of federal spending, and future projected deficits, what role should healthcare providers play?

The healthcare industry’s normal response is to do nothing aside from complaining, and then adjusting to the significant reductions in reimbursement.  Spending more money, or even maintaining current funding levels, does not guarantee quality of care and service.  However, there is only so much money you can strip out of the current healthcare structure without causing irreparable harm to patients.  Major cuts, the size of which will be necessary to make a meaningful impact, will require a new business model.

I would argue that following our normal path of adapting is tantamount to kicking the can down the road.  

The Patient Protection and Affordable Care Act (PPACA) made an attempt to reduce the number of uninsured Americans but largely missed the boat in achieving material and sustainable reductions in healthcare spending.  Yes, I know what the Congressional Budget Office projected – important savings.  I know what the President and the Democrat leaders promised.  I am not accusing them of misleading the American people.  Rather, I am zeroing in on the phrase "sustainable reductions”.

The fact is that you cannot control healthcare spending over the mid-to-long term, whether it is for Medicare or commercial insurance, until you completely restructure the way patient care is delivered, how it is paid for and consumers are more financially responsible for the care they receive.  Tort reform should be included in the fix, as should improved accountability for quality and service, but those are not big drivers of the increased costs which this year doubled the rate of inflation and overall economic growth.

Congress, as I have said many times before, lacks the political will and moral courage in the current volatile political climate to revisit healthcare reform.  Democrats, some of whom understand the structural problems that contribute to higher costs, are of the view that any effort by Congress to lead a material restructuring will provide ample fodder for Republicans and Tea Party devotees to re-scream government takeover, socialism, the trashing of personal liberties... You get the point.  Republicans, while deserving much credit for the innovative ideas for Medicare reform in Rep. Paul Ryan's "Path to Prosperity", are seeing a rising tide of independent voters who are increasingly uncomfortable with, trending to outright opposition of, what is essentially privatization of a program that most Americans feel is a successful government program.  

This has all the makings of a black hole environment that will preclude Congressional action, must less leadership.

The most important business in Washington today is not the “people's business” unless you believe that average Americans today are focusing more on the next election rather than jobs and scrapping by to pay the bills.  The really depressing part is that when the 2012 election cycle is over, regardless of the outcome, the political operatives that create the red-hot, demonizing rhetoric, will begin thinking about the 2014 off-year election.  

So who is going to take the lead on this necessary restructuring?  Who will take the chance to design and promote a new approach -- from how hospitals are designed and operated to the role of physicians and other providers, to the payment mechanisms, economic alignments, and incentives?

Doing nothing, and adjusting to the marginal tweaks from Washington, is tantamount to kicking the can down the road.

What would you do?    

© 2011 John Gregory Self

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GUEST BLOG: Jobs In The Growing Healthcare Industry

Today marks a first for HealthCare Voice:  a guest blog posting. Taylor Dardan is a dedicated cancer prevention advocate and supporter of private healthcare. He steadfastly believes that America's healthcare system in one of the finest in the world and is one of the most innovative and robust market sectors in America because it consistently draws among the top medical and business talent.  He is a medical student, and lives in the Southeastern United States.  -- Editor

 By Taylor Dardan

The healthcare industry, already one of the largest business sectors in the US, is one of the few career fields that despite the hard economic woes, is continuing to hire.  In fact, healthcare jobs are expected to grow faster than any other job field, with an extraordinary 3.2 million new jobs projected to be created by 2018.  And it’s not only surgeons, specialists, and primary-care physicians whose jobs are in demand, its registered nurses, home health aides, medical assistants, and medical secretaries. 

In fact, with over 580,000 new jobs expected to be created within the next five years, registered nurses are one of the most in-demand careers in the entire US.  Furthermore, this number doesn’t even include the thousands of jobs that are slated to become available as older nurses retire.  A large majority of these new jobs are expected to be in home health care services and outpatient care, where there is expected to be about 35 percent job growth.  Likewise, home health aides should have no problem finding employment as the field is expected to rapidly develop as an expected 384,000 new jobs are expected to be created. Home health aides work as hired caregivers to people who are unable to either leave their homes or live on their own.  As baby boomers continue to age and diseases with a late onset like mesothelioma, Alzheimer’s, and Huntington’s are diagnosed in increasing numbers, the amount of people needing home health aides is expected to rocket. 

Medical assistants, on the other hand, are on the opposite end of the healthcare spectrum.  Medical assistants, a staple of the healthcare industry and who perform administrative and clinical tasks, are in demand across the country already and their ranks are expected to grow by 27 percent.  Although jobs on the administrative side are largely in hospitals, the largest and slowest growing healthcare industry segment, they are still expected to far outpace the average job growth as America expands its health coverage to meet the burgeoning needs of an aging population.  Even jobs that are far more related to administrative duties than health care, such as medical secretaries and medical transcriptionists are expected to experience significant levels of job growth.  

Ultimately, as a large portion of Americans age and experience late onset disorders and diseases, it will force the entire healthcare industry to expand rapidly.  A large portion of the job growth is expected to be related to the diagnosis and treatment of cancer.  Researchers at the National Cancer Institute however, have reported that by 2020 the health care costs associated with cancer treatment could skyrocket up to $158 billion, a stunning 27 percent increase.  In fact, even if there is no increase in the rate of cancer diagnoses, increasing healthcare and technology costs could easily push the costs up to between $173 and $207 billion with just a two percent to five percent increase annually. 

 

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7 Vastly Overrated Business Books

BNet, the very interesting interactive web site from CBS, has just produced mini reviews of what they consider to be seven vastly overrated business books.  There were a few surprises.

BNet's contributor  Geoffrey James, who reviewed each of these seven books, begins his summary with the statement:  "Most business books are awful, some are mediocre and a (very) few are truly useful." 

1.  The One Minute Manager - "There is no panacea for good management, and it's certainly not going to be contained in a book that essentially treats management as being easy-peasy."

2.  Jack Welch:  Winning - In the past, business executives waited some time to allow for history and the markets to value a CEO's accomplishments.  Not any more..."Today, however, business leaders seem obligated to write self-congratulatory paeans that give new meaning to the word 'vomitable'." 

3.  The 7 Habits of Highly Successful People  - "The problem with Covey is that he alternates between the painfully sanctimonious and the painfully obvious."

4.  Atlas Shrugged - "As a novel, Atlas Shrugged isn't overrated, since most literary critics consider it one of the worst-written novels of all time. However, the book is highly influential in the executive suite because it espouses a philosophy of business that justifies the status quo and encourages executives to feel self-righteous... even when they're royally screwing the public or their employees." (Just think, the former Fed Chair, Alan Greenspan, who could not believe that the big banks wouldn't do the right thing and appropriate regulation was unnecessary, apparently admired this book.)

5.  Who Moved My Cheese - "The idea behind this book -- that you can't assume that what you're doing today will get the same rewards tomorrow -- is sufficiently obvious to encapsulate in a single sentence.  What's offensive about the idea is that it blames employees for not "getting" this concept, as if it should be their responsibility for resetting their goals and rewards." (Personal note:  I threw it in the trash after the second chapter.  Feeling guilty, given the numerous rave reviews from friends, I retrieved the book, got through one more chapter before pitching it back in the waste basket. There it remained until trash day.)

6. The Art of War -  "This book is NOT overrated if you're planning to play 'Shogun: Total War' or any other computer or board game that simulates medieval warfare.  However, as a guide to business behavior, it's seriously flawed..."(Personal note: Business is not war. The principles of war do not apply unless, of course, you think killing your customers is a good idea.)

7.  The Wealth of Nations - "While there's no question this book has been influential, it suffers from being treated as  scripture rather than a thoughtful work that reflected the state of business and government in the mid-18th century.  This limitation is particularly clear when Smith's work is cited in defense of a free market economy in the 21st century, nearly 250 years after the book was originally written."

For every business book I have read, there have been 10 or more for which I wish I had not wasted my money. However, since my agent, who arranges for my speaking engagements, has strongly encouraged me to write a book, it is hardly appropriate for me to be too critical.  

For daily reading, I thoroughly enjoy the BNet daily news feeds and I recommend this site. There are some great thoughtful articles.

About the reviewer:  Geoffrey James has sold and written hundreds of features, articles and columns for national publications including Wired, Men's Health, Business 2.0, SellingPower, Brand World, Computer Gaming World, CIO, The New York Times and (of course) BNET. He is the author of seven books, including Business Wisdom of the Electronic Elite (translated into seven languages and selected by four book clubs), and The Tao of Programming (widely quoted on the Web as a "canonical book of computer humor".)

© 2011 John Gregory Self

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Apple Redefines Retail, Delights Customers

Apple has redefined the rules for retailing and continues to set records for performance.  Known as a company that consistently delights its customers with innovative new, cool products, its retail operations are critical to the company’s phenomenal record for innovation.

“They basically took the old book of retail, threw it out and started over,” Piper Jaffray Analyst, Gene Munster, said in USA Today on Thursday. 

Apple defied conventional wisdom that computer makers make poor retailers.  Gateway tried it with their country store concept in the early 2000s. Poor locations, uneven in-store service (I could never get waited on. With checkbook in hand and store associates chatting it up in the back I left and bought somewhere else) and poor merchandising produced a financial disaster, forcing them to close more than 180 stores in 2004.  Gateway is now owned by Acer.

At the core of their stores and customer interaction design is an overarching pillar of the Apple corporate culture: delight your customer with a great experience.

It is definitely working.  Apple now operates 323 stores employing more than 30,000 people worldwide, including 16 high profile stores.  One, their glass cube store in New York, is open 24/7, 365 days a year.  That one store brings in between $400 and $500 million per year, according to USA Today.

Sales last quarter shot up 90 percent to $1.5 billion to $3.2 billion thanks in part to the introduction of the iPad, the company reported.

Their retail success is not due to just their clever, well designed gadgets – computers, iPods, iPads and iPhones – but also to the way the stores are designed both in terms of layout and for customer interaction.

When you enter an Apple store you are met by a greeter. For those of you who have had the experience, you know these are NOT your Wal-Mart greeters.  They are hip, they are cool and they armed with an iPad to capture your name and why you are visiting the store.  When the first sales associate becomes available – the stores are almost always busy – they meet you at the product station.  If you own an Apple product and have a question, you are directed to the Genius Bar where Apple experts can help you solve a problem.  Most technical issues are resolved in the store, including hard drive replacement.  Compare that with a certain technical squad at one of the other big box retailers who also sell Apple: replacing the hard drive means surrendering your computer for up to two weeks.

When you buy a computer, a phone or one of their other products, an associate from the supply room brings it to you – having been electronically alerted by your sales associate with a special iPhone.

There are no “check out” counters.  Using the same iPhone that transmitted your product selection, the sales associate “rings up the sale” using credit and debit cards right on the spot.  Within seconds, you receive a receipt via email.  I do not know what happens when people pay with cash or check, but I suspect that process is innovative as well.

While our economy continues to sputter in a slow recovery mode, and with an ongoing onslaught of dire predictions that the U.S. has lost its innovation and competitive advantage in a global economy, I have a suggestion that will probably help improve your spirits for the future of American business.

Visit an Apple store.

 

© 2011 John Gregory Self

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Delighting Your Customers

Improving the customer service experience is one of the new buzz phrases that many healthcare executives are using in connection with improving their HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) scores. 

For my non-healthcare readers, HCAPHPS scores are important because they will drive higher rates of reimbursement in the near term.  Beyond that, the reality of the federal deficit and long-term debt crisis requiring significant cuts in Medicare spending, HCAPHPS will become a tool to penalize non-performing hospitals with materially lower rates of reimbursement.  For many organizations on the bubble of survival, those reductions could lead to closure.

In other industries, such as the consumer technology segment, tablets, MP3 players and software, an exceptional customer experience is the defining factor between market leadership, acceptable mediocrity, and/or embarrassing failure.

Apple is one company that understands the importance of the customer experience.  Delighting the user and excellent customer experience are hard-wired into the culture.  Some would argue those two phrases are two of the most critical elements in defining what makes Apple a leader in innovation and their ability to deliver products that work – that delight the customer.

By contrast, Microsoft’s reputation is “we get it right – the third time.”  They move product to market and then try to improve on it through endless updates and patches.  The Zune MP3 player and the VISTA operating system are two products that quickly come to mind.

At Apple, the designers are key to the development process.  They are among the most important people in the product development process, and other members of the team know and respect that.  At Microsoft, product development rarely includes designers, according to those who do business with the company.  They are an almost “after-the-fact” part of the process.  Recent “improvements” in Outlook are another example.

Apple’s products work and they typically delight their customers. Yes, Apple makes mistakes in design and production, the early roll out of MobileMe and the antenna for the iPhone 4 are two examples of mistakes that made it to public consumption, but for the most part, their mistakes are made and corrected in the design process. For Apple CEO Steve Jobs, the rule “is do not lie to yourself and call something great when it isn’t.”  Jobs will dump product design or development ideas that are not meeting the Apple standard of great and delay product introduction.

Apple’s design of their retail stores and technical support programs are, again, based on delighting the customer.  Microsoft does not control its distribution and its technical support is legendary – bad. Amazingly, many of the computer manufacturers that run Microsoft products have worked hard to match the dismal Microsoft customer service experience. 

While the specifics of Apple’s business model are not applicable to healthcare, their emphasis on delighting the customer and improving the customer experience certainly can and should be adopted by healthcare leaders.

Personal Disclosure:  My  less-than-a year-old Toshiba laptop with its Microsoft Outlook and Business Contact Manager program is now a very effective paper weight next to my MacBook Pro. 

 

© 2011 John Gregory Self

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Stay Tuned for the Future

I have been blogging for more than three years.  I have written more than 240 posts and received more than 18,782 page views.  My focus has been on recruiting, talent management and public policy in the healthcare industry.  

The past three years have been challenging.  I left a company that I founded and built. It was an emotional, gut-wrenching but necessary decision.  I started a new company, JohnGSelf Associates, Inc. and things are going very well.

I have thoroughly enjoyed the process and the intellectual challenge of writing a blog twice a week. To my loyal and supportive readers, a heart-felt thank you for joining me at HealthCare Voice, either through the host site on Typepad, or through LINKED IN, FACEBOOK or PLAXO. Please know that your comments, compliments and suggestions have been an enriching part of writing the blog.

But now it is time to move on to a broader range of subjects and ideas.  

In the next month, I will share my plans for the future. Until then, keep reading and commenting.  

Thanks for your many kind words.

© 2011 John Gregory Self

 

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Principles, Integrity and Our Enabling Bad Habits

Principles are important.  Integrity matters.

We were once a nation that admired our leaders in politics and in business – who stuck to their principles and who conducted themselves in an ethical manner. 

Here is where I – and many of you – get frustrated.  For too long, the majority of our political and business leaders have not been true to their principles. Let's not talk about integrity when it comes  to politics or Wall Street.

This week we saw the conviction of a billionaire hedge fund manager who clearly broke insider trading rules to make – not earn – even more money.  In government, members of Congress have known for a long time that this nation’s slide deeper into debt – with more than $53 trillion in unfunded liabilities – would one day spark an economic crisis unlike anything this nation has ever experienced. But for years, no one spoke with any conviction about making material reductions in spending. Both political parties were more focused on the next election cycle, not in coming to grips with this very dangerous addiction to deficit spending. It was easier, and more convenient the dire consequences notwithstanding, to simply kick the can down the street.

The chickens have come home to roost.  Next year, every penny of what U.S. residents pay in taxes – those 55 percent who actually pay anything at all – will go to fund entitlement programs and the interest on the debt.  The $1.65 trillion deficit spending for discretionary programs will simply be added to our long-term debt that is already $14,326.739.262.229 as of 1:55 AM GMT today.

No wonder our primary banker, China and several of the major fund managers, are nervous.  And you should be as well.

Now here is a bigger inconvenient truth: we are a population of enablers.  When fiscal responsibilities require that we give up a program, subsidy or benefit that impacts our lives – real or imagined– we are more likely to voice opposition with a wink of an eye or we chastise the politician who would dare cut a particular program that might be unpopular with their political base. We are enablers because while we drop phrases like “shared sacrifice” when we dish gossip at a cocktail party or church, sadly we no longer collectively understand the concept.

Over the next three to five years, many of these same politicians that we criticize today will be forced to make tough fiscal decisions that could save our nation, or send us into an irreversible not-so-slow, painful slide into the role of a debtor nation with the inevitable result that the U.S. will become a “second tier power”.  This is a very real possibility.

The key to our survival will be our ability to re-focus on those principles that made this nation great and support those political leaders who will do what is right with integrity, not necessarily what will endear them to their political base.  Finally we must be willing to passionately embrace shared sacrifice.

Forget about economic principles, the machinations of budgeting or government accounting.  Without our support of these three core principles, we will face a national financial calamity that will be more painful than anything we have known in modern history.  

© 2011 John Gregory Self

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Is Our Pizza THAT Bad?

Dominoes Pizza has taught us an important marketing lesson and along the way given us a better product.  Perhaps there is a message for the healthcare industry somewhere in this remarkable and successful turnaround.

Dominoes launched a nationwide television campaign 15 months ago that was more than just a little different. They began by admitting that their product was not that good.  To add some historical context, it had not been good for a very long time.  In the 1980s, working late at Hermann Affiliated Hospitals in Houston, we would frequently order a midnight pizza.  The standing joke was that when the pizza was delivered in 30 minutes or less, you threw out the pizza and ate the box. It had more taste. It was no surprise that when the company asked what was wrong with their product consumers repeatedly said the crust tasted like cardboard. The negative feedback from customers was brutal.  Their advertising campaign moved from pointing out that their product was not that good, to announcing they were making significant improvements to their crust, cheese and sauce. They began using better toppings, like real chicken, not a compressed version of various and questionable chicken parts.  Then the company ran ads asking customers to tell them how they were doing. 

Sales soared. This week Dominoes delivered another quarter of rising profits and revenues.  The company’s stock price has risen more than 150 percent since the company launched this risky campaign.  The public seems to like their candor and the product improvements. Moreover, the reservoir of goodwill that Dominoes is building will be invaluable as long as they do not forget these tough lessons learned.

Dominoes Pizza has proven that if you really want to stand out in the marketplace, you must be willing to take risks.  Smart risks, but risks nonetheless.  Harvard marketing professor Youngme Moon would agree.  With the Dominoes success in mind, hospital CEOs should watch this video promoting her book "Different" and think about your organization and how coming reforms will force healthcare organizations to re-examine their model and how they position themselves.

Watch Video

Healthcare is facing some of the toughest economic and regulatory challenges in its relatively short history as an industry.  From the planned and very visible reductions in reimbursement contained in the Patient Protection and Affordable Care Act as well as additional cuts that are in the pipeline but are currently not so visible, to the looming deficit and long-term debt crisis, we face a future that, in the most understated of words, will be transformational. 

The professional lives of healthcare leaders and the environment in which they work will be radically different.  They will be forced to change.  Change, not adapt.  It is going to be the type of transformational change that will require a reconstruction of the entire business model. This change will mark an end of the big box hospitals of staggering size with a maze of hallways and poor signage will have to give way to a strategic focus on population groups while operating smaller, cost efficient facilities. The new economic model will be based on keeping people out of hospitals and providers will be paid not for how much they do, but for the quality of care and outcomes they achieve as well as customer/patient satisfaction. 

Over the next 20 years the hospital industry will need to move from the wholesale marketing model that focuses on physicians, their patients and their poor health, to a retail model where there is real competition and where success will be based solely on performance.

It is easy to be critical.  Let's face it, hospital executives and industry thought leaders are in a tough bind.  It is hard to lead change when you are constrained by an existing business structure that is hopelessly complex, from a patchwork of payment systems to federal, state and local regulations that limit the ability of mainstream hospitals and entrepreneurs from leading the transformation.

Given that hospital executives are, for a variety of good reasons and some that are not so good, loathe to publicly confess their problems as Dominoes did, they may miss a marketing opportunity to drive the real structural change that the costly and uneven healthcare provider segment needs. 

The GOP budget plan to privatize Medicare may save the federal government a lot of money and temporarily drive the bond market vigilantes away from the front door, but it will not solve the bigger problem.  You cannot target one group and one program like Medicare and not expect a massive political push back as well as political consequences.

This approach will fail not because it reflects a political calculation to shrink the size of government, but the politicians have no real broad strategy to change and improve healthcare in America.  Their current effort amounts to fiddling around the margins.  Meanwhile, as the political debate gathers steam, the American public believes, alternatively, that either we have the greatest “system” in the world or that it is too expensive with questionable quality and hurts the nation's ability to compete globally.

Why don’t we at least think about the Dominoes approach?

© 2011 John Gregory Self

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Healthcare Trends, Contradictions and Microsoft

I was reading an article last night that lamented the incredible -- some would say unbelievable -- problems in America's healthcare "system."  No surprise there."  Earlier in the week, I encountered a maddening customer relationship snafu with a global technology company.  The article and my poor service experience served as a stark reminder that healthcare is not the only industry with bad service deliverables and amazing contradictions, but, unfortunately, it is still the gold standard.

This led me to share some thoughts that I find interesting, frustrating and representative (read: tip of the iceberg) of what is wrong with the healthcare industry and our interactions with patients/customers.

1. An onslaught of slick television commercials promoting the benefits of new drugs under the guise of improving patient awareness/education actually generate patient requests for drugs they do not need. Unnecessary visits to the physician requesting one of those miracle drugs ( with scary potential complications) and higher costs result.

2.  We feel a "little off" – perhaps a cold is coming on -- so we call the doctor, or his/her assistant, and request an antibiotic.  Maybe that will magically thwart what is more than likely a virus. Higher costs and the rapid expansion of the number of  life-threatening drug-resistant infections is an unintended consequence. 

3. The claim that ridiculous malpractice lawsuits are driving up healthcare costs is a common theme in the national conversation regarding healthcare reform. A common solution: impose tough tort reforms that will reduce these claims and lower costs.  The state legislature may act but absolutely nothing will change except for reducing the size of the medical malpractice bar and improving the market for physician recruitment.  In Texas, we have tort limits.  The result:  medical liability insurance rates have declined as have the number of malpractice cases, but healthcare costs in Texas are similar to those states that have done nothing and quality of care is really no better. 

4. Hospitals produce expensive television commercials championing quality of care and service and then wonder why patients quickly become dissatisfied with the uneven, siloed, inefficient -- and sometimes dangerous -- care/service they routinely receive. The contrast between what is promised and what actually occurs could not be more startling except, perhaps, in the airline industry where television ads never mention the cramped legroom or those miserable center seats in the coach cabin.

5. Healthcare leaders agree that something must be done to lower healthcare costs but they frequently decry new technology or structural reforms that will lower costs as being too expensive to undertake unless, of course, someone else (hint: our debt-strapped government) pays the bill. The result: we chase the status quo and wonder why our costs continue to rise.

As a healthcare executive with more than 30 years of experience, it is nice to know that our industry is not alone in terms of our ability to find a dark room in which to stumble around. The technology sector is certainly not immune. 

I had to call a large computer software manufacturer for help with their office suite program for my new but not-a-Windows laptop.  The telephone decision tree was endless including an initial and slightly huffy legal privacy disclaimer that was beyond annoying.  I finally spoke with a customer "service" representative -- not in the U.S. -- who, after five minutes of questions and my repeated answers due to a bad satellite link, assigned me a "case" number and promised to transfer me to a specialist who could take care of my problem.  She promptly transferred my call to a non-working telephone extension.  I had to start all over with the annoying legal disclaimer, the endless automated decision tree and the repeated explanations due to the bad satellite or the local telephone system, in whatever far away land those customer service people were located.  I could have been talking to one of the mega-banks. In Microsoft's defense, when I did finally reach a customer service presentative in their Apple section, he was knowledgable and solved the problem.

My first reaction: did the Microsoft executive who designed this customer service technical support system formerly work in a teaching hospital?

© 2011 John Gregory Self

 

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Perjury: America's New Epidemic

I started a new book over the weekend -- James B. Stewart's "Tangled Webs -- How False Statements Are Undermining America."  

Based on my early reading, and the author's recent interview on Charlie Rose, this is going to be a fascinating read with disturbing issues to consider.  Perjury and making false statements to investigators is apparently so common -- epidemic levels -- that law enforcement and financial regulatory agencies rarely prosecute these cases without other charges.  

Stewart is a former Wall Street Journal Page One Editor and reporter who won a Pulitzer in 1988 for his reporting on the stock market crash and insider trading. In this new work, he focuses on cases involving people at the top of their fields -- Martha Stewart, I. Lewis "Scooter" Libby, Barry Bonds and perhaps the most notorious liar in the history of the financial industry, Bernard Madoff.  

These are interesting stories and that the subjects decided to lie when they did not have to -- with the exception of Mr. Madoff whose fraud was beyond comprehension -- is a disturbing commentary on American business. They were all rich, successful and well educated who were willing to cross the line and lie.

Why am I reading this book?  Mr. Stewart, who went to law school, is an accomplished story teller and promised to answer questions that puzzled many:

• Why would homemaking trendsetter Martha Stewart have lied about a relatively small stock trade when she was, by all accounts, a billionaire?  What caused her seemingly solid alibi to fall apart?
• Why was Mr. Libby, the chief of staff to the Vice President, the only high government official charged in the Valerie Plame-CIA leak scandal when he wasn't even the person who leaked her identify to columnist Robert Novak?
• Barry Bonds, a baseball star of epic proportions earning more than $15 million a year, was granted immunity from prosecution as long as he told the truth under oath about illegal steroid use in professional baseball? And yet he was convicted of obstruction of justice because there was a question of lying under oath.
• Was Bernie Madoff, who kept a ponzi scheme going for more than 20 years despite repeated inquiries and investigations, "an evil genius, a brilliant liar or something far more complex?" Until his scheme fell apart, he was one of the most admired people on Wall Street.

In researching cases for the book, Mr. Stewart said there were numerous examples.  He ruled out sexual scandals and divorce cases because they were among the most common. Apparently spouses trying to conceal wealth or other information from the prying eyes of matrimonial attorneys and judges, believe lying is perfectly acceptable.  

That this common practice floods into business is something that should concern us all.

© 2011 John Gregory Self

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