Greetings from the University of New Hampshire! Shot above is from downtown Portsmouth, NH, one of the coolest little town towns in New England in my humble opinion. We zip up there on weekends for dinner regularly since it’s only about a 15 minute drive. Lots of great restaurants, breweries, shops, all on the water. I highly recommend it if you come up this way.
Here’s this week’s links. No real theme this week. I’ll be back Sunday with an essay.
As usual, willing good for all of you!
Read
What: Smithsonian Magazine, The Cuyahoga River Caught Fire at Least a Dozen Times, but No One Cared Until 1969
Why: (Click on the link to see the picture of a river on fire.) I was talking about environmental health in my US Healthcare Systems class last week and mentioned that in the United States in the mid-20th century, pollution had been so bad in some places that rivers had actually caught fire.
The water was nearly always covered in oil slicks, and it bubbled like a deadly stew. Sometimes rats floated by, their corpses so bloated they were practically the size of dogs. It was disturbing, but it was also just one of the realities of the city. For more than a century, the Cuyahoga River had been prime real estate for various manufacturing companies. Everyone knew it was polluted, but pollution meant industry was thriving, the economy was booming, and everyone had jobs.
Wealthy communities can afford environmental protection. It took Cleveland until the 70’s to clean up their river. This is probably about where much of China is today - according to friends who have lived there, and news reports, air pollution is so bad in their cities, it is often unsafe to go outside. But as they get richer, the people will demand a healthier environment. It’s good to remember we were there once, too.
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What: WSJ, Big Nonprofit Hospitals Expand in Wealthier Areas, Shun Poorer Ones
Why: (You may need to cut and paste the link) I see this with hospital chains up here that I watch. You can see them expanding into wealthier suburbs and shunning poorer communities.
It’s important to remember that even non-profit hospitals have to make money to survive. Medicaid payment is a joke in healthcare. You cannot run a hospital on Medicaid payments. At least not a hospital you would want to take a loved one to. Every hospital leader worries about their payor mix. This refers to the mix of insurances that their patients bring. If your payor mix drifts too far downward into Medicaid, meaning most of your patients have Medicaid instead of commercial insurance, your hospital is going to be in trouble financially, and likely to fail. This is why hospital chains divest hospitals in poor communities - they lose money for the system, even after accounting for referrals.
I’m not sure what the solution is. Probably micro-hospitals that have a lot less overhead and a lot less capability, which means patients will have to travel farther for higher level care. We will see.
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Watch
What: Hoover Institution, The Code: Silicon Valley and the Remaking of America (14 min)
Why: Interesting discussion about the origins of Silicon Valley. I think I will read the book. I like that they make a point of the Valley not being a planned thing, but an emerging phenomenon.
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Listen
What: The Journal, 'Putin's Chef' Now Serving Up Gains for Russia in Ukraine (18 min)
Why: The founder of the Wagner group was a restauranteur who became Putin’s chef. It’s the career journey of a mass murderer, but interesting nonetheless as an insight into how autocrats operate.
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What: The Dispatch, Gov. Sununu: Why New Hampshire's Different (58 min)
Why: The 2024 presidential race is starting to take shape, and it looks like my governor is going to be throwing his hat in the ring. I like what he has to say in this interview and how he says it. I think he did a pretty good job managing COVID in a state where most people do not like to be told what to do. I doubt he has much of a chance, but it will be interesting to see him try.
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What: HBR IdeaCast: Find Joy in Any Job: How Do I Improve the Role I Have? (27 min)
Why: This actually has some useful leadership tips - like really talking to your employees about what sparks joy for them. It also offers some tips on how to talk to your boss about what you like doing and negotiating to do more of that. This ties into my essay about being a rocket launcher.