Hasta La Gadget!

Jet-lagged and exhausted from a red-eye flight, I arrived home remembering the faces and eyes of those I had met after being in one of the most destitute and overwhelming places on earth: India. Not thinking about sleep, I headed into Operation Smile’s Global Headquarters to be with those who work every day to change the lives of thousands of children living with cleft lip, cleft palate and other correctable facial deformities.

My journey with Operation Smile began when my husband Bill and I agreed to travel to the Philippines for a one-time medical mission. Bill was a young plastic surgeon and I was a pediatric nurse and social worker. We had five small children. Like everyone else, we had commitments, debts and responsibilities.

But for my husband and I, the world changed on that trip. There, a woman handed us a basket of bananas. She thanked us, and said that if we could ever come back, her child would still be waiting. Right there, it hit us. We hadn’t been able to treat her child. And no one else would ever treat her child. We suddenly knew there was so much more to be done. And then it became our responsibility.

Had we followed any sort of logic or business plan to establish Operation Smile as a leading global children’s charity, I assure you we would be nowhere. Instead, we took on the unthinkable, set unrealistic goals using unorthodox methods, and achieved unexpected and wildly successful results.

I walked into the Operation Smile office after my India trip, bypassing emails and neat stacks of folders in search of a high-school student who I knew was busy developing her own ideas about change. Her decision, unlike millions of others, was to start a positive movement. She, like millions of our youth, was using her phone, but for much more than just texting.

This high-school student rallied several hundred peers to join her awareness campaign and agree to donate $5 for a child. She was working towards the $240 cost of one surgery by using her passion and emotion to change lives. I owed her my energies to help push the movement forward.

While my own five children were unexpectedly raised in a global atmosphere of service and giving, my 14 grandchildren are now starting to learn quite naturally what it means to care and serve. They, like thousands of students involved with Operation Smile, are being taught to lead and to act. My question to people I meet every day is, “What if this was your child?”

There is no logic to poverty, despair or disease. I applaud our youth as the lifeblood of Operation Smile, and will continue to support thoughtful emotion as a means to another beginning. Let’s look beyond logic and share the emotions that build kindness and connections. And then we can all smile.

To help support Operation Smile, donate a photo through the Johnson & Johnson Donate a Photo app. Johnson & Johnson will donate $1* for every photo donated to help heal a child’s smile through surgery.

*Johnson & Johnson has curated a list of trusted causes, and you can donate a photo to one cause, once a day. Each cause will appear in the app until it reaches its goal, or the donation period ends. If the goal isn’t reached, the cause will still get a minimum donation.

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Debates about health care frequently focus on the number of people with and without insurance, because it’s a relatively straightforward thing to measure. Either you have coverage or you don’t.

But an equally important question is what kind of insurance you have — and that includes whether your policy leaves you exposed to large, potentially crippling out-of-pocket expenses. The answer makes a big difference.

A big co-payment might discourage you from filling a prescription to treat a serious condition, or from seeing a specialist whose attention you need. If you get sick and end up in the hospital, a high deductible could leave you owing many thousands of dollars, forcing you into financial distress.

You wouldn’t be uninsured, but you would be underinsured.

You’d also have lots of company.

Recently released data, including two brand new surveys, suggests that millions of Americans with insurance are in just that situation. And while there would almost certainly be more of these people if the Affordable Care Act were not in place, those who still face high medical bills are disproportionately poor and sick — in other words, the very people who most need the protection that health insurance is supposed to provide.

It’s a complicated situation to parse — in part because, strange as it sounds, high out-of-pocket costs also have an upside. But the findings from those two new surveys tell a story that gets too little attention from policymakers.

The first comes from the Commonwealth Fund, which for many years has been asking respondents about their medical expenses and how big those expenses are, relative to household income. It defined the underinsured as those whose out-of-pocket expenses are more than 10 percent of household income or, for people who are at or below twice the poverty line, more than 5 percent of household income. By its definition, about a quarter of all working-age adults, some 31 million people, were underinsured as of 2014.

That’s proportionally more than twice as many people as were underinsured in 2003, although the percentage has been stable for the last few years. The report is full of interesting and potentially telling details — like the fact that, among the most populated states, the problem was far worse in Florida and Texas than it was in California and New York.

But perhaps the most important survey finding is about the consequences for people who fit into the underinsured category. Some took financial hits: 47 percent of respondents said they exhausted their savings to pay medical bills, 23 percent were dealing with collection agencies and 7 percent had to declare bankruptcy. Others who were underinsured opted not to get recommended care: 26 percent didn’t fill a prescription because of expense, while 24 percent didn’t get prescribed follow-up treatment or tests for the same reason.

These findings are consistent with other recent studies — including one from the Henry J. Kaiser Family Foundation, published in the spring, which found that about one-quarter of all non-elderly Americans with private insurance don’t have enough liquid assets to pay the deductibles on their health insurance policies. As Drew Altman, the foundation’s president, wrote in the Wall Street Journal, those people will “have to put off care or incur medical debt” if they develop any serious health problems.

Of course, a major goal of the Affordable Care Act, or “Obamacare,” is to protect people from precisely these situations — not simply by helping people without insurance to get coverage, but also by setting minimum standards for what insurance must cover. Mostly those standards apply to the “non-group” market — that is, for people who buy coverage on their own, directly from insurers or through new insurance exchanges, rather than through employers.

The new healthcare law requires that all plans include “essential benefits,” even benefits such as prescription drugs, rehabilitation, mental health and maternity care that non-group plans often previously left out. The law also sets limits on out-of-pocket expenses. People with household incomes below 250 percent of the poverty line ($48,500 for a family of four nowadays) are eligible for special tax credits that offer yet more protection against high out-of-pocket expenses. These requirements raise premiums overall, and that’s why so many people (particularly younger and healthier consumers) experienced “rate shock” when the the Affordable Care Act first took effect. But the law by design discounts those premiums for low- and middle-income buyers through a series of tax credits.

Have those reforms helped make health care more accessible and affordable? If so, by how much? That’s where the other new study — from the advocacy group Families USA, based on data from the Urban Institute — can shed some light. More people had insurance, the report noted, and people buying coverage with federal financial assistance tended to have better protection from expenses. Even so, the report pointed out, one in four people in the non-group market were still going without recommended medical care because of the cost.

Ron Pollack, president of Families USA and among the Affordable Care Act’s most enthusiastic proponents, told The Huffington Post the Affordable Care Act “has not only expanded health coverage to more than one out of three of the previously uninsured, it also provides subsidies to low-income people seeking help with deductibles and co-payments. However, even with these significant improvements, more than 25 percent of those with year-round insurance are forgoing needed health care because they find these costs unaffordable. This can best be fixed by reducing the burden of high deductibles.”

Survey data like this is not always the most reliable source of information, since it relies so heavily on personal recollections and impressions. The RAND Health Experiment, a decades-old study conducted by the RAND Corp. that is more or less the holy grail of health care economics research, demonstrated that people are pretty lousy at distinguishing bad care from good care. Throw in the fact that physicians don’t always know, either, and it’s likely that at least some of the people skipping medical care were no worse off — since the tests or treatments they avoided were unnecessary.

Economists also argue, plausibly, that high cost-sharing encourages people to be more aggressive consumers for health care — whether that means shopping for cheaper policies or picking providers of care that can perform the same services for less money. In fact, most experts think the increase in out-of-pocket costs is a major reason that private health insurance premiums, and health care costs generally, are rising at historically low rates. When conservatives and business executives talk about giving people “skin in the game,” this is what they have in mind. It’s why employers were increasing cost-sharing before the Affordable Care Act became law — and why they’ve continued doing so since.

Many experts would say the trick with designing an insurance system is striking the right balance — in effect, exposing people to just enough costs that they start to think like consumers but can still afford their medical care when they are sick. Others emphasize the need to design benefits in a way that steers patients toward the most effective kinds of care, either by linking cost-sharing to quality (as an initiative called Value-Based Insurance Design would) or simply by managing and coordinating care more effectively (as integrated group practices like Kaiser Permanente traditionally have).

Notwithstanding the caricature of Obamacare as a far-left, government takeover of health insurance, the Affordable Care Act was an effort to blend these different approaches. If these two reports are correct, there’s more work to be done.

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(Photo Credit: Shawn Brackbill)

There’s a bit of a personal struggle in the songs of Mackenzie Scott, the Brooklyn-based musician known as TORRES. A voice that’s inner being is fighting the ills of denial and isolation while trying to not get caught up in the intoxicating realities of life. With her new album Sprinter, it’s about a journey growing up and trying to find balance not only internally, but also within this vast universe. Scott’s music is about how we move and connect with the fundamentals of our own existence.

Recently, I was able to chat with Mackenzie Scott during a stop on her current tour in Dallas about the cosmic feeling of her new album and what she struggles with as an artist.

I really like the flow of your new album. There’s a lot of space to work with. Speak about the sound of the album.
I really just wanted to experiment with sounds that I haven’t had on my songs before. I loved the way it sounds to have a guitar on every song. That’s my favorite instrument. I wanted it on every song, but some of the songs, I didn’t want it to be so obvious that it was a guitar. That’s what I did on my first album; everything had that folk tinge to it. With this album, I wanted to use the guitar as well as other instruments to make sounds that I haven’t had on my music before. That was a cosmic sound that I was going for. I wanted it to sound like the planets. I wanted it to sound like meteors moving through space, and beams of light. Basically, otherworldly sounds.

Right. I do get a cosmic feel to it, much like a score to a movie.
I wanted there to be moments that felt entirely out of control or unexpected. Of course, as we know, we have no control over the cosmos.

When listening to the whole album, I love the transitions between songs. How do you piece everything together to have that connection throughout the album?
I really went with the order that I felt was going to feel the most like going from a gallop to a really slow walking pace. When I wrote the songs, the only two I knew where I wanted them in the track listing was first and the last song, but everything the middle, everything in between “Strange Hellos” and “The Exchange”, I went with the order that felt most like a decrescendo.

I think this album is something that at first you have to experience as a whole body of work from beginning to end. Talk about the importance of having a cohesive album as oppose to just a collection of songs.
That was something I was more intentional with this record as oppose to my first. I think that was because over the last few years I’ve discovered that my own favorite albums are concept albums. They don’t have to be heavily rooted in a concept, but something that feels cohesive, like it’s meant to be one movement. With that in mind, that was to be a common thread to tie everything together, and for me, it’s a couple things. It’s my voice, my physical singing voice, which I make sure it’s recognizable as me in every song, in every recording, because that’s one instrument that I know that’s just going to sound like me. It’s not going to sound like anything or anybody else. The other thing was the sounds, the instrumentation. I kept up the entire way through with the cosmic theme but also sort of a cosmic cowboy theme I guess. Almost like a country western record set in outer space. That’s the vibe that I wanted.

Thematically, what’s the common thread of the album?
More than anything, it’s a reexamination of childhood and a longing for acceptance and love from certain people, but simultaneously, a refusal to be claimed by certain people or groups of people. It’s a desire for personal connections, but rejection of ultimately damaging institutions.

There’s clarity with your vocals where you can connect with every word. What’s your song writing process?
The process is generally me keeping notes on different ideas and phrases that I like and jotting them down through all the days, random moments, and random places. When I eventually do sit down to write with intention I pull out all the notebooks that I’ve kept or scraps of paper, and I start piecing things together weirdly and seeing what makes sense thematically. Not just the words and phrases that look good together and sound good together, but the ones seem to have commonality in their meaning.

How long have you been doing music seriously?
I’ve been doing music my whole life, but I guess I can consider the beginning of college. I was in the school of music business, but again, I didn’t have a career then. I was just writing and playing coffee shop gigs and things like that. I didn’t actually tour or start doing this professionally until my first record came out two and half years ago.

Since that first record came out, what have you learned about yourself?
I learned that I can do a lot more than I thought I could do. I wasn’t so confident in my abilities as a musician, as a performer. The writing as gotten better but I always felt assured in the writing. It was more the performing aspect. I wasn’t confident or assured after making the first record, before or after. I’ve learned that the more I expect of myself, the more I’m going to get out of myself, which is satisfying for me.

As an artist, what are your biggest challenges?
Personally, it’s not very enjoyable to talk about myself or talk about the process. Of course, I’m respectful and I understand that it’s just a part of the job, but I didn’t really anticipate or I just didn’t understand how PR works until I was in it (laughs). It’s hard to talk about myself because I usually just prefer to let the songs speak for themselves. That’s just personal and I’ll get over it. Professionally, just surviving; coming up with the finances to not only go on tour but actually sustain myself and pay my rent. That’s proving itself, at this point, impossible, hopefully not for too long.

TORRES will be playing at the UFO Factory (2110 Trumbull Ave) in Detroit on Friday, May 22nd wsg Aero Flynn. For more information on the show, visit ufofactory.com. TORRES new album “Sprinter” is available now. For more information, visit torrestorrestorres.com.

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Pinterest is the go-to destination for wedding-planning brides and backyard barbeques, alike. Now as users scroll through pins during their lunch break, they may notice some new types of pins popping up that are seamlessly interconnected with the crowdsourced content. Pinterest is making itself more attractive to advertisers with new, targeted pins and video-like ads, dubbed “Cinematic Pins.” The company … Continue reading

“Mindset over skill set.” I recently heard this phrase in a talk on smart hiring strategies, and it struck me that mindset is really what we’re talking about when we talk about meta-skills. While hard skills are tangible and measurable — you either know SQL or you don’t — meta-skills, those that help you learn new skills, are what make you a more valuable employee.

You may argue that you don’t inherently have these skills or that they’ve lain dormant for too long. But there’s good news: meta-skills can be learned. It just takes practice. In my view, the meta-skills most highly valued by today’s employers fall into four categories: seeing, understanding, envisioning and doing.

Seeing
Having a vision often requires taking notice of what’s most often overlooked. Are you truly “seeing” what things need to change in you or your organization? Are you recognizing gaps and thinking about ways to fill them? Are you seeing areas where efforts are duplicated, tasks could be streamlined or opportunities seized?

Seeing things for what they are doesn’t require that you be a visionary. Simply observing what’s working well or not and being alert to opportunities to work more effectively can make you more valuable to your team and company — but only if you make sure that what you’re noticing gets noticed. As the Department of Homeland Security reminds us, “If you see something, say something.” Be vocal and visible within your organization so your ideas and observations don’t go unnoticed.

Understanding
There’s a great moment about understanding in Harper Lee’s “To Kill a Mockingbird,” when Atticus Finch is discussing empathy with his daughter, Scout.

“You can never understand a person until you consider things from his point of view — until you climb in his skin and walk around in it.” One of the first steps in strengthening relationships with the people around you is to understand not just where they’re coming from, but what they’ve overcome. Ask them about their background, goals and interests — and listen carefully to what they have to say. What experiences have shaped who they are today? What are the challenges they’ve faced or the problems they’re hoping to solve? What inspires them?

When you try to understand where another person is coming from, your first task shouldn’t be to focus on the commonalities. If you only look for ways in which you’re similar, you’re bound to overlook what’s different. When we can see differences and consider them on their merits, we move beyond our own perspective. We don’t just see things from a different angle or in a different light; we see things in an entirely different context. New contexts create the opportunity for new ideas and new approaches to flourish.

Envisioning
If you could shape your ideal role in the workplace, what would it look like? What are the projects you dream about doing? How would your workplace function differently? Envisioning doesn’t mean forsaking practicality. It means taking a blue-sky approach to your ideas, charting your goals, and creating a plan to get there.

If you’re the kind of person who benefits from some rigor and a list of steps, then I recommend looking at Claudia Azula Altucher’s book, Becoming an Idea Machine. She has a series of daily exercises that will challenge you to see the world in new ways by looking differently at what’s around you. For example, she’ll challenge you to come up with 10 apps that you’d download right now or to think of 10 ways to make air travel better.

As mentioned above, experiencing new contexts can unlock creativity. Not only should we look at differences in our “near-in” world to inform our thinking, we should also look for similarities in different worlds. As a board member of a performing arts organization, I am often called on to address challenges similar to ones experienced at my own organization. But solving challenges in an arts organization vs. a financial services company is very different. Same challenge, different context. These experiences have helped me think more creatively about problems in my own back yard.

Doing
Doing is the meta-skill that encourages you to dig in and get your hands dirty. It’s about designing prototypes that bring ideas to life, whether it’s a new product, a new process, or a new approach. Doing is the process of trial and error that hopefully leads to perfection. It lets an innovator and a valued employee quickly see what works and tweak the things that aren’t working quite as well as hoped for.

In his book, The Lean Startup: How Today’s Entrepreneurs Use Continuous Innovation to Create Radically Successful Businesses, serial entrepreneur Eric Ries emphasizes that one of the key factors of success for many of today’s most dynamic new companies is their focus on the MVP — the minimum viable product. As Ries notes, “A core component of Lean Startup methodology is the build-measure-learn feedback loop. The first step is figuring out the problem that needs to be solved and then developing a minimum viable product (MVP) to begin the process of learning as quickly as possible.” This is doing; it’s prototyping, and it works because it’s the action, the first series of steps, that leads to reactions, improvements and refinements.

Keeping relevant
Mastering these meta-skills will go a long way toward ensuring your success as a highly valued employee in your organization. Job skills in high demand today may not be tomorrow, so being able to learn new skills and approaches isn’t just critical to your success in the workplace – it’s fundamental to your relevance. Seeing, envisioning, understanding and doing might not be spelled out in your job description. But the simple truth is that people who can show they have these skills mastered are the ones who stand out. They aren’t just doing their job, they’re creating their next job title.

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