You can blame criminal elements, but counterfeit products enter markets through stupidity.

The principal of Occum’s Razor is used by most of us in our day to day lives, whether we know it or not. All things being equal, the simplest explanation is most likely to be true.

There’s been a lot of speculation about counterfeit produce in US markets recently, from fake Tiffany rings on e-bay to major influxes of counterfeit drugs into the US pharmaceutical market place.

This is not robbery, it’s not theft – it’s a lesson in false confidence. At some point, someone was taken for a fool in a circumstance where they should have known better. In almost all cases, they were motivated to ignore or downgrade the risk element because they had something to gain. When we ignore the tell-tale signs of fraudulence, it’s almost always because we want to believe.

There’s a reason they’re called confidence scams. The con man doesn’t need the real product; he doesn’t even need any product at all. All he needs is your confidence. This seems like a good deal to me.

As I read these stories, I’m constantly brought back to the same question: How are so many people in this country able to ignore the advice they have been given since childhood by mothers, fathers, teachers and bosses?

If a deal looks too good to be true, then it probably is.

Great deals come with simple explanations. The rent for this apartment seems very cheap, but the owner needs to leave town urgently for 6 months and doesn’t have time to wait around. This hotel seems cheap, but they’ve only been open two weeks and they are attracting customers away from established competitors. Sensible and simple explanations.

If the simple explanation is either missing – or you have cause to doubt its veracity – it’s time to back away.

Most of us have seen it on the streets of major cities. There’s a guy selling designer goods out of a suitcase; the boxes are all top end brands – Calvin Klein, Ray-bans, Gucci. $10 for the 50ml bottle that sells for $70 in Macy’s. Hungry tourists crowd round to get themselves a bargain.

Now and again a furious buyer returns shouting at the vendor. They’ve opened the box and the product is a cheap imitation.

But what are they complaining about? Of course the product is fake. They’re produced for $2.00 and sold for $10.00. No other plausible explanation existed from the beginning. You can hope that they’re stolen if your conscience allows it, but even then – what are the chances?

Some research for this blog threw up some incredible message boards where people complained at length that the Tiffany ring they had bought on e-bay was not the real thing. The price was $6.00. Come on. Seriously?

The perfume is fake. The handbag is not really from Gucci. The sunglasses are not really Ray-bans and yes – the $6.00 ring is not really from Tiffany. If you paid $6.00 and expected a Tiffany ring, then you are an idiot by anyone’s definition.

So when it comes to the healthcare industry’s issue, who is really to blame for the influx of counterfeit drugs into the huge US market? (40% of the world’s prescription drugs are sold in the US.) The answer is simple. At some point the supply chain moves from illegal to legal. It moves from the criminally devious to the honestly stupid. Breaking this link in the chain is the answer to combating counterfeit produce.

At a corporate level, every bit as much as at a personal level, we are responsible for making sensible decisions. We must assess risk, identify things that need explanation and follow a sensible, logical course of action.

In every occurrence of a fake product entering a market, someone is failing to do these things. Someone is chasing a bargain or a glut – and an opportunity to benefit personally – that is blinding them to their obvious responsibility to see things for what they are.

If you don’t 100% trust the source you’re buying from, you have to be 100% sure you have the means to assess the product before you either use it or pass it on.

Buyers across the pharmaceutical supply chain would do well to keep Occum’s Razor close at hand.

Education, not legislation, is the key to lower healthcare spending.

In 2005, the British chef and media personality Jamie Oliver launched a highly successful campaign to raise awareness of the poor quality of food being served in British schools. The result was to transform the way Britain thinks about school food, delivering healthier, balanced meals and most importantly, educating children early about the benefits of eating properly. Oliver himself was awarded an MBE by the Queen (a civilian medal of honor for service to the country.) His approach has been used with great success across Europe.

Then he came to America.

You can watch the details of Oliver’s treatment at the hands of US school employees he met and the US media in general on YouTube (‘We don’t want to eat lettuce all day, who made you king?’) sufficed to say he was shot down in flames from minute one, and he returned home having failed completely.

Recent discussion about the growing cost of healthcare delivery remains focused on the level of investment necessary to keep the nation healthy, but to endlessly debate legislation and government investment misses the long term issue entirely.

The spiraling cost of healthcare in the US may be the direct result of defensive medicine, malpractice and government mandated programs like EHR, but there is no question where the real answer to reduced health care spending lays – healthier people.

It is education and not legislation that is the real answer.

The British chef and campaigner for healthy food 

in schools suffered a series of media beatings.

When Jamie Oliver was sent packing so emphatically by a firmly united front of American education workers, local media and national TV personalities, this country missed a major opportunity to start the move toward lower healthcare costs. 

Regular exercise, healthy eating and the limitation of obviously dangerous practices like smoking and heavy drinking are the keys to lower spending. This begins and ends with personal choices. The earlier we begin to encourage these choices the better.

One of the many reasons David Letterman gave Jamie Oliver (a long time friend of his incidentally) for why he would fail was the power of fast food chains. They’re not going anywhere, he says.

A typical McDonalds in London

McDonalds is not going away, but it can be forced to evolve. In the UK, it has. Gone are the gaudy red signs and plastic furniture, in favor of subtle dark green and high-spec leather chairs. Salads are not an after thought, they are a key part of the menu, as are many other healthy choices. You can still get a Big Mac if you want one, but McDonalds knows its future success depends on delivering more healthy options because they are simply what the consumer wants.

We the people are in charge of what fast food chains serve. We have the power in the long term to reduce the cost of healthcare in this country through the way we live. It’s happening in other countries, we could make it happen here.  

This would dramatically shift the debate about healthcare spending. 

High unemployment and major skill shortages. A problem with only one solution.

By Josh Kaplan

Is there really such a thing as the wrong kind of job?

With job creation on the lips of every aspiring and incumbent politician, it’s ironic that Washington DC itself is one of the main centers of the imbalance.

Washington DC has seen a boom in IT jobs in 2011

The DC area has experienced a steady decline in job opportunities since a slight peak in March of this year. Based on the number of jobs placed online by hiring companies and agencies, 2011 has ended badly for the capital’s job market.

But for Computer Systems Analysts, Web Developers, and Network and Computer Systems Administrators the outlook is much more positive.

A report this week from wantedanalytics.com shows a significant increase in IT jobs in the area.

The trend is likely to continue into 2012. The question is what to do about it. As we’ve seen across the engineering industry, massive requirements for skills only create jobs if there are people with the right skills to fill them. Without the right skills available in the market, you have urgent open vacancies that contribute nothing to job creation.

Bridging the gap between mass unemployment and skill short market places is a problem with only one long term solution: training. The shortage in IT has been self created. When healthcare companies – one of the areas at issue - moved to 1099 contractors instead of retaining their in house talent, they lost the skills they need with familiarity and experience of their organization to get the job done.

There is clearly a major opportunity to retrain large numbers of unemployed workers if proper programs are put in place either by the government or by the private sector.

As demand increases, project delivery will only suffer more. It’s time to look seriously at retraining options.

In the meantime, IT professionals would be well advised to pack a bag and head for DC. 

Two reports, one conclusion: EHRs need more support in implementation

by Josh Kaplan

A report released today by AmericanEHR partners is not the first to highlight major shortfalls in EHR uptake across physician practices. It’s not even the first this week. A study by healthcare research firm SK&A, released Tuesday, provides more cause for concern.

Physicians have until 2015 to make 'meaningful use' of 

EHR systems

Most of the findings from both reports are predictable: EHR uptake is proving more difficult in smaller practices with fewer physicians; double the number of patients and you double the level of adoption; satisfaction is higher wherever the respondent has been involved in the EHR selection process.  No surprises in the bulk of the findings.

However, some of the stand-out statistics are genuinely shocking:

(1) 21% of physician offices are unaware of EHR government incentives.

These incentives, provided for by the 2009 stimulus package, include $64,000 dollars over six years for Medicaid and $44,000 over five years for Medicare. Physicians become eligible for the incentive by demonstrating ‘meaningful use’ of EHR Technology.  

(2) 73% of physician offices without an EHR have not determined any time frame for EHR adoption.

In 2015, hospitals and doctors become subject to financial penalties through Medicare if they have not adopted electronic health records, yet the vast majority have not even considered a timeframe for implementation.

(3) 49% of respondent physicians received less than the 3-5 days recommended training on EHR systems.

Moving from adoption to meaningful use and ultimately to genuine added value requires proper training and this is not being received by half of the physicians responding.

As 2012 approaches, the majority of physicians’ offices remain disengaged and ill informed. Even those that have adopted EHRs are not providing sufficient training to make the systems effective.

If EHR adoption is to reach targeted levels, it’s vital that those implementing the systems know when, why and how they should do it. That means having a timescale for implementation, knowledge of the incentives and penalties and ultimately, a plan to properly train the end user.