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The North Korean State of Mind

The Wife and I watched a 2004 documentary over the weekend titled “A State of Mind” that was incredibly enthralling.  I’ve never been to North Korea, but I’ve known many South Koreans, and I’ve seen a few collections of photographs from various travelers that have managed to make it to the country over the last ten years, and I’m always interested in any kind of media that manages to claw it’s way out of that country.

One reason for my intrigue is that the pictures I’ve seen are the closest to my memories of what it looked like when I arrived in China in 1984.  China was just a few years into it’s experiment of opening to the West, and it’s very difficult to describe what it was like to see a thoroughly communist country wading tepidly into the waters of capitalism.

“A State of Mind” follows two young North Korean gymnasts through their training regimen to participate in the “Mass Games” which are held more or less every year to demonstrate the power of the North Korean state, the singular mind of its people, and the Communist ideal of the group overpowering the individual.  These games are elaborate gymnastic, visual, and auditory productions designed to shock and awe the North Korean population to even higher levels of devotion to “The General”, Kim Il-Sung.

I previously mentioned how the wholesale lifting of hundreds of millions of Chinese out of poverty has to be one of the greatest miracles in history, and nowhere is this point driven home more than the contrast between China and the North Korea of today.  North Korea has barely progressed since 1950, while China is challenging for world economic supremacy.  South Korea, likewise is a beacon of economic progress, and it’s all eerily driven home by the gymnasts and their families who confess to the camera that performing for the Great Leader is and will always be the highlight of their life.  Electricity blackouts, food shortages, and the lack of any progress over the last fifty years are all the fault of the Imperialist Americans.  North Korea has truly succeeded in a total religious education of its population on the virtues of communism, and it’s almost like you’re watching a farcical episode of Monty Python mocking the heady days of communism in the 50s and 60s when you see otherwise intelligent, driven people in total worship of their deranged leader.

The ultimate shame is that the North Korean people, like the Chinese, Burmese, Vietnamese, a host of nations in Africa, South America, and Central Asia, are completely stifled.  But nowhere is it as bad as North Korea, and as someone who remembers the flood of refugees flooding North China during the late nineties as millions starved, I was left with a genuine feeling of total frustration.  This film is important to remind people that it’s all been tried and failed before, right down to the 1984-esque state radio in every North Korean kitchen that broadcasts propaganda and cannot be turned off.  While it’s easy to criticize the evils of capitalism, and decry abuses of greed, it’s hard to see a corollary anywhere in world history where capitalism has produced a wasteland of human potential.

Communism works, and it works well.  It is the greatest engine of equality the world has ever seen as it swiftly ensures that everyone is equally poor.  Watch this film for the cautionary tale that it is, and watch it to be amazed at the talent and devotion of the North Korean people.

Book Review: When China Rules the World

Reading is one of my favorite things to do, and it’s become harder and harder to make time for books over the last few years.  However, over Christmas I was given Martin Jacques’ book  “When China Rules the World” and I read most of it on the six flights we took over the holidays.

This is an extremely important book, in that I feel Martin accurately distills and describes a few integral pieces of China and the Chinese mindset that are almost universally missed by Western commentators.  These pieces, when placed in the proper context can often combine to explain the more (to Western eyes) puzzling questions about China, events that happen within China, and China’s reactions to external pressures.

One of the reasons why I enjoyed this book is that the author is a master at providing historical context and to illustrate and reinforce his ideas.  With a history as long as China’s this isn’t a small task, but he accurately makes the point that few nations are as cognizant of their history and traditions as China.  Ignoring thousands of years of constant cultural development leads to gross misunderstanding, and is something that is all too easy to do from a Western perspective that’s driven by the acceptance of a Western order that is really only three centuries old.

Jacques begins his book with the relevant facts of how China will most likely overtake the US as the largest economy in the world by 2027, and focuses on the central question of the book: What will a modern world dominated by China look like?  The prevailing thought of most attention paid to China is that capitalism, free markets, and Western style economies inevitably echo Western values of freedom, human rights, democracy, and culture.  In other words, free trade begets free societies.  Not necessarily so in China.

This misguided belief that a swing towards Western style freedom and government is inevitable is a key miscalculation that negatively affects US foreign policy and undermines true understanding of China and the rest of East Asia.

Reasons for China not following the Western model of modernism coalesce around different set of values.  In China, unity and stability is a key value that is reinforced by the strong, hierarchical family unit, the universal acceptance of Confucian thought, and the reality that China is a civilization-state, not a nation state.  The Chinese desire of unity explains the tolerance of the “one state, two systems” approach to Hong Kong, Macau, and Taiwan, and even within the numerous special economic zones found within the country.  This type of duality is almost inconceivable to the West.  Stability is valued highly due to China’s  experiences with turmoil during its history (estimations of 25 million dead during Manchu invasion, 50 million dead during Taiping rebellion, and as many as another 50 million dead during World War II and the ensuing Great Leap Forward and Cultural Revolution), and it’s long experience with a strong central government and its emphasis on a Confucian trained and tested government bureaucracy.  Stability, therefore, is enough of a priority that the Chinese are content with a system that values the group over the individual.

History teaches us that the Chinese civilization has never wavered in it’s attitude of superiority towards outsiders.  Indeed, even when conquered by external invaders, which happened often throughout history, the invading groups (Mongols, Manchus) forsook their own identities and adopted Chinese customs, dress, and language while moving their capitals and governments to China.  Today there is an overwhelming sense among the Chinese that China is finally regaining it’s rightful place in the world as the Middle Kingdom.  Most forget that in the 1800s, the Chinese standard of living was slightly higher per capita than that of Europe.  England had a strong navy and easy access to coal close to its urban centers, China did not.  A crippled and weak end of the Qing dynasty, the Japanese invasion, World War II and the disastrous effects of Communism contributed to a net decrease in China’s GDP between 1820 and 1950.

The idea that modernism must revolve around the Western model is rejected by the examination of how little modernity has affected Chinese politics.  China has always had a strong central government that was paternalistic in nature and was bound to the collective well being of society.  This is unlike Western governments, which have evolved to the point where they exist as a utilitarian entity in exchange for popular support.

Jacques also spends significant time exploring the reasons behind the current Chinese policies towards trade, it’s own citizen’s freedom, and it’s long term goals.  In the light of the many historical and political contributing factors, it’s much easier to understand China’s currency peg (which hurts China more than it hurts the US), it’s continuing support for US debt, and it’s aggressive stance towards opening its own markets.  According to Deng Xiaoping, two things must remain for China to lift its population from poverty: domestic stability and international peace.  Seventy-five percent of China’s economy is accounted for by international trade of some sort, and while this may decrease as China continues to diversify, this is an unprecedented level for a country that is so large.  This precarious balance between its economy and the implicit social bargain (like all Confucian states have) to its citizenry for future standard of living improvement are the key drivers to China’s behavior.

This book isn’t without its faults.  Jacques, like the good Marxist he is, glosses over the disastrous effects of Communism for China’s people and its economy.  Like many intelligentsia (Thomas Friedman and almost any other environmentalist) , he finds himself almost in awe of the incredible power that the Chinese Communist Party has to command policies that he wishes or wants to see implemented.  His exploration of China’s tributary system and it’s possible resurgence in the future is incomplete as it doesn’t resonate well with the Western reader.  Some of the book’s information is outdated or at least could have been updated, and some of the statistics feel as though they’ve been cherry picked.  There also doesn’t seem to be enough credit given to the remarkable lever of capitalism: lifting hundreds of millions of people out of poverty in just thirty years is nothing short of a miracle.

While the overall message of the book is that China will not become the US or a prototypical Western nation-state, this doesn’t mean that the China of today will exactly mirror the China of tomorrow.  It does mean that we shouldn’t prescribe the Western template to China, and should remain mindful of the powerful historical currents that remain in full force for China.

Hello From London!

Some thoughts on the way over:

• US Airways website is S-L-O-W.  Nice, but man, it’s slow.
• Their inflight entertainment system, in a word, sucks.  It runs Windows too – I got to stare at a blue screen of death for roughly 4 hours, after they shut down and rebooted the entire system three times.

Some thoughts from our time so far:

• The weak dollar sucks.  It was like a hundred bucks to take the nice train from Gatwick to Victoria station.
• London still has phone booths, everywhere.  It’s really odd seeing them, as I can’t remember the last time I’ve seen one in the US
• Sara doesn’t do very well with jetlag.  Especially when she has a cold.
• I don’t do very well in the cold.
• In England, bacon is “streaky bacon”.  Bacon in England is like ham or something.  I liked it, Sara says “gross”.
• If you ask what black pudding is, they’ll tell you, and then they’ll give you a free sample, which you then have to try.  I’ve had worse.
• Harrods is nuts – total pandemonium.
• Don’t let your Original Bus Tour pass expire at the end of a day when you’re cold, it’s dark, and you’re trying to get somewhere.
• My feet are killing me.

Some pictures:

What do Banks have to offer Healthcare?

Most of the discussion during the Medical Banking Leadership Forum seemed to center around the idea of providing PHRs or processing transactions.  The idea goes that banks should somehow get involved in the Personal Health Record (PHR) space by providing platforms for customers to view their health records since so many of their customers are used to logging in through banks.  The other view is that banks are really good at processing transactions, and bank networks are secure, safe, and fast, and so healthcare transaction processing (many of these transactions being financial after all) should logically be handled by financial institutions.

I take a slightly different view.  First, while I think that banks should get involved in the PHR space, I think it should be in a different capacity than simply providing a spot to store or view health data.  Instead, I think that banks should instead focus on being in the identity management business, an “identity broker” if you will, and provide authentication services to any PHR vendor or hospital that might be interested.  If you think about it from the PHR vendor’s perspective, their service increases in value the more confidence they can have in the validity of the identities they serve.  Correctly identified accounts means you can combine them with other data sources (at the account’s request of course) so that the PHR can serve as the hub of a person’s medical data.  Incorrect data is almost impossible to manage or transfer between systems, and serves to defeat the original stated purpose of a PHR.

The financial services industry (read: banks) are one of the few industries that take identity management SERIOUSLY.  Multiple forms of identification are required, addresses are consistently maintained, and people really care about making sure their passwords to their accounts are remembered and treated securely.  Nobody types their username and password to their checking account on their monitor at work, or sends it in an email to their friend who needs it, etc.

If I were a bank, I’d use that asset (the one-time and continuous identity management) and sell it to PHR vendors (again, with the account holder’s consent).  Instead of creating a new account with Google Health, let me authenticate with my Chase username and password, and everyone can feel comfortable.  The PHR can now rest assured it’s got clean data, the account holder trusts Chase and has an interest in maintaining their information.

As for the second prevailing view: banks are the best at financial transactions, my response is, “So what?”  Maybe as some claim, everything in healthcare is a financial transaction (or should be a financial transaction) but that’s like saying lets let Visa and Mastercard determine the price of the car I’m buying.  Banks already process all the financial transactions, and without in depth knowledge of the services being rendered, they’re not going to be able to price, process, or provide transparency to healthcare claims.  A lot of discussion seemed to revolve around the vein of “but we can get paid to move the data” and again, who cares?  If banks really wanted to get involved in the healthcare claims adjudication process, they should invest in technology tools that provide a platform for insurance plans to define and transaction rules related to services and payments.  Not a single bank in the Medical Banking Project (save for one that I talked with) has any desire to do this.  The solution for banks in this area is to get closer to the details, not farther away.  That’s where all the cost savings and the benefit of transparency exists anyway – at the long tail of the bell curve.  Banks should know better anyway, they’ve been preaching this for years.

Out in Las Vegas for ASHP

This weekend and through Wednesday of this week, I’ll be attending ASHP in Las Vegas and helping out at our booth.  We’re bringing our 20×20 booth (everyone likes to comment on how it’s BLACK) and will have quite a few new things to demonstrate to those who are interested.

This year we’ll have a demo of our Sentinel RCM Mobile Manager handheld device.  It’s a device we built on the Symbol MC70 platform and is the first Windows-based product we’ve released.  We were able to leverage some nice libraries that let us provide some really fast searching on large numbers (65,000+) of drugs.  The product provides a lot of functionality for pharmacy users without them having to march back and “tether” their device to a machine or docking station.  Ordering product, checking prices, receiving product, and reconciling inventory can all be done wirelessly.  Catalog updates and software upgrades are downloaded automatically each night when the unit is docked for recharging.

We’re also showing the latest updates to our HealthBIT business intelligence tool.  We’ve seriously upgraded the Report Builder (formerly named Query Builder) functionality which provides a really nice step-by-step graphical method of building reports to access the data we collect for the application.  All you need is a web browser and you can drag and drop your way to assembling really powerful reports, choosing outputs, and then sharing these reports to other users in your organization.

This is my first time visiting Las Vegas and being how I don’t gamble, am married, and promised my wife that I wouldn’t go to any Cirque shows without her until we could come back together, there’s not much for me to do here.  Probably good that I have to go through budgets for next year during downtime.  I have to say the Venetian hotel is really massive by any standard, and the room I’m in is probably the biggest I’ve ever stayed in.  One surprise is the weather: roughly 34 degrees out right now which seems COLD to me for a desert, but what do I know?

Stop by the booth to say hello if you’re interested!