WORDS MATTER — OR DO THEY?

[PERSPECTIVE FROM THE 19TH HOLE: This is the title I chose for my personal blog, which is meant to give me an outlet for one of my favorite crafts – writing – plus to use an image from my favorite sport, golf. Out of college, my first job was a reporter for the Daily Astorian (in Astoria, Oregon) and I went on from there to practice writing in all of my professional positions, including as an Oregon state government manager and a private sector lobbyist. This blog also allows me to link another favorite pastime – politics and the art of developing pubic policy – to what I write. If you are reading this, thanks for doing so and please don’t hesitate to respond so we can engage in a dialogue, not just a monologue.]

I have always said there are three kinds of people when it comes to receiving information in today’s society…

  • Those who like words
  • Those who like pictures and other graphics
  • Those who like numbers and charts

Of course, there are variations on the themes, as well as combinations of all three.

Those who know me know that I like words better than the other “stuff.” For this blog, I’ll focus on the power of using certain words in certain circumstances – or, given the first example, ignoring the simple meaning of words on their face.

That example is the U.S. Supreme Court. In its recent decision upholding the federal ObamaCare health care law, justices on the prevailing side appeared to ignore four key words in the Affordable Health Care Act: “Established by the state.”

The words were contained in the long and complicated health are act that cleared both the U.S. House and Senate without one Republican vote on the “yes” side. The four words were meant to indicate that federal tax credits would be available only to citizens who received their health care through STATE health insurance changes.

Of course, since enactment of the law, most states have passed on creating exchanges – or, in the case of Oregon, failed to do so successfully.

If it was a drafting error for the four words to be included in the Health Care Act, well the fact is that the words were there and they were there several times. In theory at least, they mean what they say. But, the Supreme Court ruled differently and, in the process, some critics said it was legislating, not opining on the meaning of a law.

The Court vote allowed the federal act to remain in place without leaving those who had applied for and/or received tax credits to continue on down the tax credit road. Was it a political move? I would say yes.

Was it the right move on the simple meaning of the words? I would say no and, while I am not attorney, I have focused on the meaning of words in all of my professional live and believe the decision ignored the direct meaning of the statute.

Let’s move on to a more mundane example, but one that illustrates an important point, at least for me. If, in writing a piece, you say that someone admitted something, you convey an impression, upon close reading, that someone did something wrong and admitted the wrongdoing.

However, if you use a more neutral word – the word said, for instance – you don’t leave the impression of guilt. I first learned this valuable lesson when I was a reporter for a daily newspaper, The Daily Astorian. In covering city and county government in that coastal community, I tried to use the neutral word in attributing quotes or paraphrases.

Words also matter when it comes to euphemisms, which exist throughout society, both in writing and speaking. On occasion, there are good reasons for euphemisms – better sometimes to pull the punch than deliver the news, sometimes bad news, more directly.

But, in politics, where I spent 40 years of my professional career, euphemisms are often used to blur the reality of an action. Look no farther than the phrase “revenue enhancement” instead of the phrase “tax increase.” The former blurs the reality, often I suggest, intentionally.

Or, the word government “investment” rather than the word government “spending.” The former makes sense if the expenditure actually produces a return on the expense – then it truly is an investment. But, more often than not, the word investment is used to blur the reality that some in government want to spend more money without regard to a return.

In a letter to the editor of the Wall Street Journal early this month, a writer made a few more points, some of which are worth noting:

  • “Investment” means spending
  • “Access to” means free
  • “All of the e-mails” means all of the e-mails I want you to see
  • “Refundable tax credit” means a handout
  • “Fairness” means theft

Thus, the writer adds, going back to my first example, why should anyone expect the U.S. Supreme Court to read “state” as state or “legislators” as legislature?

So, in a number of ways, words matter, especially to those of us who focus first on them rather than on charts, graphs or pictures.

The message is: Try to use the right words, understand what the words mean and be careful about the impressions you convey when using them.

FINDING THE SMART MIDDLE: ANOTHER THOUGHT

I wrote recently in this space about my aspiration that political leaders from Salem to Washington, D.C. would find what I call the “smart middle” to solve pressing public policy problems.

That goal seems ever more remote as elected leaders continually run for office in what has been called a permanent campaign. They appear to be focused on putting their opponents or members of another political party on the defensive by name calling and offensive mailers or social media messages.

And, frankly, the loss of real politics is one reason why I hung up my shingle as a lobbyist after more than 40 years in the business – not the only reason and not the major reason (my age factors into the equation), but still one reason.

But this different thought has been coursing through my brain lately: One of the reasons that politicians have so much trouble finding the smart middle is that they are lot like us. We have the same trouble.

In our everyday work or social life, rather than working with others, many of us seek to work our will. We want what we want when we want it without working to understand another’s point of view.

We want to advance our own cause – our own point of view and, to those who may disagree with us, we say, in effect, forget, I want my own way.

As I write this, my own goal is to be open to middle ground in all of my relationships. If, on occasion, I hold a view on the basis of some moral or strongly held principle, then I won’t compromise. But, if I hold a view just because I hold a view, then there is ample reason to find the smart middle.

If we did this more in our everyday lives, then it would be more logical for us to expect our politicians to do the same – to find the smart middle, which, after all, is supposed to be the definition of politics, the art of compromise.

HEALTH CARE REFORM SUCCESS — IN MEDICAID, IN OREGON

 

[PERSPECTIVE FROM THE 19TH HOLE: This is the title I chose for my personal blog, which is meant to give me an outlet for one of my favorite crafts – writing – plus to use an image from my favorite sport, golf. Out of college, my first job was a reporter for the Daily Astorian (in Astoria, Oregon) and I went on from there to practice writing in all of my professional positions, including as an Oregon state government manager and a private sector lobbyist. This blog also allows me to link another favorite pastime – politics and the art of developing pubic policy – to what I write. If you are reading this, thanks for doing so and please don’t hesitate to respond so we can engage in a dialogue, not just a monologue.]

Given all of the controversy over health care reform, one key fact has tended to escape much attention lately.

It is this: Health care reform is working in Oregon, at least in terms of the state’s participation in the Medicaid program, the joint state-federal program that serves low income Oregonians.

There may be continuing tension over the operation of a health insurance exchange in Oregon, with the legislature’s decision, in the aftermath of the controversy over former Governor John Kitzhaber, to scrap Cover Oregon and turn responsibility for the exchange over to the Department of Consumer and Business Services.

Of course, the recent U.S. Supreme Court decision only adds to the tension as the Court, in a ruling that caught many observers by surprise, decided that four words in the national health care law (“established by the state,” as in health insurance exchanges established by states that would yield approval for federal tax credits) didn’t mean much.

So be it, I guess.

But should be no controversy over the Medicaid program here.

To verify this, I give you a piece written by Oregon’s Health Authority (OHA) Director Lynne Saxton in a message to all OHA employees. It should be added that Lynne is a great friend of mine as we forged a friendship as I represented her former employer, Youth Villages-Oregon, over a number of years.

**********

Measuring success through positive outcomes
Last month, we released the 2014 Health System Transformation report that lays out the progress of Oregon’s coordinated care organizations (CCOs) on key quality and financial measures. More than 434,000 Oregonians have enrolled in the Oregon Health Plan since January 1, 2014, and the coordinated care model continues to show improvements to Oregonians’ care for the second straight year. We know where the future challenges lie, and are focused on addressing these transformation issues.The report shows improvement in several areas including decreased emergency department visits, decreased hospital admissions for short-term complications from diabetes, decreased rate of hospital admissions for chronic obstructive pulmonary disease and an increase in patient-centered primary care home (PCPCH) enrollment. But there are areas for improvement as well, including the rates of cervical cancer and chlamydia screenings for women.

Metrics are the best way to keep us accountable for the work we do and the outcomes we strive for. Having measurable goals focuses our efforts and determines our success. Last month, we also posted the CCO financial reports for 2014. CCOs are continuing to hold down costs. Oregon is staying within the budget that meets its commitment to the Centers for Medicare and Medicaid Services to reduce the growth in spending by 2 percentage points per member, per year. We are required to stay within a 3.4 percent growth rate and we are meeting that requirement. (The national growth rate from fiscal 2010 to 2013 was 4 percent. Some states including California (13.7 percent) and Indiana (10.7 percent) saw double-digit growth during those years, according to CMS data analyzed by the Kaiser Family Foundation.)

As we continue our internal work of aligning our divisions to reflect health system transformation, these reports remind us the coordinated care model is helping us achieve the triple aim of better health, better care and lower costs. Oregon’s health system is continuing to improve care for the nearly 1.1 million Oregonians who need it most. Thank you for the part you play in our collected efforts.

Before she took over as OHA director, Lynne established solid track record at a major Oregon non-profit organization, Youth Villages-Oregon, that serves at risk children and their families. At Youth Villages, she placed substantial on producing outcomes – success in the services for children that could be measured six, 12 and 18 months after discharge. The rate of positive outcomes was greater than 80 per cent.

Now, in her new roll for the State of Oregon, Lynne is leading her staff to emphasize outcomes again and there is no better record that what is happening with the state’s Medicaid program.

FOND MEMORIES AT THE HOME OF GOLF

FOND MEMORIES AT THE HOME OF GOLF

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[PERSPECTIVE FROM THE 19TH HOLE: This is the title I chose for my personal blog, which is meant to give me an outlet for one of my favorite crafts – writing – plus to use an image from my favorite sport, golf. Out of college, my first job was a reporter for the Daily Astorian (in Astoria, Oregon) and I went on from there to practice writing in all of my professional positions, including as an Oregon state government manager and a private sector lobbyist. This blog also allows me to link another favorite pastime – politics and the art of developing pubic policy – to what I write. If you are reading this, thanks for doing so and please don’t hesitate to respond so we can engage in a dialogue, not just a monologue.]

As professional golfers (and perhaps an amateur or two) head to the home of golf for the British Open – the Old Course at St. Andrews – it seems to be a good time to share some of my personal memories of this special place.

It was the golf icon Bobby Jones who uttered this sentence: “If I were to set down to play on one golf course for the remainder of my life, I should choose the Old Course at St. Andrews.”

Agreed.

St. Andrews – both the seven golf courses there that are part of the St. Andrews Links Trust and the town itself, with its center, St. Andrews University – took my breath away when I arrived there the first time with my wife, Nancy, on a visit to the homeland of her parents, Scotland.

We arrived on a Sunday and the Old Course is closed on such days, becoming a park for residents and tourists alike, lying, as it does, astride the North Sea. It was a beautiful day, sunny and warm, as we strode around the course and stopped, of course, to take the obligatory photos at the Swilcan Bridge near the 1st and 18th holes.

After that first visit, we took a few other trips to Scotland, none of which included a return visit to the Old Course. So, in 2012, we ventured back there with my daughter, Lissy, her husband, Tim, and two grandchildren, Mason and Kate. Again, we arrived on a Sunday and walked around the Old Course as a park. The Swilcan Bridge beckoned us again.

That bridge is a golf icon. Many golfers remember a few years ago when the best golfer of all time, Jack Nicklaus, bid farewell to all of his appearances at the Old Course on a solitary walk across the Swilcan Bridge. He lingered on the top for a few moments, not to accept all of the applause, but, apparently, to savor the moment one last time. He then went on to the 18th hole and, fittingly, sunk a birdie putt for his last official golf hole in a tournament he won several times.

On our family’s walk that Sunday, we saw hundreds of tourists and residents alike, plus one horse and a few dogs, who enjoyed “the walk in the park” as much as we did. It strikes me as a master stroke – pardon the play on words – for the owners of the Old Course to make it into a park one day a week. Everyone seems to relish the trek around the course, which often includes a walk over to the adjacent North Sea beach.

As our family arrived in St. Andrews, we took steps to do what every golfer wants to do on the Old Course, which is to play. To put it mildly, it’s difficult to get a tee time. We were not able to do in advance, so as nearly everyone does, we signed up for what’s called the “ballot.”

It’s essentially a lottery and, if your card is chosen, then you get to play the course.

On Monday, my daughter, my son-in-law and I set off on what’s called “The New Course,” which, despite its name, dates to the 1860s. During that round, my wife got the call we had hoped for: We would be playing the Old Course on the next day!

Our glee was followed by a foreboding reality – we would have to tee it up on the 1st tee in front of all sorts of bystanders who would be there, not to see us, but to watch anyone play on the Old Course.

Rather than provide my own description, let me quote from one of my favorite books – Two Years in St. Andrews — by one of my favorite golf authors, George Peper, now the editor of Links Magazine. Here is what he wrote:

“No matter who you are, to stand for the first time on the 1st tee of the Old Course is to experience the greatest natural laxative in golf. So intimidating is the opening that Dwight Eisenhower, a five-star general who once held the fate of the free world in his hands, couldn’t handle the pressure. He slinked to the second hole.

“There you are, barely a dozen steps from the front porch of the Royal & Ancient Golf Club, the full weight of its four-storied grayness upon you. Thirty-two clubhouse windows face that tee, and you can feel eyes piercing from everyone one of them, especially from the Big Room – front and center on the ground floor – where the blue-blazered members sip their gin and tonics and peer imperiously through graduated bi-focals.

“You feel their eyes, lasered into your temples. You feel the eyes of every golfer in your group, every golfer waiting to play, every lurking caddy, raking greenkeeper, and passing motorist, every shopkeeper, dog walker, street cleaner, beachcomber, and windsurfer, every gull, snipe, and pigeon, every fisherman on every trawler in the North Sea. Most of all you feel the eyes of Old Tom Morris and Harry Vardon, of Henry Cotton and Bobby Jones – of every great player, live or dead, who has ever walked these fabled links. And you don’t want to disappoint them.”

That was exactly how we felt as we prepared for the inevitable tee time.

My daughter, Lissy, put it well when she said that, when her tee time came, she was afraid she would be sick. But good news here – to Lissy’s relief, she piped a great drive straight down the middle, as did her husband, Tim. Mine was okay, too, and so off we went on what would be an experience of a lifetime – a family trip around the Old Course.

Our score didn’t matter, as is often the case in Scotland. We just relished the place and loved reliving history.

No doubt these memories will come flooding back as I watch the British Open early next month. Pardon me, to all in Europe it is “The Open,” which, of course, is designed to separate it from what is deemed to be its lesser counterpart, the U.S. Open.

So, yes, let’s relish the memories and make new ones on the Old Course for “The Open.”