Here’s an interesting WSJ article that looks at American health care delivery and divides it into two well known camps: Best Practices or Market Forces. The Best Practices approach argues that experts should acquire scientific knowledge, evaluate its quality, then define Best Practices that should be delivered throughout the system for both providers and people. Market Forces argues instead that delivery should be based on what people want and will pay for with providers who decide what they want to give and at what price.

You can see metaphorically the two approaches to persuasion in this case. Persuasion can take either a Source or a Receiver orientation. With the Source approach everything depends upon how the Source thinks and acts, the process and the outcome flow from Source creativity and action. The Receiver orientation is just my Rule, It’s about the Other Guy, Stupid. It doesn’t matter what you do, it matter whether the Other Guy changes.

The Best Practices approach to health is that Source orientation. The Source is the expert and drives everything else. By contrast, Market Forces hit that Receiver orientation and the emphasis upon the Other Guys.

Sure, it takes two to tango and you always have Source and Receiver mixed in every persuasion play if only because we’re talking about communication and those parts must always play. This isn’t Either-Or. It is emphasis.

My bias from both experience and research is on that Receiver, Other Guy orientation. I was never smart enough and could not find enough smart enough partners to get close to the Queen of Tomorrow solution where a bunch of us experts Made It Happen. As long as I kept my own supreme intelligence and efficacy in a straightjacket and maintained a laser beam focus on Other Guys, I could occasionally find success.

Given the size of the persuasion problem here with over 300 million Americans and a couple of million providers of various types, I don’t see how any expert or group of experts can possibly arrive at a solution that actually works. Sure, you can pretend like the Obama Administration does with their health and safety interventions, assuming, of course, you can get them past a court – whodda thought persuasion had to be legal? But even when legal, they don’t produce much Change in Other Guys.

And, isn’t that the TACT?

I first read about John Maynard Keynes as a great investor, not the famous economist, in the “Adam Smith” book, The Money Game, in 1970. Smith noted that Keynes piled up a small fortune for King’s College, Cambridge from 1922 to 1946 demonstrating a skill unmatched in his time and now maybe for all time. We get an update on this story.

From 1924 through 1946, while writing numerous books and overhauling the global monetary system, Keynes also found time to run the endowment fund of King’s College at Cambridge. Over that period, according to Messrs. Chambers and Dimson, Keynes outperformed the U.K. stock market by an average of eight percentage points annually, adjusted for risk.

If you chase down the Chambers and Dimson paper and look at Table 2 on page 46 you find that the index average per year for that time period was 7% but Keynes averaged 15%, doubling the index over a 20 year period. That is staggering good, like Keynes must have known the Queen of Tomorrow. His record is better than Lance Armstrong’s Tour de France winnings or Barry Bonds home run record or Roger Clemens, and you see where I’m going with this.

Note one little observation about Lord Keynes during 1922-46.

As a director of the Bank of England, Keynes was privy to inside information about interest-rate changes, although there isn’t evidence that he traded on it.

During the time period in question, the Bank of England was the most powerful bank in the world. Stated another way, Keynes was the Ben Bernanke of his time only with considerably more power and considerably less transparency. If Keynes was not an insider, the term has no meaning.

How could Keynes have NOT traded on insider information? He always had his memory with him and his formidable mind, too. After he walked out of meetings with the world’s top bankers and investors, generals and politicians, should we believe he forgot those conversations when he made his moves for the endowment at Cambridge? It would be psychologically impossible for him to literally take off his insider hat, put on his outsider hat, and do his buying and selling for Cambridge.

Please realize that I am not saying that Keynes did criminal trading. What he did was legal then, as it was for Joseph P. Kennedy! But, if today Ben Bernanke was also functioning as the chief for the Princeton endowment fund, people would raise more than eyebrows. Bernanke could not legally do today what Keynes did then. And, with good reason. The opportunity for corruption is obvious.

I am claiming that Keynes may not have been such a great investor after all. Good grief, look what Warren Buffett did as a public trader in Omaha, Nebraska. Imagine him as the head of the Fed during the same time period. You think he might have done a little better still?

There’s a Difference between Persuasion, and Smoke and Mirrors; With Persuasion the Illusion Lingers.

P.S. The painting at the top of the post is from the National Portrait Gallery in London and depicts Keyes with the famed Bloomsbury Group. Keynes remains the most unusual economist. Near the end of his life he declared, I should have drunk more champagne.

Ambling along we observe . . .

Dr. Freeman leads a group called Walk With a Doc, which encourages patients to get out, once a month or so, to stroll the city with their physicians. The group’s most recent walk, in January — walkers can be hard-core, too, no matter the season — drew 135 people, including 10 doctors.

Let me count the ways.

1. Everyone who walks with a doc is healthy enough to not need a doc. The intervention is not an intervention, but merely an indicator of healthiness and sociability.

2. A 14 patients to 1 doc ratio. The AMA won’t like that because it would mean they’d have to wildly increase the number of students they admit and pass through medical programs. Think that might cut into physician pay?

3. You train people in biology, anatomy, pharmacology, cardiology, and on and on and then how do you use that skill? As a walking leader? Yeah. That makes sense.

4. Count the steps this program generates. Go ahead do the math even if it requires data mining and huge datasets since we’re going national with it. Healthy people walking with physicians once a month. As a persuasion intervention aimed at making healthier people, this is a crazy waste of time and effort. As a fun social event, it’s fine, but that’s not the point.

5. Imagine the liability issues when someone gets hurt. If you’re out walking with your doc and you blow a knee or get hit by a biker (sweet irony there) who pays for it? Imagine the press on that one.

Mavens, what’s the strategy behind this persuasion play tactic? Clearly the muggles are out on the streets in gangs of 150 huffing and puffing FauxItAlls, but to what end? Sure, we’ve got a bunch on nice Cues (Authority, Liking, Comparison, Commitment/Consistency), but no one is thinking about the strategy.

But, if you don’t jeté, then at least strut!

Robert Caro publishes his fourth volume on Lyndon Baines Johnson. This book covers Johnson’s final years as master of the Senate through becoming President following the assassination of John Kennedy. The reviewer, former President Bill Clinton, offers a sharp, concise, and smart summary of LBJ’s skills.

If you were a partisan, he’d call on your patriotism; if a traditionalist, he’d make his proposal seem to be the Establishment choice. His flattery was minutely detailed, finely tuned and perfectly modulated. So was his bombast — whatever worked. L.B.J. didn’t kiss Sam Rayburn’s ring, but his lips did press against his bald head. Harry Byrd received deference and attention. When L.B.J. became president, he finally had the power to match his political skills.

Most people hated Johnson for a wide variety of reasons ranging from Left to Right: Viet Nam and Civil Rights to name two big ones. Johnson accomplished more legislatively than most Presidents and it came from his knowledge of the Senate and his persuasion skills. You feel the tension and the glory of this in Bill Clinton’s book review.

See the mix of Arguments and Cues. See how Johnson made his Box and Play fit each unique person.

More importantly, see the Rules.

It’s about the Other Guy, Stupid.

You Can Get Farther with a Kind Word and a Gun Than You Can with Either Alone.

But, if you know the rest of the story: Power Corrupts Persuasion.

P.S. Excellent book review from Clinton. He fails to fail as many reviewers do and avoids those clumsy nuances a smart reviewer intrudes upon either the book writer or the book topic. Clinton reviews the book well. He also admits his respect for Johnson, providing another reason why so many progressives hate Clinton like they hated Johnson. And, as good as Clinton was as a persuasive President, Johnson still leaves him in the shade. If you like Big Government, you need to study the Great Society.

Here’s a free sample of cancer. Care for one? How about you? What, no takers?

Okay, here’s how you prevent cancer. Like that better? Sure, you do. So do this.

Keep a predictable schedule.
Move frequently and avoid prolonged sitting.
Ditch the vitamins and supplements.
Get an annual flu shot.
If you’re over 40, talk with your doctor about the benefits and risks of taking a statin and low-dose daily aspirin.
Wear comfortable shoes.
Take inventory of your medicine cabinet once a year.
Cash in on healthy-living incentives.
Think of your doctor as a partner, not a friend.
Know yourself by keeping records of your medical data.

This from a review of a book from Dr. David Agus, professor of medicine (and scientific science) at USC. Lots of great blurb quotes for the book, too, from well known scientific sources like Al Gore, Michael Dell, Lance Armstrong, and Steve Case.

People will believe anything if you wear an attractive lab coat. Stethoscope optional. Comfortable shoes required.

All Bad Science Is Persuasive!

P.S. Quite a crew of scientific scientists at USC. They know about the new perils of traffic fumes and cell phones.