Management Expense

Management is an expense to any business, much more than say, stamps.  Obviously any business that is using snail mail, is going no where fast.  Today I walked into the credit union and only half of it was open ..... they were paperless, so there were no withdrawal slips.  I was both shocked and impressed.  Half the cashiers were gone.  Welcome to 2012.

Going paperless is a way of cutting down on expenses.  So how do we manage ...management expense?  What is it?  There are groups of people that run an organization, the official group, hired to do it ..... and the unofficial, the ones that were not hired to do it but do so anyway.

When Centene came to town to take over medicare for kids and single moms, they opened up a subcorporation known as Superior.  They put another subcorporation, Nursewise under Superior, this enterprise was a duality.  Managed by Centene but own by La Fe.  La Fe had recently received millions from the tobacco lawsuit and chose to invest in a telephone triage center that could be available to their patients, and Superior could have the service available to its members.  Sounds good so far until you realize that these organizations have separate agendas.

La Fe is about six feet from Mexico, located in second ward, a non for profit operation that caters to the second ward downtrodden.  But it has lots of patients that come from Juarez, Mexico and they look the other way.  You can see the La Fe complex on google, it is a huge building and it provides more than healthcare.  La Fe has a string of clinics on the border, so it wants to reach as many people as possible.  

Now there are those that want to give healthcare to people in need and they dont care where they are from.  This sounds great, I know my sister's sister had a kid that was burned and needed some very expensive healthcare.  She lobbied the Shriners and they took up her cause, they picked up the kid, flew him and mom to one of their hospitals ..... and it didnt cost her a cent.   I have always and still do think the Shriners are a great group of men that volunteer to keep their children's hospitals working and fiscally sound.  The guys with the funny hats, run around in those little cars, and dress up as clowns, to raise money, and give a good part of their lives to helping those in need.  Heroes all.

But La Fe is operating on tax payer money, they are non profit, so they pay no tax, they probably have a property tax discount.  Yet they do not answer to the taxpayer.  The Nurses at Nursewise are licensed in Texas, not in mexico.  But have to take calls from mexico because the doctors have patients in mexico.  Sometimes they call all the way from mexico city.  Now some of those calls are from people that are related to the doctors, but they are taking medicare patients and getting medicare funds, so who knows which dollar is coming from where.  

Women from across the border, ready to deliver, wait in the bushes and rush into the county hospital so their baby can be a citizen.  Then they apply for their citizenship, and pretty soon you have an entire family on welfare.  It is not unusual to have an ambulance go pick up a patient at the border who is shot and who is a citizen.  In one case they were protecting one of the cartel people.  Of course they needed a lot of police, so they got sheriff, el paso police, border patrol .... all of these people were walking around the hospital in tactical gear, armed to the teeth, and not but one stone throws from a high school.

So fiscal pressures are a little bit different on the border than let us say Wisconsin.  So who is running the place.  Superior has Irene Armendariz, and her sister, allied with the old guard.   Now these people have power and they hire, people they know, neighbors, cousins.

And this is why management is expensive, the group in charge is unofficial and have their own agenda.  By hiring as they do and keeping the same people on the payroll regardless of skill or qualification, and without looking for the cream of the crop they use up resources that otherwise could have gone to profit.   Now not to pick on Superior or Centene, but obviously this goes on in other organizations.  What so bad about President Bush going to Yale or Harvard.  Who cares.   So he gets a scholars ID and makes Cs when Candy, is a college professor, so what?

Needless to say how do you solve the problem, by moving people around.  If you know who the group is, you move them to another place.  That goes for everybody.  The lowest paid to the highest paid.   And this way you can find the cream of the crop.
Why settle for $1 dollar when you can make $2.  Yes it is an inconvenience, but no employee, CEO is going to quite when he makes $150,000 a year.    

Now I could be wrong, fact is that in a very short time Centene has gone from a million dollar corporation to a Billion dollar corporation so they must be doing something right.