JOURNAL HIGHLIGHTS: Roads I Have Traveled . . . Excerpt # 1 1998, Introduction to Baroness Cox Deputy Speaker of the House of Lords

by Dr. James W. Jackson

Founder, Project C.U.R.E.
Author, The Happiest Man in the World: Life Lessons from a Cultural Economist

Note: I want to share with you a bit of the life of one of my very dear friends from England. Baroness Caroline Cox is one of my heroes. This short introduction is taken from my soon-to-be-released book, “Better Off: Rediscovering the American Experiment.” In the weeks that follow, the JOURNAL HIGHLIGHTS series will include excerpts from my actual journals that cover our work together in the little country of Nagorno- Karabakh Keep an eye open for the new book release.

One Tough and Compassionate Lady
When it comes to personifying the economics of the interior, I don’t believe there is any finer example in our contemporary era than Baroness Caroline Cox.

Caroline Cox became a registered nurse in the 1950s and met her future husband, Murray, while working at a London hospital. After marrying and starting a family, Caroline earned a first-class honors degree in sociology at the University of London and a master’s degree in economics. She went on to write several books on nursing and teach sociology at a London university, where she collided head-on with academic elites who forced their Marxist views on the students.

After enduring years of their intimidation, she coauthored The Rape of Reason, which courageously exposed their warped beliefs at a time when standing for democratic ideals was extremely unpopular. In 1977, Caroline embraced a new challenge as the director of nursing education research at Chelsea College, University of London.

Prime Minister Margaret Thatcher was so impressed with Caroline’s indomitable spirit, high energy, and brilliant work that she exerted her considerable influence to see Caroline become Baroness Cox of Queensbury and a life peer in the House of Lords in January of 1983. Lady Cox became Deputy Speaker of the House of Lords in 1985 and served in that position until 2005.

What did Baroness Caroline Cox do with her new title and position of influence?

Instead of just parking herself on the red leather benches in the gilded chamber of the House of Lords, Baroness Cox began using the precious assets in her market basket to help other people become better off. Penetrating the Iron Curtain of the Soviet Union, she risked her life to deliver load after load of desperately needed humanitarian goods to Communist Poland, Romania, and Armenia.

Lady Cox also sought to help the people of Nagorno-Karabakh. Mass murderer Joseph Stalin had arbitrarily separated the small country from its motherland, Armenia, and had given it to Azerbaijan to placate the violent Muslim extremists. Eventually Azerbaijan, Turkey, and Russia embarked on a plan of ethnic cleansing that would systematically annihilate the inhabitants of Nagorno-Karabakh. Baroness Cox stood up in the House of Lords and brought the situation to the attention of Parliament and the world. No one else seemed to care … except Baroness Caroline Cox. But Lady Cox didn’t just talk about the situation; she sprang into action. She traveled to Yerevan, Armenia, climbed into a military helicopter, and flew into the war-torn enclave of Nagorno-Karabakh to help evacuate the wounded and dying. Her nurse’s training also equipped her to provide essential medical care to the evacuees.

I first met Baroness Cox in 1997 when she and her executive assistant, Stuart Windsor, came to Colorado to get better acquainted with Project C.U.R.E. After learning about our international experience, they had determined that we were the best organization to help them with their humanitarian work in Nagorno-Karabakh.

I joined the baroness on her thirty-ninth trip to the decimated country, where I learned that she had once walked directly through the line of weapon fire, waving a white tablecloth attached to a branch, and crossed the Azerbaijan border to personally confront the Muslim thugs who had been murdering the Karabakh inhabitants and torching their homes. She was determined to meet these thugs face-to-face so they would take her seriously. They soon learned that Caroline Cox was one tough lady!

Over the years her compassionate endeavors have led her into many zones of conflict throughout the world, including Sudan, Nigeria, Uganda, Myanmar (Burma), and Indonesia. She even injected goodness into the former Soviet Federation, helping government officials change their policies on orphaned and abandoned children and establish a foster-care system that would place children in families rather than institutions. (I would enthusiastically encourage you to read Andrew Boyd’s book Baroness Cox: A Voice for the Voiceless, which chronicles Lady Cox’s inspiring life story and the magnificent humanitarian work she has been involved in.)

Baroness Cox has received many international awards for her humanitarian work, including the Commander’s Cross of the Order of Merit of the Republic of Poland; the prestigious Wilberforce Award; the international Mother Teresa Award; the Mkhitar Gosh medal conferred by the president of the Republic of Armenia; the anniversary medal presented by Lech Walesa, former president of Poland; and an honorary fellowship of the Royal College of Physicians in London, England.

After all these years, Lady Caroline Cox is still investing her life, her unique abilities, and her influential position to spread goodness around the globe. She’s a classic example of how just one person, guided by the economics of the interior, can help others become better off.

Next Week: Connecting with Project C.U.R.E.

© Dr. James W. Jackson   

Permissions granted by Winston-Crown Publishing House

  

www.jameswjackson.com 

Dr. James W. Jackson often describes himself as "The Happiest Man in the World." A successful businessman, award-winning author and humanitarian, Jackson is also a renowned Cultural Economist and international consultant, helping organizations and governments to apply sound economic principals to the transformation of culture so that everyone is "better off."

As the founder of Project C.U.R.E., Dr. Jackson traveled to more than one hundred fifty countries assessing healthcare facilities, meeting with government leaders and "delivering health and hope" in the form of medical supplies and equipment to the world's most needy people. Literally thousands of people are alive today as a direct result of the tireless efforts of Project C.U.R.E.'s staff, volunteers and Dr. Jackson. 

To contact Dr. Jackson, or to book him for an interview or speaking engagement: press@winstoncrown.com

JOURNAL HIGHLIGHTS: Roads I Have Traveled ... Excerpt # 5 Ukraine and Atlanta January 1997

by Dr. James W. Jackson

Founder, Project C.U.R.E.
Author, The Happiest Man in the World: Life Lessons from a Cultural Economist

(continued): Ukraine/Atlanta: January, 1997): After sharing some other more generalized observations of international health-care systems, I began to describe the unique role Project C.U.R.E. plays in providing donated health-care products to newly developing countries around the world. I explained how we are presently shipping medical goods to over forty different countries. Then I related to them the way Pro­ject C.U.R.E. got started and a bit of its colorful history. The group was fun to talk to because of the extreme diversity of the individuals, combining the Ukrainian delegation with the board of directors of the Association of American Physicians and Surgeons (AAPS) resulted in a very interesting mix. 

While I was talking, one of the AAPS board members raised his hand. I stopped and acknowledged him; then he asked, “Mr. Jackson, just why are you doing what you are doing, and why are you here helping the Ukrainians rewrite their laws?” Dr. Ballantyne, who is famil­iar with my past, just looked at me and grinned. I knew he was wondering just how I was going to handle the question.

I began to tell them what a dramatic difference God had made in my life—how he had changed me from a person who was totally consumed with accumulating wealth for myself to a person devoted to sharing God’s love by helping hurting people around the world. As I glanced across the room, I saw Dr. Raisa Burchak, the wife of Dr. Fedir Burchak, the legal advisor and personal confidant of the president of the Ukraine. She had her lace handkerchief out and was crying. Perhaps it was the first time she had ever heard about the transforming grace of God.

I finished my part of the speaking agenda by challenging everyone there to consider moving from a personal position of success to a position of significance in their lives: “Do some­thing significant that will last forever.”

After the session, Dr. Fedir Burchak and Raisa came up to me and hugged me. Dr. Raisa said, “I learned many things during these hours, but perhaps the greatest thing I learned I learned from your heart.”

Sunday, January 12

It is necessary for me to return to Denver early, so I will be unable to personally say good‑bye to my new friends from the Ukraine when they board their flight for their return trip. But as I left the symposium and boarded my plane to fly home to Denver, I had to stop and thank God for allowing me to be a small part of such a historic occasion.

Who would have ever believed on December 17 that all the necessary elements for success would have come together in such a short time and allowed us to actually organize, offer, and present this economic symposium?

I don’t know at the moment how the newly proposed health-care laws will be accepted in the Ukrain­ian Parliament, but I rest in the fact that when Dr. Mark Johnson and I saw the need to help, we were able to respond in instant and complete obedience. I will always hold as extremely valuable the memory of how God blessed our simple efforts to help and brought together all the correct people in such a short span of time, and did it in a way that brought honor to God and dignity to the efforts. 

Dr. James W. Jackson often describes himself as "The Happiest Man in the World." A successful businessman, award-winning author and humanitarian, Jackson is also a renowned Cultural Economist and international consultant, helping organizations and governments to apply sound economic principals to the transformation of culture so that everyone is "better off."

As the founder of Project C.U.R.E., Dr. Jackson traveled to more than one hundred fifty countries assessing healthcare facilities, meeting with government leaders and "delivering health and hope" in the form of medical supplies and equipment to the world's most needy people. Literally thousands of people are alive today as a direct result of the tireless efforts of Project C.U.R.E.'s staff, volunteers and Dr. Jackson. 

To contact Dr. Jackson, or to book him for an interview or speaking engagement: press@winstoncrown.com

JOURNAL HIGHLIGHTS: Roads I Have Traveled... Excerpt # 4 Ukraine & Atlanta 1997

by Dr. James W. Jackson

Founder, Project C.U.R.E.
Author, The Happiest Man in the World: Life Lessons from a Cultural Economist

(continued): Ukraine/Atlanta: January, 1997: Nowhere else could they have accessed the information, intelligence, and experience available to them in Atlanta this weekend. And perhaps most important, they are experiencing the gift of love and concern for the people of Ukraine and their future. They have been, for the most part, responding with appreciation; however, each has lived an entire lifetime under the old, centralized Soviet system, and occasionally I could see that it is difficult for them to break from the “security” of that system.

Dr. Mark Litow, the actuarial consultant, used his time to identify and explain some of the strengths and weaknesses of the US health-care system. He spoke of the types of systems involved and the six distinct market groups receiving health care in the US. He pointed out how, as the US has moved toward a more socialized, centralized health-care system, we have increasingly been pushed further and further into debt. Today half of the US deficit is caused by Medicare alone. He suggested three desirable elements to be included in health-care reform:

1. Reasonable cost

2. High quality

3. Access to treatment

Dr. Litow used a lot of charts and overhead projections to simplify the understanding of his facts. For the largest portion of his time, he presented concepts he feels are necessary for the reform process and package.

The openness of the meeting made it conducive for the Ukrainian delegation to freely discuss their present health-care system. They revealed that in 1985, the equivalent of US$180 was allocated per person per year for health care in the Ukraine out of the government budget. In 1994 it dropped to only $16 per person per year. Now the system has completely collapsed, and the state is completely irresponsible. They have eliminated over sixty thousand beds from hospitals throughout the system, and their doctors have not received their government paychecks (only the equivalent of US$50 per month) for four or five months.

The situation has made criminals out of nearly every doctor, since doctors are now forced to treat patients privately (from their back doors or in some secret place) in order to try to generate some cash on which to live. Presently such activity is punishable by imprisonment. The situation has presented the entire country with a huge moral problem. The state simply cannot come up with the necessary $1.8 billion to provide medical care for the people this year.

As we broke for the dinner hour, a whole lot of frustration was evident, but what had been presented to the delegation was making sense, and comments were indicating hope and the possibility of workable ideas.

Following dinner we combined the Ukrainian delegation, all of our presenters, and the board of directors of the Association of American Physicians and Surgeons (AAPS) for our final session of the day. I was chosen to speak during the first half of the session. The final portion would include a round-table discussion in which the Ukrainians would explain their present system and situation, and the entire group could ask questions or offer insights.

I had thought about what I was going to say for several days and had also used the flight time from Denver to Atlanta as an opportunity to crystallize my thoughts. I did not want to denigrate the Ukrainian health-care system and exclusively emphasize their problems. So I decided to share with the whole group some of the observations I had made in my hospital Needs Assessment Studies around the world. The Ukrainian delegation could readily identify with each of the problems, but I wouldn’t be pointing my finger directly at them. I titled my presentation “International Health-Care Observations.”

I am continuously crisscrossing the avenues of a bankrupt portion of the world, viewing the aftermath of the great social experiment of the past eighty years. It promised everything and ultimately delivered nothing. Why? Because you can only pursue the philosophy of redistribution for a limited period of time. After you have stripped the treasure chests of accumulated wealth from a nation and wasted it without any plan to replenish the coffers, it becomes impossible to redivide and redistribute “nothing.” That sort of set the groundwork in my presentation for the following observations:

1. In theory, you can argue that a centralized health-care delivery system has the advantage of efficiency, but lost-opportunity costs are unacceptably high. In my book What’cha Gonna Do with What’cha Got?, I tried to explain the economic principles of scarcity, choice, and cost. Items are scarce because they have two or more alternative uses, but eventually you must choose one of the alternatives. The next highest valued other thing or other use you give up is the real opportunity “cost” of what was chosen, because you have to do without that. In North Korea, the health-care system is very centralized and very regimented. It appears to be efficient, but the rigidity of the system disallows any creative or altered approach to a medical procedure. The lost-opportunity costs are very high. 

2. A centralized health-care system does not allow for keeping pace with medical discoveries and new technologies. Example: The head doctor in one of Cuba’s largest hospitals begged me to bring in new medical procedural and research books. “We are so restricted,” he said, “we don’t even know current medicine.”

3. Health care that is freely available to all is the same as equally unavailable to each. Example: In Brazil and Peru, I saw people coming to a clinic in ox carts, in old buses, or on foot. They would stand in line all day only to have to return the next day and get back into line because they were unable to receive help.

4. A centralized health-care system produces overspecialization and undertraining in general family medicine. Example: In Uzbekistan, a young doctor told me, “I am trained to remove gallbladders. I don’t have to be responsible for anything else.” One man in Moscow told me, “I’m sorry the hallway is completely dark, but the man who is trained to change lightbulbs doesn’t work anymore, so we are in the dark now. I don’t change lightbulbs.”

5. In a centralized health-care system, there is a built‑in disincentive to take any risks or make any decisions to do anything new. Example: In Minsk, Belarus, I watched a medical team in a burn unit just stand and watch rather than deviating from the standard care procedure. In a centralized system, there is no way to experience a reward for doing something new or different, but there is almost a certain possibility of experiencing loss for trying something different.

6. When a centralized health-care system controls a single source of medical supplies and goods, the level of quality usually suffers, and the delivery system for those goods becomes inadequate. Many of the hospitals I visit around the world experience the same thing. Example: Doctors often tell me, “Mr. Jackson, we have not been able to get the medical supplies we need for several years now.”

7. A centralized medical system can seldom get the cost-versus-value ratio correct. Example: In countries where the value of the health care given is greater than the individual cost paid, people use too much health care. Long lines form, and the people who really need the care are excluded because of the long lines. If the cost charged is greater than the value received, then no one can afford the health-care services.

8. Hospital stays are longer where there is a centralized health-care system. Example: In Kazakhstan and Uzbekistan, it is not unusual for a patient who has experienced a heart attack to stay in the hospital seven or eight weeks. The hospital receives its budget allocation based on the number of patient days. There is no incentive for the patient to be sent home earlier.

After sharing some other more generalized observations of international health-care systems, I began to describe the unique role Project C.U.R.E. plays in providing donated health-care products to newly developing countries around the world.

Next Week: Change in more than health care.

© Dr. James W. Jackson 

Permissions granted by Winston-Crown Publishing House 

www.jameswjackson.com

Dr. James W. Jackson often describes himself as "The Happiest Man in the World." A successful businessman, award-winning author and humanitarian, Jackson is also a renowned Cultural Economist and international consultant, helping organizations and governments to apply sound economic principals to the transformation of culture so that everyone is "better off."

As the founder of Project C.U.R.E., Dr. Jackson traveled to more than one hundred fifty countries assessing healthcare facilities, meeting with government leaders and "delivering health and hope" in the form of medical supplies and equipment to the world's most needy people. Literally thousands of people are alive today as a direct result of the tireless efforts of Project C.U.R.E.'s staff, volunteers and Dr. Jackson. 

To contact Dr. Jackson, or to book him for an interview or speaking engagement: press@winstoncrown.com

JOURNAL HIGHLIGHTS: Roads I Have Traveled... Excerpt #3 Ukraine and Atlanta, 1997

by Dr. James W. Jackson

Founder, Project C.U.R.E.
Author, The Happiest Man in the World: Life Lessons from a Cultural Economist

(continued): Ukraine/Atlanta: January, 1997: Dr. Mark not only got the right Ukrainians lined up to make the trip—even on such short notice—but was also able to raise almost $7,500 in twenty-four hours to cover the airline tickets from Kiev to Atlanta. In addition to Dr. Ballantyne, we were able to secure Dr. Michael Tanner of the Cato Institute, a prestigious, conservative think‑tank organization from Washington, D.C., and Mark Litow, a consulting actuary from Milliman and Robertson in Brookfield, Wisconsin. We are going to have a powerhouse symposium!

Dr. Mark was relentless on the phone, and I was tempted to buy some stock in AT&T as I watched his international telephone bill escalate. But everyone was amazingly available, and all the speaking participants were willing to come and charge no fee at all!

Friday, January 10

I arrived in Atlanta about 3:00 this afternoon and checked into the Sheraton Gateway Hotel. Before long the rest of the group began arriving. Our chosen group from the Ukraine includes Dr. Fedir G. Burchak, head of the Committee for Legislative Initiatives and the personal confidant of and legal advisor to the president of the Ukraine. Accompanying Dr. Burchak is his wife, Raisa, a very intelligent Ukrainian lady and editor for an encyclopedia company. Also attending the symposium are Dr. Alexander Korotko, the deputy minister of health for economic affairs, and Dr. V. G. Nicolaev from the R. E. Kavetsky Institute of Experimental Pathology, Oncology, and Radiobiology. He is also head of the academy of artificial organs and biomedical engineering as well as a member of the board of directors for the National Academy of Sciences of Ukraine. Additionally, there are three Ukrainian translators.

The speakers for the symposium include Dr. Paul Ballantyne, head of the economics department of the University of Colorado, Colorado Springs; Dr. Michael Tanner of the Cato Institute, Washington, D.C.; Dr. Mark Litow, consulting actuary for Milliman and Robertson in Wisconsin; Dr. Miguel Faria, editor of the Medical Sentinel and author of Vandals at the Gates of Medicine; and yours truly, Dr. James W. Jackson, representing Project C.U.R.E.

It is absolutely a miracle to have arranged for all these important people to get together in one place in the world. It is an even greater miracle to have gotten them all together on such short notice. Who would have dared to think it was possible.

Saturday, January 11

This morning we all met together and hit the ground running. Tape recorders were set up to capture the audio portion of the symposium.

Dr. Ballantyne had the responsibility of handling the first session of the symposium. His assignment was to explain the basic principles of economics in terms that can not only be understood but can also be conveyed to members of the Ukrainian Parliament. It will probably be the first time anyone has ever taken the time to explain the basic concepts of free-market capitalism to the Ukrainian delegation.

I was so confident of Dr. Ballantyne’s ability to share the simple, basic rudiments of economics that I found myself relaxing and thoroughly enjoying the presentation. He began by talking about wealth versus poverty and the importance of production factors like land, labor, capital, and the entrepreneur. He explained the gross domestic product (GDP) concept and asked why it is possible for the United States to produce $25,000 per person per year in output while the Ukraine produces only $1,600 per person per year. He went on to explain how the market system works as it does and how people benefit through voluntary exchanges.

He then explained the economic trilogy of scarcity, choice, and cost and drew a graphic of the supply-demand curve, discussing how to determine “just the right price” for a commodity or service. Dr. Ballantyne, as usual, was nothing less than brilliant in his presentation. He has always had the ability to take complex concepts and make them extremely easy to understand and remember.

When Dr. Ballantyne finished laying the economic foundation for the free market system, Dr. Michael Tanner took over. He began to slowly build on the foundation Dr. Ballantyne had formed. I could see where he was going and chuckled inside. He methodically presented the concepts of health care as they relate to basic economics. He explained logically why long lines of people wait in the Ukraine to receive health care. He also showed with simple economic graphs why their system pushes people into criminal activities on the black market. He then presented the three necessary elements of a successful health-care delivery systems: (1) the recognition of the self‑interest factor, (2) the need for encouraging competition, and (3) the absolute necessity of including and honoring freedom of choice. He pleaded with them to allow into their new health-care system the right for patients to legally contract with the doctors of their choice so that there would be an accountable relationship established between the doctor and the patient rather than the doctor and the government, which would ultimately leave out the consideration of the patient. 

Dr. Tanner recommended the inclusion of three main elements in the new Ukrainian health-care system:

1. Ensure the right of contract between the patient and the doctor.

2. Reform how payment is made (i.e., have the patient pay the doctor rather than having the government paying the doctor).

3. Develop some rational formula for the people to purchase adequate health care.

By that time the Ukrainians were really beginning to understand the benefits of a free-market-system approach to health-care delivery. Dr. Tanner carefully explained the formula Va (actual value) and Vi (value to the individual) = C (cost). When both values (Va and Vi) are equal to the cost, the patient will purchase the optimal health care available. The Va (actual value) could be zero if the Vi (value to the individual) is equal to the cost. For example, if the doctor is very pretty, you may pay for the visit even if there is no actual medical value to you at all. The big problem is when the Va and Vi are greater than the cost, which encourages people to use too much health care. Then the people who really need the health care will be excluded because of the long waiting lines to see the doctor.

Dr. Tanner told them that when the formula for health care has to be reformed, there are really only three ways to do it:

1. The traditional way: The government intervenes and rations health care (e.g., “You can only see the doctor once a month.”)

2. Managed care: The insurance company steps in and says, “You can only come in and see the doctor once a month.”

3. Cost Increases: Take the control away from the government or the insurance company to arbitrarily increase the cost and allow the individual patient to pay with his or her own money for the cost of the service.

Several times the speakers cautioned the Ukrainians not to design their new health-care system after the current US system. The Ukrainians agreed. They had already proven that the centralized system of more government does not and cannot work over the long term. That’s why they are now demanding free-enterprise reform.

Dr. Tanner then patiently taught the group the concepts of insurance. The Ukrainians quickly agreed that they had been thinking of insurance as simply another way to prepay and finance their old centralized government system rather than seeing it as a way to spread out the risk among many people. The Ukraini­ans said they would have used insurance funds to cover known and routine problems rather than uncertain eventualities.

In recapping his session, Dr. Tanner encouraged the inclusion of four factors in the new re­form:

1. Link all the monies for payment of health care in some way to the patient.

2. Allow patients the freedom to establish a contract with the doctor of their choice.

3. For routine care and voluntary care, raise the cost of treatment and have the individual pay for part of it.

4. Develop a private insurance market for spreading out the risk among a large number of people for high cost and nonroutine procedures.

By the time Drs. Ballantyne and Tanner were through with their first sessions, the concepts they had presented were making a world of dif­ference in the minds of the Ukrainian delegation. They began asking questions about the possibilities of including the creation of medical savings accounts for individuals and families. 

Next Week: Changing a nation's health care system. 

© Dr. James W. Jackson   

Permissions granted by Winston-Crown Publishing House

  

www.jameswjackson.com 

Dr. James W. Jackson often describes himself as "The Happiest Man in the World." A successful businessman, award-winning author and humanitarian, Jackson is also a renowned Cultural Economist and international consultant, helping organizations and governments to apply sound economic principals to the transformation of culture so that everyone is "better off."

As the founder of Project C.U.R.E., Dr. Jackson traveled to more than one hundred fifty countries assessing healthcare facilities, meeting with government leaders and "delivering health and hope" in the form of medical supplies and equipment to the world's most needy people. Literally thousands of people are alive today as a direct result of the tireless efforts of Project C.U.R.E.'s staff, volunteers and Dr. Jackson. 

To contact Dr. Jackson, or to book him for an interview or speaking engagement: press@winstoncrown.com