Saturday, November 19, 2011


In May of this year, House Bill 1491 was sent by the Texas Legislature into the Public Health Committee for review. The bill, sponsored by Rep. Elliott Naishtat, would sanction the physician’s recommendation of medical cannabis to patients without any reprisal or condemnation from the legal or medical communities. Even more importantly, HB1491 allows for the prescribed medical use of Cannabis as an Affirmative Defense against marijuana possession charges.

This is very similar to the Arizona law that protected me from fear of prosecution or arrest while living in Arizona with responsible medical use and a letter from my doctor.

While the law may begin by simply stating a person can present an affirmative defense, if properly supported by a Judiciary that will uphold this defense, positive changes will be affected through fewer bodies incarcerated, especially the sick ones. When the D.A. realizes that the Judges will not jail a person for medically recommended treatment, s/he should follow that it is not in their interest to prosecute such cases, and subsequently refuse to file charges. When law enforcement realizes that the D.A. will not file charges on a medical defense, they will stop wasting their time and further endangering the health of the patients, by arresting them.

While this is NOT medicalization in the “California” sense, it is a GIANT LEAP in the right direction.

Most importantly, it loudly overplays the propagandist rhetoric demonizing cannabis as an illegal street drug that is destroying our “youth”.

And while the most favored arguments against any cannabis use are invented under the inauthentic auspices of protecting the nation’s children, no medicalization effort of yet has included the service to children.

Forbidden fruit always tastes better

From my experience and studies of addiction, communications and human behavior, I would claim that exactly the opposite behavior would be predicted from children raised in a culture where cannabis is medicalized and socially accepted. It is human nature to want what is forbidden; what is not allowed is especially exciting to the developing and curious brain of a child or teen. Medicalization and the unrestricted media, transparency, and advertisement that would come with it, may instead have the effect of desensitization rather than increased curiosity.

Texas HB 1491 appears to be lost in committee. It’s time to wake them up and remind them! Follow the link to the members of the Public Health Committee. Take time to stay on them, stay with this issue.
Follow this link to the Texas Legislature, and another list of links directly to the Public Health Committee Members.
If you need another reason or reminder of why this is so very important in Texas, take a look back at my blog entry “The Five Worst States to Get Busted With Pot”, here’s a link so you don’t have to search for it:

Stay posted, stay involved…

Stop the Mexican Schwag War:  Buy American!
The Green Association for Sustainability

Monday, August 22, 2011


Is Pot Addictive?
The answer to this question has eluded mankind for nearly one hundred years!

Prior to that, marijuana was not illegal, nor considered an addictive or harmful substance; at least, not by the U.S. government’s standards. Alcohol was the bane of society in the early 1900’s as prohibitionists marched in the streets, many of them quietly addicted to Opioid Tonics freely available from the corner druggist.

As with anything, the answer to the question depends on the presumed definition.

Addiction is a psychological state in which the object of addiction can be any number of drugs, actions, or substances. Calling cannabis addicting in this context is NOT telling the truth, but is a trick of semantics in a society where food has become the most common and dangerous addiction.

Dependence is a physical state in which the object of dependence causes enough physical distress as to make the user continue their addiction even through obvious deleterious consequences. Nicotine has been cited as causing the greatest dependence in humans.

Cannabis does not cause physical addiction or create a physical dependence. There are no dependency-causing chemicals in Cannabis. Any physical discomfort felt by a cannabis user on cessation is psychological.

Although Cannabis can cause psychological addiction, so can any substance or human action: Prohibiting marijuana for a psychological addiction is like criminalizing dice for gambling disorders.

Unlike opiates (Heroin, Morphine), cocaine (Crack), benzos (Xanax), nicotine, and alcohol, Cannabis carries no risk of physical addiction, and has no substances that create a physical addiction. A psychologically addicted user may report anxiety upon "withdrawal"; any "withdrawal" symptoms are purely psychological. Although many studies have proved this, the argument of addiction is one of semantics and medical terminology, as well as ICD-9/10 (Diagnosis) coding.

Cannabis cannot create the condition of "drug dependence"; however, cannabis can create "drug abuse", as can a can of hairspray and a package of bath salts.

Prohibition has not stopped the use, recreational or medical, of marijuana. Cannabis is freely trafficked into the United States from Mexico by violent, dangerous and warring cartels. Although billions have been spent, US Federal forces such as the DEA, INS, and ICE have been unsuccessful in stopping the influx of low-grade cannabis into the United States. This “Schwag” has no medicinal value, and is cheap and widely available and easy to get, especially for the young. Even IF the Feds got their way, and all of the progress in medical cannabis was reversed, the cartels will assure that their brand of blood stained pot is on American streets. Wouldn’t it be better if the sick, suffering, and dying had access to clean, quality Cannabis, safely and transparently available, and prescribed specific to symptomology?

The Green Association for Sustainability
K. Rojas,

FRESH CLIPPINGS: Qaddafi Wisdom:


“Women, like men, are human beings. This is an incontestable truth…”

--The Green Book, 1970, M. Qaddafi 

Friday, July 29, 2011


A letter to My Representative
Re-tweeted this evening:  Congress Sucks. 
Short, simple, to the point, and right now, probably about all you need to say.  But who can keep the outrage from spilling out? 
You already know that I can’t!
I wrote it after many Notebook scribbles and news searches, hours of blog surfing and comment reading, as we paced through the day in Boehner’s clutches.  I wonder if his fellow Republicans are angry about being brow-beaten into changing their votes.  Some even made conciliatory comments as to why they wimped.  In the end, it was wasted time. 
Boehner is intent on making a name for himself, of being the next “Newt”.  He is flush with power, and will only be happy if the bill has his name on it.  Pandering to the Tea Party faction may get him temporary fame; historically, elite factions rarely last longer than a generation, and few are looked upon favorably.  At one time, McCarthy was popular among some people.  So was Hitler.   
DEAR REP. AL GREEN (Dem.- District 9 Texas)
I am writing IN SUPPORT of YOUR RECENT NO VOTE on John Boehner's Debt Limit Bill. Boehner, drunk with Power at winning the Speaker seat, and is blackmailing President Obama by holding the Congress and The American People hostage.  
Thankfully, the Senate also realized that those who can least afford it are asked to do the most.  The argument that reinstating the Bush tax cuts will hurt new job growth, reminds me of a similar failed Republican policy of the 1980’s:  The “Trickle Down Theory”.   The Corporate CEOs and small business owners who support the Boehner plan are counting on no one remembering the tragic results of that policy.
Stay strong in your support for a passage of an increased debt limit.  How the Budget is to be paid should be decided when the budget is passed.  Not when the bills are due.

K. Marie Rojas

Wednesday, July 27, 2011

DR. OZ The Truth About Marijuana?

On Wednesday, July 27, 2011, DR. OZ (NBC) addressed the issue of Medical Marijuana. Intending to “tell the truth” about marijuana, the show addressed several issues regarding the scientific, social, and legal issues surrounding medical marijuana. In summing up the show, Dr. Oz called on those states that have passed medical marijuana initiatives to implement them, citing states like New Jersey and Maryland, who have not implemented dispensing regulations.

Although I applaud these efforts, Dr. Oz did not achieve his intent of telling the truth. I found the two statements below especially disturbing.




1. Cannabis Sativa (White Widow, Haze) has a high ratio of THC to CBD, both cannabinoids, that creates a more "cerebral" effect compared to the heavier opiate like effect of Cannabis Indica. Medicalization has bred out much of the "paranoia" associated with Sativas, and most strains found in dispensaries are a blend of Indicas and Sativas, with Indicas being the most prevalent. In addition, Indicas are easier to grow, heartier, and produce more product per plant than the 12-20 foot spindly Sativa plants. Cannabis Indica has been proven efficacious in treating anxiety, insomnia, PTSD, and other stress disorders.

MARINOL is the trade name of synthetic THC. It is available in 2.5, 5, and 10 mg. capsules. It was released as a generic in 2009, under the name "Dronabinol". Unfortunately, this did not lower the price much. A dosing schedule of 5 mgs. three times a day, or 90 capsules per month, would cost approximately $600.00. Few insurance companies cover this medication, and even fewer physicians prescribe it.

Marinol can be very effective for intractable nausea and vomiting. It also helps with cachexia, allowing ill patients to maintain their weight. It is ONLY THC, however, whereas Cannabis contains many different cannabinoids. Especially notable is the lack of CBD (Cannabidiol). Depending on the ratio of THC to CBD, CBD alters the THC effects. High CBN levels compared to THC produces the pain relieving and muscle relaxing effects that are looked for in medical strains. High THC with Low CBN levels is what produces the unwelcomed side effect of anxiety or paranoia. Many dispensaries offer "High CBN" strains for patients looking for specific medicinal properties.

By itself, Dronabinol is specifically effective, but does not have the range of medicinal relief found in inhaled marijuana. For those seeking relief for these specific symptoms, a prescription model that combines dronabinol with marijuana, may reduce the amount of inhaled cannabis while increasing appetite and reducing nausea and still offering pain relief. The financial costs, however, make the use of Dronabinol restrictive, especially when plant cannabis is legally available at a much lower cost.

2. Cannabis does not cause addiction or create a physical dependence. Addiction is a psychological state in which the object of addiction can be any number of drugs, actions, or substances. Calling cannabis addicting in this context is NOT telling the truth.

Although Cannabis can cause psychological addiction, so can any substance or human action: Prohibiting marijuana for a psychological addiction is like criminalizing dice for gambling disorders.

Unlike opiates (Heroin, Morphine), cocaine (Crack), benzos (Xanax), nicotine, and alcohol, Cannabis carries no risk of physical addiction, and has no substances that create a physical addiction. A psychologically addicted user may report anxiety upon "withdrawal"; any "withdrawal" symptoms are purely psychological. Although many studies have proved this, the argument of addiction is one of semantics and medical terminology, as well as ICD-9/10 (Diagnosis) coding.

Cannabis cannot create the condition of "drug dependence"; however, cannabis can create "drug abuse", as can a can of hairspray and a package of bath salts.

Prohibition has not stopped the use, recreational and medical, of marijuana. The illegal Cartels will make certain that the sick, suffering, and dying will have access to Cannabis; it would be much better if it were available safely and transparently, and provided specific to symptomology.

The Green Association for Sustainability

Friday, May 20, 2011

MEDICALIZATION IN ARIZONA: Medicinal Marijuana - No Easy High

According to a local newspaper in Pinal County, Arizona, securing medicalization was only part of the battle to bring medical marijuana to Arizona.  There are still physicians who are resistant to writing prescriptions for medical marijuana, although the article mentions that physicians can and probably will write for Marinol, the pharmaceutically available THC.  Not in any way a substitute for whole plant cannabis, Marinol can be effective for nausea; however as with other oral nausea pharmaceuticals, the difficult task remains of having to ingest medication while vomiting intractably.

Another issue in the Arizona medicalization law, as well as ALL medicalization laws, is the restriction on growing and harvesting personal use plants.  Delaware's medicalization this month saw a complete restriction on private grows, forcing patients into clinics or other state or Big Pharma regulated and run organization.  Last year, four other states medicalized without the right to grow in order to pass a medicalization bill.  Arizona's law states that a medical marijuana patient can only grow 12 plants IF THEY LIVE MORE THAN 25 MILES FROM THE NEAREST DISPENSARY.   Although I understand that some restrictions on growing may be necessary in large urban areas to avoid crime or other undesireable sequelea, such restrictions should be specific and definitively defined so that those who are able to grow safely and securely, can do so.  How far they are from a dispensary should be less important than where the grow area is located, i.e., in a school zone or a business district may not be such a good idea. In Rural areas, and those who live on and own larger lots, for example, should have the right to grow.

The issue of growing is an important issue and right that should not be denied.  Voters who are over-eager to pass medical marijuana bills are agreeing to let the state control their ability to grow the plant, giving up an inalienable right, and giving control to the government and big Pharma. 

A small ray of understanding emerged in the article when it was reported that one interviewed physician, Dr. Hill, admits that because of the existance of cannabis receptors in humans, it is probable that humans evolved with the cannabis plant, and have been using it for thousands of years.  Still, Dr. Hill, an oncologist, states he will not prescribe cannabis to his patients, even though he knows through experience that it does help cancer patients, citing possible Federal retribution, and reflecting the fear factor that the Federal Government can retaliate. 
Although reformers are frustrated at physician's fear and refusal to prescribe, the doctors have good reason to be afraid:  This is not the first time that the government has tricked them when it comes to cannabis.  In 1937, the Marihuana Tax Act allowed physicians to prescribe cannabis to their patients, provided they submitted the proper tax fees and paperwork.  In practice, the requirements were extremely precise and difficult, and even the smallest error would result in large fees, loss of license, and even incarceration.  The American Medical Association recommended then that physicians do not prescribe Cannabis, and claiming loudly there after that cannabis was considered to have "no medicinal benefit."  They have been perpetuating this lie for nearly 75 years. 

To read the article in full go here:

"...the rport of my death was an exaggeration."   --  Mark Twain

Monday, May 16, 2011

NORML: The Five Worst States to Get Busted With Pot

One more reason to, RIGHT NOW, send a letter to your state representative regarding Texas HB 548  and HB 1491! 

TEXAS LANDED AS NUMBER TWO on Paul Armentano's latest list of the top five worst states to get busted in.  Oklahoma was number one, probably because of the laws that allow for life sentences for simple possession.  Texas takes the number two spot due to the fact that the state arrests more of it's citizens on drug charges than any other state. 

Add to that the insult that 97% of these arrests are for possession only, and we have some of our best citizens locked up for no good reason...and I know for a fact that the Houston Police have much better things to do than arrest people for a gram of Kind or a dime-bag of having group target practice on the lone "he-was-armed" robber.   

For the full article by Mr. Armentano, Deputy Director of NORML, click here:

And while you're there, check out what's happening in Texas Legislative Session  82

Friday, May 13, 2011


Today, MPP (Marijuana Policy Project) announced that Delaware has become the 16th state, plus the District of Columbia, to pass a medical marijuana bill.

The bill, SB17, passed the Senate with bipartisan support, and was signed into law by the Governor today.  In MPP's notifying email, the following diseases were listed as qualifying for medical marijuana under this bill:

cancer, HIV/AIDS, multiple sclerosis, decompensated cirrhosis, ALS, Alzheimers, PTSD (Post-traumatic stress disorder), intractable nausea, severe seizures, severe and debilitating pain not responsive to other treatment

MEANWHILE IN TEXAS, HB 1491 continues to sit in committee.  Click Here to send your representative a letter!

The Green Association for Sustainability

Saturday, March 26, 2011

Monday, March 7, 2011

P4P: Examining Physicians Pay for Performance paradigms

Pay-for-Performance among Healthcare Professionals: A Mathematical and Comparative Analysis
A statement is proposed in the form of a factual claim:
Pay for performance systems are effective tools for improving quality, morale, and organizational effectiveness.

Quick definitive rhetoric in supportive of or hostile to such a claim is a one way trip towards making waste with a hasty generalization. Dependent factors include the amount of artificial economics being infused into the field. The compensation of employees is often considered only in bottom line terms: Labor is purchased as any other commodity, and wages fluctuate according to Adam Smith-type free market forces, depending upon demand and supply economics. Compensation, to the detriment of many employers, is often considered only as a cost of doing business. For those administrators who have begun to see employee packages as an essential human relations tool, compensation is an important link in the chain of capitalism: Compensation promotes or dissuades production; the level of production promotes or dissuades capital; the amount of capital promotes or dissuades the corporate economy; the corporate economy promotes or dissuades the organizational ability to recompense; worker compensation promotes or dissuades production…and so on.
From a purely logical and mathematical perspective, these dependent factors would create a normal regression analysis equation in the form:

Where βx²+βx represents the dependent variables affecting pay structure as outlined above, and represents the average base pay (Y-intercept). This polynomial is recognized as a parabola, with beta amounts reaching a peak positive or negative Y value. In other words, the value for peak performance is not a straight line in which the greater the pay, the better the performance; yet rather is a parabolic curve for which at some point, increased performance is no longer enhanced by greater pay, but rather decreases in quality. This can be the result of many different variables, including a larger patient base, less time spent per patient, and abuse of tests and procedures for financial gain.
Issues surrounding pay structures of the healthcare profession are inherently complex, and becoming even more so as the healthcare crisis in America continues to deteriorate. According to the former editor of the Journal of the American Medical Association, George Lundberg, M.D., JAMA, the economics of the healthcare industry cannot be equally compared to manufacturing or even other service industries because of the amount of artificial economics infused into the US healthcare system. Although some healthcare industries are more vulnerable than others to artificial economic factors, most healthcare economies have been affected in some way by managed care, government intervention, technological growth, and a fluctuating labor market (Lundberg 2003). Imperative and life-saving services have been eliminated as government funds are relinquished for other political efforts, particularly the military-industrial complex.
While patriots may think of this as part of the sacrifice and duty of wartime, which appears as a perpetual condition of the 20th Century and into the 21st Century, especially in regards to the continuing post 9-11 Middle East conflicts, giving one’s life for their country should not involve a tortuous lack of medical care and slow death by illness for our own citizens. We blow life-sustaining breath and continue compressions on foreign lands as we watch our own people flat-line in the name of Caspian Sea hegemony theories, oil, and the fear of terrorism.

Healthcare systems as an endeavor into capitalism have been walking a fine line since the introduction of medical insurance in the early 20th century. To address the factual claim regarding the viability of pay for performance compensation systems, I turned to the classic sociological and communication literature of two 20th century philosophers and academics, Abraham Maslow and Max Weber. Both are icons in the field of motivation and the human condition. Consonance and dissonance of traditional and personal belief systems are weaved throughout both of their themes: For example, performance expectancies of professional knowledge, abilities and skills will create dissonance in an employee who is first concerned with the needs and safety of family; yet, a performance bonus would be consonant with the employee’s fourth-rung esteem needs. Max Weber’s wrote that the Protestant work ethics and penchant for thriftiness are in consonance with successful capitalism models; yet work for the purpose of earning riches is dissonant to these same Protestant ethics. Weber’s infamous work in the area of bureaucratic management bring consonance to the management theories between the traditional dissonance of public and private organizations. They are, claims Weber, one and the same.

Maslow’s Hierarchy of Needs

Four common reasons bring people to enter the healthcare profession. Among these include the noble motive of a genuine quest to take care of people; and, less commonly, to reap the financial rewards traditionally associated with the industry and expanded by the massive technological advances of the 20th century.

Maslow’s Hierarchy of Needs requires that human survival needs are necessary before any other human need can be fulfilled. The first level of Maslow’s pyramidal hierarchy is that of physiological needs. It is the base of the pyramid, the largest, most important human need and all others are built upon these physiological needs. Following closely are the “Safety Needs”. Both of these base and basic human needs are controlled to some extent by the employer. The employee’s first quest in securing employment will be to seek out an organization that can provide for the physiologic needs, and secondly, that will provide some semblance of security. Too, healthcare professionals realize that there is money to be made in this industry, as the technological advances of the 20th and 21st centuries have improved the odds of making a good living in the healthcare field have increased dimensionally. But Maslow is quick to point out that although money is essential to survival and safety needs, it is not a panacea to a fulfilling and successful career and in consequence, to the issue of motivation of workers through their compensation—more specifically, through their paycheck.

Prior to Maslow’s first publication of his “needs” theory greater than 50 years ago,, motivation theory focused on specific, sustaining basic factors such as biology, achievement, or power to explain what sustains human behavior . Abraham Maslow, a social scientist and academic, synthesized a large body of research regarding human motivation into twp groupings of 8 needs. The groups were titled “growth needs” and “deficiency needs”. Deficiency needs are at the base of the hierarchy, and each need must be met before advancing to the next (Huitt 2003)

The growth needs reveal characteristics such as being problem-focused; incorporating an ongoing freshness of appreciation of life, a concern about personal growth, and the ability to have peak experiences. These characteristics were differentiated into the following four needs to top the pyramidal structure

Over the past 50 years, scientist and academics to continue to cite Maslow’s Hierarchy of Needs as support for a number of social theories; so much so, that the Hierarchy of Needs can be inferred as generally accepted social theory. Maslow clearly shows us that the amount of pay a person receives is only motivating to a certain degree, and the affect that money will have on ones life continues to increase, but more slowly—the amount of change that more money will make in motivating an employee’s life is relevant to the employee’s physiologic needs. The amount of performance that the employer receives (dependent y factor) in return for his investment in larger pay (independent x factor) minimizes as the physiological needs of the employee are met, creating an asymptotic relationship correlating the amount of money an employer pays to the less the measurable increase in job performance.
Max Weber and the economics of capitalism
Max Weber earned his esteemed reputation when he published The Protestant Ethic and the Spirit of Capitalism, a volume that economics specialist David Landes describes as “the most influential and provocative essays ever written” on the social sciences. Weber’s thesis was based on the warrant that Protestantism promoted the rise of modern capitalism, not by encouraging prosperity or invention, but by defining and sanctioning the everyday behaviors ingrained in Protestantism that were conducive to successful business. Weber began by affirming the underlying Protestant doctrine of predestination. Although belief in predestination did not succeed two generations, this dogma was “converted into a secular code of behavior: hard work, honesty, seriousness, the thrifty use of money and time” …both lent us by God (Landes 1998). Weber’s widely read work influenced Protestant America that a true Calvinist Protestant’s aim was not one of riches as divine favor, but of a different kind of businessman: one who aimed to live and work in a certain way; a way that mattered, and riches were merely a by-product of intrinsic value in work. As Maslow identifies the extent attached to the importance of money, Weber’s theories define the other given reason for becoming a healthcare professional: a true calling to take care of others and satisfaction with the intrinsic value of that task.
Max Weber went on to write “Bureaucracy”, an expose of the motivational components of the government administrative human relations system. The compensation system used by the federal government is considered by many to be one of the most desirable compensation packages for American workers available. Many of these ideas are now found in current human relations and motivational literature (Stillman 1998).
“Modern Officialdom”, as Weber named it, consists of enumerated items that describe the employees place in the organizational mission. Weber lists the characteristics of administrative management, and notes that government administration is not so different than private organization administration. Some of the concepts Weber espouses are noted with their relationship to healthcare management.
1. The principle of fixed and official jurisdictional areas generally ordered by rules or laws: federal and state wide statutes on the practice of medicine, and separate required licenses for each state (jurisdiction).
2. The principles of office hierarchy and levels of graded authority: State Licensing and education delineating physicians from nurses, nurses from social workers, social workers from lab technicians…and so on.
3. Office management, official activity, and the following of general office rules or laws; (medical drugs and devices usage laws, certification, state Health department requirements, and accreditation).
4. The employ is a ‘vocation’, and is set for a career; (generally true for professionals that have invested a good deal of education into their healthcare career choice).
5. The ethical duty to avoid abusing the power of that vocation; (the Hippocratic Oath, the American Medical Association ethical guidelines)
6. Regular pecuniary compensation according to status rather than amount of work done. (Physician compensation is greater than in nursing, which is greater than in admissions or clerical work)
Finally, Weber did not exclude the economic aspect, identifying a monied economy as essential to the leveling and democratizing effects that is the reward of his complex ideology of administrative organizational management, as applicable to private corporations as it is to government
What type of system is fair?
Since artificial forces control healthcare economics, compensation plans must be devised based on the organization’s culture, missions and goals. We have established that pay for performance is only effective to the point that the employee has reached the necessary material goals relevant to that employee’s culture and values. After that, intrinsic goals are better at motivating workers than the possibility of a merit raise at the employee’s annual review.
Still, that is not much help to corporate leaders, who must provide an attractive, fair and motivating compensation package for their employees, including the professionals. The US Federal government human resource systems modeled after Weber’s theories on bureaucracy are considered some of the best compensation plans, and comments to friends and family who secure a federal job seems to always includes the phrase “great benefits and security!”
The successful consonance of compensation for motivation in the private sector is so rare, that when a company does achieve a successful mix of pay and benefits, the story makes journal news. Meyners and Co., an 80-person, seven-partner, 45-CPA firm in Albuquerque New Mexico has successfully implemented a pay-for-performance system based on 360-degree feedback and win-win agreements. Using bonus pay for performance rather than a merit raise, Meyners and Co. also consults other firms in human resource issues.
A core competencies evaluation is essential to the plan. Core Competencies are defined as “specific skills and duties employees must be able to perform well to meet the firm’s profitability goals” (Brotherton 2003). The H-R executives at Meyners and Co. evaluate the core competencies as including 1) workplace behavior (core values) 2) business skills (core competencies); and 3) performance measures (meeting goals/win-win). . A 360-degree feedback performance analysis required the comprehensive creation of specific positional core competencies. (Refer to Rojas, K. “A Human Resource Management Plan”, for an example of a 360-degree feedback performance analysis for the RN Clinical Director position in the opiate-agonist addiction treatment field). While all three were included in the 360-degree-feedback, goal accomplishment assessment was the final analysis of a management by objectives plan, in which employees and supervisors established specific performance or educational goals and agreements that contributed to the organization’s mission (Brotherton 2003).
Perhaps the most innovative structure of this plan is in the method of payment for working hard to reach those goals: Rather than adding a percentage to salaries based on a pre-determined merit schedule, pay for good to excellent performance analysis is made through bonuses. Employees received annual salary raises by means of Annual Cost of Living Adjustments (COLAs).
Individualized evaluations are central to the pay for performance plan by Meyners and Co. This element is incongruent with pay for performance purist detractors’ positions, who claim that teams have become such an integral part of organizational structure that individual assessment is futile. Such across-the-board categorizing of industries—service, manufacturing, retail—is short-sighted one-way thinking that has no place in the creativity required to manage and motivate employees, whether the organization employs five or five thousand people.
Pay for performance is just one of the many issues facing healthcare today, but because of the chain relationship illustrated above, is the lynch-pin of the private autonomous healthcare care system that the United States is known for, be that good or bad. Although organizations and think tanks are busy rhetoricizing and analyzing the issue, only a handful of organizations have reached the balance that has proved effective in the Meyers and Co. example. We can infer from a comparative analysis between Max Weber’s governmental agency management theories and general tenets of capitalism that business management is universal regardless of the organization’s bottom-line. Accepting that governmental management of healthcare in the form of socialized medicine may indeed provide healthcare for all and a government compensation system that has proved itself to be effective; but must also ask if the consequences of socialized medicine are not too great a cost for the already frail democratic attempt. The recent healthcare crisis across the country has had serious deleterious effects on the rates of pay and methods of compensation for professionals, paraprofessionals, administrators, and support personnel in charitable hospitals, motivating entire medical units to close their doors to the infirm across the nation (Vaknin 2002). Imperative and life-saving services have been eliminated as government funds are relinquished for other political efforts, particularly the military-industrial complex.
Works Cited
Halsall, Paul (1998). Frederick W. Taylor: The Principles of Scientific Management, 1911. Modern History Sourcebook. Accessed on 10/31/03 at
Hunt, William G. (2003). Maslow’s heirarchy of needs. Education Psychology Interactive. Accessed on 10/31/03 at
Landes, David S. (1998). The Wealth and Poverty of Nations. New York: W.W. Norton. Pp 650.
Lundberg, George D. M.D. (2003) Severed Trust: Why American medicine hasn’t been fixed. New York: Basic Books.
Vaknin, Sam. (2002) The Sickly State of Public Hospitals. Accessed on 10/30/02 at
Weber, Max. (1947). Bureaucracy from Essays in Sociology. Translated by H.H. Gerth and C. Wright Mills in 1946, Oxford University Press. Accessed in Public Administration: Concepts and Cases 6th Edition written and edited by Richard J. Stillman, 1999. Boston: Houghton Mifflin. Pp 54-59
Health Data Management, Apr 2009. CPOEs; Editorial; Professional Journal.