April 1, 2026 Forum

Jack

It’s hit healthcare and fallen off of it like a fly hitting a fan. The juggernaut of healthcare industrial complex has blocked progress in this regard. I’m going to go off on a rant here, guys. It took 53 minutes before I went on a rant, Jeremy. But the healthcare industrial complex where 20 cents on every single dollar is given to people through their dividends for people who have no relationship to the delivery of healthcare, 20 to 30 cents on every single dollar spent in America on healthcare is given to people who have no part of healthcare at all. And until that changes, social entrepreneurship is going to struggle with getting a foothold.

Mark

I’ve got a lot of things to say about this. Thanks, Jack. I don’t know if you know David Olds personally, but you know, you were in the Denver area for a while. But this was a pediatrician who 50 years ago looked at outcomes for first time moms. Over 80 percent were unmarried. Their average age was 20. And then he established a pilot program in Elmira, New York. He also reached out to Denver and Memphis and got a program started. You talk about assets.

The big thing initially that jumped out was that first time moms were followed closely and right through delivery. They were then followed during the first two years of the baby’s development. They found that the big thing that was sold to the people who funded the program from the federal, state, and county level was the marked decrease (over 50 percent) in emergency room visits. But the other assets, if you will, were seventy nine percent decrease in mothers who continued to smoke, which led to an 18 percent reduction in preterm birth, 35 percent in pregnancy induced hypertension and other side benefits, including 25 percent decrease in child abuse and neglect. There was a 48 percent decease in child abuse and neglect among low socioeconomic status mothers and the learning of English was promoted. And largely my wife works in this area to the present day. She largely works in the Hispanic community. Emphasis is placed on the importance of learning English while preserving your culture, and on increasing employment. There were a whole lot of other side assets, if you will. But the bottom line is among all the health care cuts, this program has been largely spared. This is because they could show that for every dollar put into the program, there was a return of five dollars and 80 cents. So, it was one of the few programs that could show on the bottom line that it was actually helpful.

But I wanted to throw in one little final thing. Even if you develop a successful program on many levels for the patient and even the bottom dollar is there’s the question of burnout. My wife told me just today that her program is the only one in the San Francisco area among a dozen counties where the original members are still involved. My wife was one of four that started the program locally 15 plus years ago. Not a single one of the other original nurses are in all the other Bay Area counties are still working there because of burnout. So I asked my wife: what do you think the difference is? It turns out she had a manager who was also a leader. Jeremy, Mitch and I are reading a book about strong ground and leadership. This particular manager was also a leader and by leader I mean she was able to adapt and had a vision. She could prevent burnout by just a little use of leadership skills that enabled her to pivot through different crises. And so if we find a successful program, we need to retain these people as well. And strong leadership is important as well.