New Health Care Trends

Change Management & The Us Health Care Debate: A Case Study

The United States has gone through a wrenching debate over the reform of health care.  The new bill cut to the essence of the United States as a republic and the sole of its citizens.  This has been high stakes change management.  What can the business world learn from this as a case study?

I have been in the change management business for more than 30 years.  I have worked with large and small companies all over the world to help them transform their organizations.  During my work I have settled on some fairly basic, but clear principles of change management.  For example, you’d better choose the right thing to work on and match that with the right leadership style.  Without such basics resistance will win.

Knowing this I thought it would be interesting to review the health care debate that has consumed the United States over the past year.  How closely did it follow good principles of change management?  How did resistance influence it?  How did leaders make their marks?

The following article is meant to be apolitical.  My interest is in management, not politics.

There is an alternative to Private Insurance

The first step in implementing change is for the leader to articulate a vision – what will the new world look like?  President Obama’s vision a year ago had tenets such as “single payer and public option”.  This is not idealism; it is real life practice that is the norm in most western democracies.  It is an alternative; but what is it and why was it attractive?  The Canadian system is worth some exploration.

I am Canadian.  Yes, I was naturalized as an American citizen in 2000; however, my experiences growing up are rooted in Canada – not the least of which is my experience with health care.

I came to the US in 1995.  One of my first meetings with my new employer was an all employee event about the changes that were being made to our companies health plan.  We were about to be HMO’d.  We were entering “managed health care” to control costs.  I was totally befuddled by the rhetoric around co-pays and doctor’s networks – not to mention the forms that I had to fill out.

I asked the meeting facilitator a question that prompted her to ask: “well in Canada what do you do?”  My naive answer was that “in Canada when you get sick you go to the doctor.”

That’s still the case.  Everyone in Canada is covered through universal health care.  Yes, it’s paid through taxes – but you have to pay somehow.  In the US we pay through insurance premiums that rise faster than the Canadian health taxes.  And even with this higher cost Americans get poorer outcomes at the system level.

That’s right; Canada wins the value for money equation at the system level.  By now we all know the big picture metrics.  There is lots of room for debate, but the strategic picture comparing the United States to Canada looks something like this:

.  Spending as a % of GDP         15%      10%

.  Spending per capita              $6700      $3700

.  Life expectancy – age               78.5      80.5

.  Very satisfied                            25%      57%

.  Very dissatisfied                        44%      17%

Why is there such a gap?  Well, Canada saves resources through all steps in the health care value chain.  Here are two primary places:

Administration: Canada has a single payer system.  That means that when you go to the doctor the bill goes directly to the government – usually one of the 10 provincial governments.  As a result you don’t need complex and layered administrative structures to check insurance plans, do billings, and run down receivables.

I think this is the biggest source of saving.  This administrative activity in the US constitutes about 1/3rd of the cost of health care.  In Canada it’s a little more than 1/10th.  In other words, the single payer approach would save the US about 20+ percentage points on cost.  That adds up when you’re talking about trillions of dollars.

A consequence of this public system is that doctors may file tax returns as “independent businesses”; however, the reality is that they work for the government.  Most of their income comes from the government as set through fee schedules that are determined in collaboration with medical advisors.  It is too complex to compare doctor salaries in the two countries, but American doctors expect to earn more than their Canadian colleagues.

Treatment: In Canada there are fewer medical resources than in the US – people, equipment, supplies, facilities.  This means priorities are required in the allocation of these scarce resources.  In the US, where there has always been a luxury of supply, this idea of “allocation” is interpreted as “rationing”.

I’ve heard lots of urban legends about Canadians not getting the treatment they need or coming to the US to buy it.  I’m sure that some of these stories can be documented, but they don’t fit the experiences of my family and friends.

Sure I had a friend that was jumped twice on the priority list as he waited for a heart bypass – he’d been on the list for months and was even in the hall outside the OR when he was wheeled back to his room.  Someone one the verge of death took his spot.  He had the operation the next day and after 20 years he’s still doing just fine.

On the other hand, my mother was in severe need of a hip replacement.  Within three weeks she had gone through all of the consultations and she had her operation.  She probably hopped over several people in the line.

These allocation (rationing) decisions are made between doctors and patients in consideration of available resources and the needs of other patients.  Sure, the government keeps a handle on this through its fiscal management; however, it does not make medical decisions.

America was looking for a new model for health care.  Canada provides an alternative, but Americans didn’t choose it.  They came up with a framework that is uniquely American; a solution that does not look like the starting vision that included single payer and a public option.  Erosion of the vision is a common result in the change business.  What happened?

I tracked the ups and downs of the debate by watching advocates from the right like Glen Beck and Bill O’Reily and their progressive counterparts like Keith Obermann and Rachel Maddow.  What a circus.  If you did a content “compare and contrast” analysis of their television programs over the last year you would think that the left and right were on different planets.  Rarely did they deal with the same issues, and when they did their perspectives were 180 degrees apart.

The great thing about “talking head cable TV” is that it let us see change management at work.  As a case study it validated some of my major ideas, such as:

.  Change depends on organizational DNA

.  Change is either continuous or discontinuous change

.  Change requires a complementary leadership style

Change Depends on Organizational DNA

Most changes fail.  We’ve been schooled to believe that failure is a function of not having a compelling business reason to change.  The idea is that if you’re on a burning platform, you will jump.  You will change because the status quo is not an option.

Well, I can buy into this to a point, but not all of the way.  We all know that the trend line on health care spending cannot be sustained.  Forecasts show that by 2020 nearly 20% of GDP will go to the health sector.  That’s one dollar in five.  Illogical projections even show that by 2080 we’ll spend 95% of GDP on health.  If we don’t bend the cost curve we could become a nation of people solely consumed by providing health services to each other.

If all you need is a compelling reason to change then the US Congress would have quickly passed a bill with the cost savings implied by single payer and public option provisions.  However, radical cost containment did not carry the day – even though there is a national consensus that costs must be controlled.

Well there’s something else going on here – and it’s something that most change leaders wish to ignore.  Change is doomed to fail if you’re working on the wrong thing.  Change will fail if you’re swimming against the organization’s DNA, its history, legacy, myths and legends of the past.  Often change leaders ignore this because it’s messy business to change the past before moving forward.  Leaders just want to get to their vision.  The President’s starting point of a “single payer system/public option” is a classic example of swimming against organizational DNA.

This whole health care debate cut to the core of what Americans believe their country to be.  The United States is not Canada.  Just listen to the Declaration of Independence that calls for “…life, liberty, and the pursuit of happiness.”  The first Canadian constitution (the British North America Act) called for “…peace, order, and good government”.  The difference is not accidental.  It goes to the heart of how people see themselves and their relationship to government.

The British Parliamentary system is rooted in the Magna Carta that started the process of the citizenry wresting power away from the entitled Sovereign.  Ultimately the people gained representative government to guide the sovereign nation; however, the idea of sovereignty – the transcendent, ongoing existence of nationhood remained with the Sovereign.  Governments come and go, but the nation remains – and the symbol of that continuation is the Sovereign – the Queen in England and her representative in Canada, the Governor General.

The Sovereign symbol is not a person in the United States.  The innovation and miracle of the American government system is that it found sovereignty without needing a Sovereign.  How?  It put sovereignty in “the People.”  The relationship of the “citizen subject” with their government was literally turned on its head.

The DNA of the United States is fiercely individualistic.  What’s good for the individual precedes that of the collective body.  This is followed by the natural selection of capitalism as the underlying economic system.  Individualism and capitalism become allies in the creation of wealth.  The accepted role of government becomes one of facilitating these two powerful ideas.  But what happens when these two ideas don’t resolve issues of social injustice such as: slavery, lack of civil rights, and barriers to health care?  When the government intervenes it does so at its own peril.

The Democrat’s health care reform ran right up against the genetics of the American republic.  The American DNA says that private health insurance has a right to make profits; and that individuals without health care have all the opportunity needed to pull themselves up and earn the money required to provide for themselves and their families.  It’s a classic bipolarity of privilege versus entitlement.  The lines were drawn before the debate began.

Choose Between Continuous or Discontinuous Change

The Executive branch had a vision for health care reform that was outside of the box.  It could see a future state that was not a straight-line projection from the current state.  It saw a world where health insurance companies had to make room for an active government.

Although the Executive was swimming up stream (working on the wrong things according to DNA analysis) it didn’t have to lose its vision of a new tomorrow.  But, it needed to implement the change unilaterally – something that is as unnatural for President’s as it is for most CEO’s.

Change comes in two forms: Continuous and Discontinuous.  Continuous change is the idea of incrementalism.  It’s the idea of clearly knowing who you are and then pushing the edges of the envelope to be better.  The vast majority of change in government, business, and personal life is continuous.  You set a goal and define a migration path to implement it.

Discontinuous change is different.  It’s a break with the past.  Something is happening in the external world that cannot be combated by current state experiences and competencies.  A rupture is required to get to the new place.

Usually when organizations die it’s because they did not adequately manage discontinuous change.  Polaroid couldn’t handle the opportunity presented by digital photography.  The legacy ATT&T now exists in name only.  We all have to do taxes but nothing links the tools that we use to do them: pencil, adding machine, calculator, computer, and Turbo Tax.  If you were making pencils 60 years ago you had to make a discontinuous change to get into the business of making adding machines.  This had to be done with callous action and foresight to separate from the past.  One foot in front of the other would not get the job done.

Why does it have to be callous; some might say tyrannical?  It’s because everything goes against the secure worlds that people have built for themselves.  There is not a step-by-step guide to get to the promised-land.  The current world must either be broken or left behind.  This takes a conviction that is counter to our culture of consensus building and participation.

The President’s vision of health care was discontinuous, yet he treated it as continuous change.  The Democrat’s interpretation of the external environment was that a single payer, public option plan was needed to provide universal health care that would bend the spending curve.  This could not be accomplished through bipartisan consensus building.

Change Requires a Complementary Leadership Style

To re-cap, a single payer – public option health system goes against America’s history.  Incremental implementation of this idea was doomed to fail.  Success could only have come from strong, directive leadership.

Democrats had to believe in their health care vision and their electoral mandate to make changes.  From the beginning they had to use their majorities to pass a bill that reflected their vision – even though the vision may have been imperfect.  Then they had to go about the messy job of breaking the old if they wanted to implement the new.  This would have caused no end of “ramming it down our throats” controversy; but it would have produced a platform for fundamental change rather than incremental.

This didn’t happen.  The ideals and expectations for consensus building and bipartisanship opened the doors to incrementalism and its subtle goal – the provision of time and space to release the forces of resistance.   These same forces are always at play during organizational change where we hear: the change is too big; we’re doing this at the wrong time; why don’t we just start over.

Even the tactics are the same in the corporate world: misinformation leading to disinformation; throwing everything possible at the wall to see what sticks; communicating not for clarity, but to cause doubt.

These resistance strategies and tactics peaked at the Health Care Summit where the President believed he could straighten the record; others saw that he wasn’t listening.  This rancor continued as the debate got back to Congress where the leadership used parliamentary rules to move the legislation forward – the opposition saw this as tyrannical, devious, and malicious.

In the end the bill that was passed into law satisfied no one.  It’s seen as the best that the parliamentary system could produce.  Not one Republican voted for it; and both the left and right on the Democratic side held the passage hostage as long as they could.

I’ve seen this movie dozens of times in the corporate world.  A new CEO rides into town with a change mandate from the Board.  Resistance is cloaked in the language of continuous, incremental change; the leadership style that starts as consensus building morphs into autocracy.

Lessons Learned

Most changes fail – even when the sponsors don’t admit it.  This result comes from not understanding the nature of change and the leadership style required to implement change.

The US health care debate highlighted principles that CEO’s should take to heart.

.  Know your organization’s DNA.  Resistance is directly related to how hard you swim against the organization’s heritage.

.  Know the type of change you seek – continuous means incremental, discontinuous means breaking with the past.

.  Know your leadership style.  Don’t attempt discontinuous change if you are a consensus builder.

In our culture it is unnatural for leaders to adopt a harsh style.  Everyone wants to be loved.  That implies that most changes will be incremental.  CEO’s should know this before they set their visions for change and underlying migration paths.

About the Author

Bud Taylor is an accomplished author, speaker, and consultant on organization transformation. Please check out Bud’s new business book at: http://www.CustomerDrivenChange.com Bud is an independent consultant and has alliances with MASMI Research of London; the International Speakers Bureau of Dallas; and Strategos Consulting of Chicago. Bud formerly worked as: Senior Vice President & Global Director of Consulting Services at Synovate Loyalty; Partner at Deloitte in charge of Change Management; and Organization Effectiveness leader for Watson Wyatt. He has served marquee clients such as: Microsoft Europe; Toyota South Africa; Canadian Pacific; Whirlpool, Sony Electronics, Cardinal Health, Black Ginger China,and the Oversea Chinese Banking Corporation. Read Bud’s blog at: http://www.CustomerDrivenChange.blogspot.com Contact Bud at: BudTaylor.consultant@verizon.net

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Shari Bayles: Laugh and Learn About Newborn Baby Care - $19.99 Shari Bayles: Laugh and Learn About Newborn Baby Care features the childcare expert helping soothe the anxieties of new parents by calmly answering some of the frequently asked questions from new mothers and fathers. ~ Perry Seibert, Rovi

The New Seditionaries $12.99 Track Listing: 1. Go Insane, 2. New Seditionaries, 3. P.G.L., 4. I’m a Mess, 5. Don’t Care About Me, 6. Lip Music, 7. See You Go, 8. Fools, 9. Worst, The, 10. (Cat’s Clause), 11. Beware, 12. Two in the Heart, 13. Walking into the Fire

The New World $14.99 Track Listing: 1. Hammer, The, 2. Only, 3. Bad Girl Blues, 4. California 85, 5. Larosse, 6. New One, The, 7. Twistin’, 8. Hanging on Hopeless, 9. She Don’t Care, 10. Echo

Daddy Day Care – Widescreen Fullscreen Dubbed $8.99 Two fathers get a crash course in caring for kids other than their own in this family-friendly comedy. Charlie Hinton (Eddie Murphy) is an advertising executive whose job monopolizes his time, making it difficult for him to stay in touch with his young son, Ben (Khamani Griffin). However, after Charlie and his partner, Phil (Jeff Garlin), are given their pink slips in the wake of a disastrous campaign for a new breakfast cereal, Charlie’s wife, Kim (Regina King), goes back to work, and with the family budget tighter than before, Charlie becomes a stay-at-home dad. After pulling Ben out of an expensive and exclusive daycare center run by the humorless Gwyneth Harridan (Anjelica Huston), Charlie comes up with a brainstorm — since he and Phil watch their own children every day, how much harder could it be to watch a few more kids and open their own day care center? Charlie and Phil discover there’s much more to running a daycare center than they ever imagined, but after a very rough start, with the help of likable slacker Marvin (Steve Zahn) their new business becomes a success — so much so that Harridan finds herself losing customers to the upstart fathers, and she starts searching for a way to shut them down. ~ Mark Deming, Rovi

Music For Health & Healing $13.99 Music For Health & Healing

Sickness & Health [LP] $19.98 Sickness & Health [LP]

Best of Mental Health $14.99 Best of Mental Health

Griffin Technology Screen Care Kit for 6th-Generation Apple iPod nano $9.99 Keep your 6th-generation Apple iPod nano looking like new with this screen care kit that features a cleaning cloth for removing smudges and 5 matte-finish, static-peel screen protectors to keep grit and dust away from your device’s screen.

Griffin Technology Screen Care Kit for Archos 7 Internet Media Tablets $14.99 Keep your Archos 7 Internet media tablet’s display looking like new with this screen care kit that features 5 matte-finish, static-peel screen protectors for guarding against bumps and scratches. The cleaning cloth easily removes smudges and fingerprints.

Griffin Technology Screen Care Kit for 4th-Generation Apple iPod touch $14.99 Keep your 4th-generation iPod touch’s display looking like new with this screen care kit that features a cleaning cloth for wiping away fingerprints and dust. The matte-finish, static-peel screen protectors guard against bumps and scratches.

Take Care of My Cat – Widescreen Subtitle Dolby $24.99 Five girlfriends graduate high school in the Korean port city of Inchon. They set out to pursue their limited opportunities, vowing to continue their friendship into adult life. Hae-joo (Lee Yo-Won) is pretty and ambitious. She gets a job working for a brokerage house and soon moves away to Seoul. Tae-hee (Bae Doo-na) works part-time for her domineering father, and does volunteer work, helping out a romantic young poet with cerebral palsy. Ji-young (Ok Ji-young) lives with her grandparents in a ramshackle hut by the docks. She can’t find a job, so she struggles to support herself. The half-Chinese twins, Bi-ryu (Lee Eun-sil) and Ohn-jo (Lee Eun-ju), continue their relatively carefree existence. Ji-young finds a stray kitten, and gives it to Hae-joo as a birthday gift. Hae-joo soon returns it, however, finding pet ownership too much trouble. Ji-young and Hae-joo grow further apart as they discover their values in conflict. Tae-hee tries to keep the group together, organizing sporadic reunions while dealing with her own problems at home. When she goes alone to visit the sullen Ji-young at home, the two realize that their connection has remained strong, and when tragedy strikes Ji-young’s family, Hae-joo is there to support her. Take Care of My Cat is the debut feature of writer/director Jeong Jae-eun. She had previously directed several award-winning shorts. The film was processed using the same bleach bypass method used in David Fincher’s Seven, which accounts for its unique saturated color palette. The film was accepted into the Rotterdam Film Festival, and New Directors/New Films in New York. ~ Josh Ralske, Rovi

Yoga Journal: Yoga for Total Back Care by Annie Carpenter - $14.99 Yoga instructor and health expert Annie Carpenter leads this program, designed to help relax and strengthen the back, easing pain and tension through the fluid movements of vinyasa style yoga. The program offers two extended segments, one focused on the lower back, and one focused on the upper back and shoulders. ~ Cammila Albertson, Rovi

Breast Health: Audible… [Digipak] $9.99 Track Listing: 1. Breast Health 1, 2. Breast Health 2, 3. Breast Health 3, 4. Breast Health 4, 5. Breast Health 5, 6. Breast Health 6, 7. Breast Health 7, 8. Breast Health 8, 9. Breast Health 9

New Balance Via Step Pedometer $21.99 Track your health with this pedometer that measures time and number of steps taken to give you a comprehensive view of your workout.

Breast Health: Subliminal… [Digipak] $9.99 Track Listing: 1. Breast Health-SE 1, 2. Breast Health-SE 2, 3. Breast Health-SE 3, 4. Breast Health-SE 4, 5. Breast Health-SE 5, 6. Breast Health-SE 6, 7. Breast Health-SE 7, 8. Breast Health-SE 8, 9. Breast Health-SE 9, 10. Breast Health-SE 10, 11. Breast Health-SE 11, 12. Breast Health-SE 12

Care Bears: Adventure In Care A Lot – Fullscreen Special $8.99 Care Bears: Adventure In Care A Lot – Fullscreen Special

Trends and Other Diseases [Bonus Track] $14.99 Track Listing: 1. I See You, 2. Trottsov, 3. Guardian Witch, 4. Stupid Bagatelle, 5. Russin L?sk, 6. Read My Thoughts, Pt. 1, 7. Read My Thoughts, Pt. 2, 8. Fire and Audio, 9. Please Tell Me, 10. Trash Romantic Land, 11. Sockeplast, 12. What’s That Guy’s Name?, 13. Fialka’s House, 14. Advokaten, 15. Krupa Question, The, 16. Agent Soda, 17. Mamma, 18. Vault Soup Medley, Vol. 1

The Care Bears: Big Wish Movie – Fullscreen Dolby $8.99 A lonely bear finds that making new friends takes more than a simple wish in this computer animated adventure for the whole family. Everyone knows that when you wish upon a star your wildest dreams can come true, but when that star is your best friend Twinkles one wish is only the first step in an unforgettable journey of friendship and caring. While a wish for some new friends may ease Wish Bear’s boredom for the time being, the melancholy cub soon learns that in order for friendships to grow, you have to nurture them and build trust as well – and that takes more than just a simple wish. ~ Jason Buchanan, Rovi

PBS Explorer Collection: Health & Fitness, Vol. 1 [3 Discs] - $34.99 Includes:Peggy Cappy: Yoga for the Rest of Us: Back Care Basics (2007) Peggy Cappy: Yoga for the Rest of Us – Heart Healthy Yoga (2008) Peggy Cappy: Yoga for the Rest of Us – Easy Yoga for Arthritis (2010) Peggy Cappy: Yoga for the Rest of Us: Back Care Basics Fitness expert Peggy Cappy leads this specialized yoga program, designed to offer the benefits of increased flexibility, strength and stamina, while decreasing back pain and improving posture, through the use of modified poses perfect for viewers with injuries, back problems, or decreased mobility. ~ Cammila Albertson, Rovi Peggy Cappy: Yoga for the Rest of Us – Heart Healthy Yoga Peggy Cappy guides viewers through a simple, effective yoga routine designed to promote heart health. There are no headstands, backbends, or other twisty advanced moves to be found in Yoga For the Rest of Us, just gentle stretches that even beginners can do on the first try. ~ Carly Wray, Rovi Peggy Cappy: Yoga for the Rest of Us – Easy Yoga for Arthritis Fitness expert and yoga instructor Peggy Cappy leads this beginner-level yoga program, designed to walk viewers through a routine that can help alleviate the pain and stiffness brought on by injury, arthritis, or other chronic conditions. The workout includes warm ups and cool downs, as well as seated, standing, and reclining poses, as well as a meditation segment. ~ Cammila Albertson, Rovi

City That Care Forgot (Japan) $39.99 City That Care Forgot (Japan)

Classic Care 1 $5.99 Classic Care 1

Classic Care 2 $5.99 Classic Care 2

Wired: Guitar Care and Repair - $9.99 Wired: Guitar Care and Repair -

Care-Sharming Sleep $15.99 Care-Sharming Sleep

Hang Up Sorrow & Care $13.99 Hang Up Sorrow & Care

Care Bears: Daydreams - $4.99 Care Bears: Daydreams -

Care Bears: Last Laugh - $4.99 Care Bears: Last Laugh -

Care Bears: Fun In The Sun - $4.99 Care Bears: Fun In The Sun -

Care Bears: Celebration - $4.99 Care Bears: Celebration -

Care Bears: Festival of Fun - $6.99 Includes:Care Bears: Songfellow Strum and His Magic Train (1985) Care Bears: Care-a-Lot Games (1985) Care Bears: Care Bear Carneys (1985) Care Bears: Under the Bigtop (1985) Care Bears: Music Video (1987) Care Bears: Care Bears Town Parade (1988) Care Bears: Songfellow Strum and His Magic Train No synopsis available. Care Bears: Care-a-Lot Games No synopsis available. Care Bears: Care Bear Carneys No synopsis available. Care Bears: Under the Bigtop No synopsis available. Care Bears: Music Video No synopsis available. Care Bears: Care Bears Town Parade No synopsis available.

In Good Health $15.99 Track Listing: 1. It Will Be Alright, 2. You Are Everything I Need, 3. Thank You for One More Day, 4. I’ll Be Free, 5. It Will Be So Wonderful, 6. Good Health, 7. Let Us Praise Him, 8. Testify, 9. I’ll Live Again, 10. Jesus Is the Light of the World

Technicolor Health $9.99 Track Listing: 1. Nothing But Change, Pt. 2, 2. Strictly Game, 3. TFO, 4. Niagara Falls, 5. Sunlight, 6. Unhurried Hearts (Passaic Pastoral), 7. Winter Water, 8. Natural Man, 9. Radio Orlando, 10. Technicolor Health

Prostate Care™ (42 medium tablets) $20.49 Complete nutritional formula for prostate health. Pro Health's Prostate Care is a comprehensive formula designed to provide vital nutritional support for optimal prostate health. Prostate Care includes potent saw palmetto, pygeum extract and pumpkin seed extract, plus eleven other prostate supporting ingredients to provide the most well rounded prostate health formula on the market.

Neurological Health Formula by Holistic Health (180 tablets) $29.9 Complete Multi-vitamin Formula. A complete multi-vitamin formula with 38 vitamins, minerals and nutrients.

The New Gladiators – B&W Subtitle $8.99 In this futuristic Italian crime drama, 21st-century Romans devise an ingenious way to take care of criminals — they make them fight each other gladiator-style on national television. ~ Sandra Brennan, Rovi

Health & Strength $14.99 In the veritable faceless crowd of DJs that flooded the reggae scene in the 1970s and 1980s, most of the best and most distinctive ones spawned a host of imitators. Only Prince Far I, with his gravelly, stentorian voice and strict spiritual focus, remained truly unique — in part because few could have imitated him if they’d wanted to, and even fewer would have dared try. Health and Strength was one of the albums he cut for Virgin’s Front Line imprint in the late ’70s; unlike the others, this one was shelved and eventually lost until a cassette copy surfaced in 1997. The cassette had been made from the original master tapes and was of surprisingly high quality; when On-U Sound’s Adrian Sherwood got his hands on it, he cleaned it up a little and released it on his own Pressure Sounds reissue imprint. The results are truly spectacular. Featuring several rare examples of Prince Far I’s singing as well as the chanting (or “toasting”) for which he was famous, Health and Strength stands with his best work. Highlights include the apocalyptic “Frontline Speech,” the admirably practical “Health Warning” (chanted over the rhythm to Gregory Isaacs’ “Sacrifice”), and “Clean Hands Pure Heart.” Essential. ~ Rick Anderson

The Relative Health of Your Horse Outside $15.99 Full title: The Relative Health of Your Horse Outside.

Metal Health $6.99 Track Listing: 1. Metal Health – (featuring Chuck Wright), 2. Cum On Feel The Noize, 3. Don’t Wanna Let You Go – (featuring Chuck Wright), 4. Slick Black Cadillac, 5. Love’s A Bitch, 6. Breathless, 7. Run For Cover, 8. Battle Axe, 9. Let’s Get Crazy, 10. Thunderbird – (featuring Chuck Wright), 11. Danger Zone – (previously unreleased), 12. Slick Black Cadillac – (live)

Brave New Films Boxset [Collector's Edition] [4 Discs] – Box $34.99 Includes:Wal-Mart: The High Cost of Low Price (2005), MPAA Rating: NR Iraq for Sale: The War Profiteers (2006) The Big Buy: Tom DeLay’s Stolen Congress (2006) Wal-Mart: The High Cost of Low Price Wal-Mart has become one of America’s most successful retail chains by offering everyday goods at low prices for working families. But just how is Wal-Mart able to charge less than many of their rivals, and what has their success done for their employees? Documentary filmmaker Robert Greenwald takes a look inside the discount retailer’s empire in Wal-Mart: The High Cost of Low Price, and discovers a company short on scruples and long on shabby treatment of the people who work for them. Through interviews with labor experts and former Wal-Mart employees, Greenwald documents the firm’s anti-union tactics, their history of paying wages often below the poverty line, the high price they charge for health benefits (employees are often encouraged to apply for government subsidized health care programs instead), their methods for driving away locally owned businesses, their practice of hiring illegal aliens for cleanup crews at a fraction of minimum wage, the abysmal working conditions and pay in the Third World plants where much of Wal-Mart’s goods are manufactured, and more. Wal-Mart: The High Cost of Low Price is one in a series of muckraking documentaries from director Greenwald which includes the films Outfoxed: Rupert Murdoch’s War on Journalism, Uncovered: The War in Iraq, and Unconstitutional: The War on Our Civil Liberties. ~ Mark Deming, Rovi Iraq for Sale: The War Profiteers Join documentary filmmaker Robert Greenwald (Wal-Mart: The High Cost of Low Price, Outfoxed) in assessing the damage done to average Americans when corporations decide to wage war. For critics of the current administration, the connection between the war in Iraq and the private corporations who profit from the fighting is plain to see. For those who may not be so easily convinced, however, Greenwald and company not only explore the questionable motivations of the corporate decision-makers whose wartime profiteering has affected the lives of countless soldiers and their families, but also the increasingly negative international reputation of the United States as a result. ~ Jason Buchanan, Rovi The Big Buy: Tom DeLay’s Stolen Congress In 1984, Tom DeLay was first elected to Congress as a Republican representative from Sugar Land, TX. DeLay wasted little time making his presence known in the House of Representatives, and earned the nickname “the Hammer” for his forceful style of insuring his GOP colleagues voted as party leaders wanted, and for his habit of making life difficult for those who opposed him. DeLay became the House Majority Leader in 2002, and made no secret of his opposition to many major government programs (he said it was his goal to eliminate the Department of Education, the Environmental Protection Agency, and the Department of Energy, among other things) and his su

I’m New Here $15.98 Track Listing: 1. On Coming from a Broken Home (Pt. 1), 2. Me and the Devil, 3. I’m New Here, 4. Your Soul and Mine, 5. Parents (Interlude), 6. I’ll Take Care of You, 7. Being Blessed (Interlude), 8. Where Did the Night Go, 9. I Was Guided (Interlude), 10. New York Is Killing Me, 11. Certain Things (Interlude), 12. Running, 13. Crutch, The, 14. I’ve Been Me (Interlude), 15. On Coming from a Broken Home (Pt. 1)

We Share Our Mother’S Health $7.99 Track Listing: 1. We Share Our Mother’s Health, 2. We Share Our Mother’s Health, 3. We Share Our Mother’s Health, 4. We Share Our Mother’s Health, 5. We Share Our Mother’s Health

Equine Joint Health Granules (60 Doese) 720.00 $29 Equine Joint Health for unbeatable prices at TotalPetSupply.com Today’s trusted online pet store that dispenses the best quality pet medications.

Equine Joint Health Soft Chews 120.00 $34 Equine Joint Health for unbeatable prices at TotalPetSupply.com Today’s trusted online pet store that dispenses the best quality pet medications.

Money, and the Law of Attraction: Learning to Attract Wealth, Health, and Happiness - $14.99 Discover the key to achieving unlimited wealth and prosperity as New York Times best-selling authors Esther and Jerry Hicks reveal how Abraham, an aspect of non-physical source energy, can help you accomplish anything in life that your heart desires. ~ Jason Buchanan, Rovi

Soul Queen of New Orleans $9.99 Track Listing: 1. Breakaway, 2. Ruler of My Heart, 3. Hittin’ on Nothin’, 4. Hip Shakin’ Mama, 5. For the Good Times, 6. Don’t Blame Him, 7. Friendly, 8. It’s Raining, 9. Wish Someone Would Care

Care Bears: Share A Lot In Care A Lot – Fullscreen Dolby $12.99 Care Bears: Share A Lot In Care A Lot – Fullscreen Dolby

Care Bears: Bear Buddies (Care Bear Toy Figurine) - $12.99 Care Bears: Bear Buddies (Care Bear Toy Figurine) -

Care Bears: Care A Lot Adventures – Fullscreen Dubbed Subtitle $8.99 Care Bears: Care A Lot Adventures – Fullscreen Dubbed Subtitle

Care Bears: Care-A-Lot Collection (2 Disc) – Fullscreen $14.99 Care Bears: Care-A-Lot Collection (2 Disc) – Fullscreen

Classic Care: Day-Dreams With Music $5.99 Classic Care: Day-Dreams With Music

Taking Care Of Business 1956-73 (Box) $214.99 Taking Care Of Business 1956-73 (Box)

Care Bears: Cheer There & Everywhere – Fullscreen $8.99 Care Bears: Cheer There & Everywhere – Fullscreen

Care Bears: Helping Hearts – Fullscreen $12.99 Care Bears: Helping Hearts – Fullscreen

Care Bears: Flower Power – Fullscreen $8.99 Care Bears: Flower Power – Fullscreen

Care Bears: Cheer There & (Easter Faceplate) - $8.99 Care Bears: Cheer There & (Easter Faceplate) -

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