What does harrassment look like?

Harassment-a primer

A picture is worth a thousand words.

What does harassment look like to the un-initiated?

Go to

http://youtube.com/watch?v=gr8MMw0UqAs

This 4 minute video goes into some detail about what harassment looks like and what its potential impacts are.

The Canadian government is in on the act through the Canadian Human Rights Commission.

Didn't know that the right to a safe working environment was a human right in this country?

Think again.

You have the right to work in an abuse free work environment.

If your work environment doesn't meet that standard, guess what.....?!!

Your employer and, perhaps your colleagues, are on the hook for damages.

Go to

http://chrc-ccdp.gc.ca/eng/content/what-discrimination#1

Defend yourself

My advice is that you start keeping a log of what you perceive is happening. It doesn't need to be detailed -minute by minute. But what you ought to do is to note:

• episodes,
• dates and times and
• who is present.

If you are married, or have a partner, tell him or her. A good partner will be your advocate and will notice if:

• you aren't sleeping,
• your appetite is off,
• you are lethargic,
• you are being self isolating
• you are self loathing
• you are distracted and moody.

Are you ill? Not your usually cheery robust self?

Your body never lies. A good indication that things aren't great is if you develop shingles.

Don't hesitate to go to your family physician. Tell him or her what is happening. (S)he may not be Marcus Welby MD but they do keep records, they do take you seriously and, they will send you on for another assessment.

Forget the usual company EAP program. These are short term, often fail to diagnose the problem and usually don't have the competence to know when they are in over their heads.

HR-a waste of time

Companies have the usual anti harassment policy. A part of the policy is that you, the victim , file a complaint usually to HR, who then may-or may not-do an internal investigation. My experience is that HR professionals are a bunch of boobs-certainly in the public service. The investigation never amounts to anything.

If you are unionized, go directly to your shop steward. Unions have a good reputation defending their members.
Not sure about where they stand? In a previous post, I gave a link for CUPE.

Use it. CUPE has a handbook which provides excellent guidance.
cupe.ca/stop-harassment-guide-cupe-locals

A great union!

If you are non unionized, go directly to a lawyer who specializes in this kind of litigation. Do not ..I repeat... do not go to you sister's friend's husband who happens to be a lawyer.

The Lawyer-choose wisely

One size does not fit all.

And, some lawyers are a lot better than others.

If the guy does not take you seriously in the 1st 15 minutes, leave.

Shop.

Ask for references before you go in.

If you do see a lawyer, bring:

• your log,
• your physician's telephone number,
• a copy of your HR file 
• you portfolio
• your log

Why your HR file??

Your file should contain your performance appraisals, an organization chart (where do you report in the structure), your work plan (if you have one) and your job description. Is there any work of which you are proud , for which you have earned praise in the organization and which was filed on your file?

 Bring a sample, if you can.

Why your portfolio?

What is this??

Another name for it is a brag book. It is popular nowadays with people out job searching. It gives a prospective employer an idea of what you can do.  There are lots and lots of examples of how to organize this, on the 'net. Typically it includes:

• your org chart
• your job description
• work samples not just from your current job but also from other jobs.
• letters of commendation

My advice is to make it colourful.

The visit-not an in and out experience

Don't expect Perry Mason or some slick bastard out of  The Wire or even Saul Goodman. Expect a guy who may want to represent you but who might not immediately see that you are in the pain you are.

So, what questions should you answer even if (s)he doesn't ask them?

Work assignment

1) has work been assigned unfairly? Just saying that you don't think its fair won't cut it.  

Demonstrate it.

Is your workload larger than others? And, is the workload being increased? How? What?

2) have you done good work that isn't ever acknowledged? What? How do you know it was any good? Did an outsider commend it formally?

Disrespect

3) are you subjected to ridicule privately or publicly?

Take a look at the Human Rts video above.

have you been disciplined publicly? When? Who was present?

4) has your work been discussed in meetings without you present? Have your colleagues been invited to comment on your work outside of your presence? Can you get quotes?

5) have you been isolated? Not invited to program functions, social functions, educational opportunities?

Appraisal

6) are your colleagues invited to evaluate your performance anonymously during the annual performance appraisal process?

7) does the performance appraisal lack substance? Your supervisor can't point to any facts which suggest that you have under-performed. In fact, you may find that the appraisal has nothing to do with your annual work plan.

8) does your supervisor not give credit where credit is due? As above, be prepared to support yourself.

Threats

9) does your supervisor refuse to meet with you to go over work or to address any questions you may have about the work?

10) have you been threatened?  This can be subtle. And, you may be so surprised, that it won't immediately register. Has your supervisor warned you that the last person who was assigned this project lost his/her job for poor performance?

11) have your colleagues berated you at a meeting and as a group?

12) has a colleague called you at home out of work hours to berate you?

13) has a colleague berated you in front of your supervisor and while the supervisor said nothing?

Fair Pay

14) has merit pay been with held without explanation?

A final word of advice if you go the lawyer route.

Bring your partner.

Nothing is more powerful than a concerned and angry partner!!!!

The next blog will deal with preventive measures. That is, how do you avoid such employers in the first place?

Have heart!

Its remarkably easy.

See you in a few days.

Now you are a bully

So-Now you are a bully

Happy?

Great!!

How much are you costing your employer? As I noted in an earlier blog, it is estimated that 20% of sick time is as a consequence of bad management and that 20% is a consequence of mental illness.

Cross reference Bill Wilkerson and the Global Business and Economic Roundtable on Addictions  and  Mental Health, for more information about this.
mentalhealthroundtable.ca/links.html

Or perhaps this is simply chalked up as the cost of doing business?
Wilkerson thinks not. In fact, the Roundtable has proposed a Charter of Mental Health Rights for employees.
mentalhealthroundtable.ca/feb_2004/Charter_February_2004.pdf

Take, as an example, the public health care sector in one of Canada's provinces-being New Brunswick.

Average sick time ranges from 10-12 days/employee/year. (Add to that 11 stat holidays per year and about 4 weeks holiday per year and you find that the average employee gets paid not to be working about 2-2.5 months per year. But that is another story)

Back to bullying and sick time.

There are about 13,000 employees. The math is simple. That means that there are between 130,000 and 150000 sick days taken per year. Using the albeit low income of $20/hr and a 7.5 hour work day, NB's taxpayers are coughing up between $19.5m and $23.4m/year to pay people for being ill.

20% of that is as a consequence of bad (aka bullying) management.

That means that NB's taxpayers (who pay amongst the highest personal taxes in Canada) are paying between $3.9m-$4.68m/year for managers to bully staff and, not be held accountable.
To read more about the impact of management behaviour on sick time, try reading Rhoades and Eisenberger (2002) or Tepper (2000) on this topic.

Oh, by the way, the number of  days lost which might otherwise be used to work are between 26,000 and 31200 days.
To get even more information on this topic, go back to Wilkerson's site and search the report :
Mental Health in the Labour Force
Literature review and Gap Analysis
By Watson Wyatt Canada ULC @
mentalhealthroundtable.ca/jul_07/WW%20GAP%20Report%20-May30_2007.pdf

If your aim is to be a corporate bully

So, you actually want to be a bully!

There are people-and I use the term advisedly- who actually go into management to bully.

These are typically the individuals who are incapable of functioning elsewhere in society or in the workplace. They are intimidated by talent, are devoid of integrity and are generally unskilled in the ways of delivering the service they manage.

They are promoted because they curry favour with their employers.

A true classic of how to advance without integrity or talent is demonstrated in the 5th season of the Wire.

Watch it.

A newspaper reporter, clueless about how to identify and build a story, is assigned a key piece based on his ability to parrot the publisher's desire to write a "Dickension article" about the homeless.

I won't spoil the season by describing exactly how he does this. But it is worth a watch and tells you everything you need to know about careerism, lying, theft of another's work and generally how to succeed without integrity.

I have learned from, and have been bullied by, the absolute best at this.

So, if you aspire to make your career as a bully,  want to know how to bully and not get caught, sued, or murdered in the workplace, here is how.

Prerequisites of a bully

• be incompetent or just barely competent to get a job done
• move from position to position within an organization just before you are discovered as incompetent
• it helps a lot to be devoid of any integrity
• lie about your work
• steal another's good work and put your name on it
• don't give credit where credit is due (especially critical if you work on a team)
• take courses as offered but absolutely don't implement what you learned
• try nothing new, take no risks and blame others if something goes wrong.
• be a careerist
• maintain optimal visibility with your superior. But always credit the superior with a good idea . Repeat their ideas as though they are brilliant. They likely aren't and everyone knows it. But, hey. You aren't try to impress any one but your boss.

Where might bullies flourish?

Like all vermin, pests, rodents and bottom dwellers, bullies flourish best in large organizations where performance is not closely monitored. This allows you, the aspiring bully, to grow as a fat as a tick by sucking the blood out of co-workers and staff without getting caught as the thief you are.

So, where is best?  

• An organization where sick time is high-10-12 days per employee is a good environment for bullies.
• It helps if the organization emphasizes compliance training over professional development
• A large bureaucracy where attention to policies takes priority over performance
• A bureaucracy which doesn't publish its policies. Keeping policies secret-especially HR policies- means that you can plausibly deny that you did anything wrong-if by chance you are caught. It very much works to your advantage if the organization is in the midst of digitizing its policies. That way, no one has access to any guidelines-usually ever.
• An organization where senior management positions are constantly changing is good. This allows you to continue your work as a bully unimpaired by nasty and unwanted responsible oversight.
• High turnover is important amongst staff as well. That way, you won't get targeted like, say, Bill O'Reiley or Roger Ailes.
• If there is a Board of Directors, it helps if the board is kept in the dark about Quality Improvement and Risk Management strategies. That way they can't ask embarrassing questions about performance, satisfaction and productivity. There is therefore much less chance that you, the bully, will get outed.
• It is very  helpful to you, as the aspiring bully, if senior managers (and no one else for that matter) can define "Quality" or "Risk" (Quality, by the way is defined as the ability to meet a customer's expectation first time every time at the lowest possible cost). That way, you can never be evaluated based on how your teams are performing-because no one knows how they should perform.

My next blog will give you "a how to" of bullying, and some markers to evaluate your successful impact on the team, the program, and the organization. 

Bullying in the workplace-ever happened to you??

Bullying and Harassment in the Workplace:

      What's it like working in a provincial civil service?

We should first define our terms.

Bullying is a pernicious form of harassment and can be:

• covert
• overt
• belittling
• defaming
• and is a direct assault on a person's dignity and psychological well-being.

Typically, Canadian unions have a good information for their members. The one union I prefer is CUPE (Just a personal preference). Go to their site to get their handbook at:

http://cupe.ca/stop-harassment-guide-cupe-locals

In any case, how do you know if you are being bullied?

Well, here are some markers.

• malicious rumours, gossip or innuendo is spread about you
• your supervisor persistently criticizes yo, demeans you or ridicules you (either privately-tough to prove, therefore; or publicly-not so tough unless your co-workers are afraid of her/him)
• is your work continually undermined or deliberately impeded?
• are you excluded or isolated (as in from meetings, office social events, educational opportunities)?
• are you subjected to threats or verbal abuse?
• have these threats turned physical?
• have you been called derogatory names?
• are you being incessantly teased or are you the butt of jokes?
• are you subjected to hazing?
• do co-workers-or does your supervisor-make threatening or aggressive gestures?
• are you subjected to public ridicule or discipline
• have your applications for vacation, leaves, educational opportunities, training been unduly refused?

At first, you can't believe that this is happening to you. Then, you descend into a sort of fog and then you get sick and your sick time starts to increase .

You are not alone.

Some indicators that there are problems in the workplace include:

• high staff turnover
• poor productivity
• high sick time

20% of sick time is as a consequence of bad management and

20% of sick time is due to mental illness caused by

bad management.

What are some specifics?

More on this in a few days

Soccer-the art of the possible in a horrible world

Soccer-the art of the possible in a horrible world

Soccer, more than anything else (and especially politics) represents the art of the possible in a world that is changing for the worse. It is the vehicle for individual and community self discovery, an expression of the uniqueness of both and, an adventure for the tireless soul. Soccer is more than just a game-it is a way of living with others.

1. Soccer unites people of different sects, opinions and, countries into a common interest using a common language.

2. As a sport, soccer requires-and teaches- diligence, discipline, focus and, courage through fair play and team building. Ajax FC, through its youth program academies in 32 underdeveloped countries is but one example of how a soccer club can be a force for building social capital, especially where so much has been left undeveloped. A measure of this academy's success is the number of youth who move onto being leaders in their respective communities and responsible citizens in their respective countries.

3. Those who best master these characteristics in turn, become role models for others to follow. Consider the example of Rooney, the elite and all-England striker, who has been praised for his contribution to charities, his role as a father and husband, and as a community leader.

4. Identity politics-especially that used by Donald Trump in his run for the Presidency, is a force for division by race, ethnicity, gender and , religion. Soccer has used identity politics, too-but in a constructive manner.

Barcelona FC has branded itself as more than just a club. It uses its excellence on the field to make people aware of issues confronting children, and advertising the work of UNICEF, branding that name on its jerseys for the world to see.

Glasgow Celtic  celticfc.net has been  force for the economic and social rejuvenation of central Glasgow.

Hearts Thistle sportanddev.org have focused its attention on improving the health status of men (in its fan base). The middle aged and those approaching senior status tend to over weight, diabetes and heart disease. Hearts has established "boot camps" reaching out to this population using diet and exercise as the means to improve the quality of life. By extension, if this program is successful, this area will see a gradual decline in cancer, heart disease and diabetes-reducing health care costs and likely improving work efficiency.

Wanderers FC is noteworthy for its ability to engage an other wise disengaged community-disengaged from voting , from social life. When the club fell into economic crisis, lost its primary financial backer, community members stepped forward and took over the management of the club. It is now a community club with a community board of directors, elected annually, accountable to those who have taken out a membership in the Club.

Each club, has in its own unique way, energized their respective communities.

5. Health care is an expensive proposition and a drain on government budgets-at the very least. It is often unnecessary where good prevention programmes are used. Hearts Thistle FC has partnered with the local health authority as noted above to reduce heart disease, cancer and diabetes amongst its core fan base.

The role of sport in fostering healthy lifestyles is well researched. What is not so well researched is the importance of sport in general and soccer in particular in community rejuvenation after disaster. NGO's like Right to Play righttoplay.com and Coaches across Continents coachesacrosscontinents.org are examples of how sport might be used to foster resilience within communities in conflict zones or struck by natural disaster.

Nigeria's "Search and Groom" and Ghana's SOS Children's Villages programs build local social capital. 

Leipzig FC and FC Bayern Munchen fcbayern.com/en/news/# has recognized the challenge posed to Germany of the flood of refugees from the middle east coming into the country. To help integrate these refugees into the fabric of that society, this club has introduced soccer programs and academies which unite locals and new arrivals. Through this same principle, to build a sense of well being amongst people who are displaced-and aren't likely going anywhere soon, Zaater (refugee) Camp in Jordan is using soccer as a means to redirect the energy of youth into a positive endeavour. Time will tell what other resilience programs will be added to this camp to help youth cope with displacement.

6. Personal disaster can be mitigated through soccer, integrated the aggrieved and marginalized into society, giving them a sense of purpose and a feeling of hope. Such is the Homeless Soccer Movement homelessworldcup.org and streetsoccerworld streetsoccerworld.org. Soccer's universal appeal, emphasis on fair play, focus on wellness and, team building has enhanced the sport's ability to make societies aware of a range of social issues from : child exploitation, to income inequality, to gender bias, to income inequality and social exclusion.

Want to learn more??
try a MOOC
more particularly take the 4 week course
Football: More than just a game
through
Futurelearn

The beginnning

Introduction

This blog will focus on a variety of topics this year including:

• designing a gender equity board game;
• the long con we call health care;
• soccer as an expression of social activism and community capacity building;
• standards for gender equity in corporate leadership and how government works against women;
• how our tax dollars promote mental illness in the workplace;
• suicide, men and why jobs are important.

New Brunswick

Where is all this coming from?

For those of you who don't know the province, it is probably the most beautiful in Canada. It is closer to New England that to Toronto and the people have more in common with that regional group than they do with Canadians. And yet, despite being a 1 hour flight from NYC, it remains impoverished. 68% of youth under the age of 25 see no future in its largest city, Saint John. And yet, the province itself is: bilingual, is on the coast with remarkable vistas of the Atlantic, has 5 universities, and, in one of its cities (Fredericton) has more millionaires per capita than any other place in Canada.



Health Care in Canada-The Long Con

US politicians have been apoplectic in their denunciation of Canada's health care system despite the fact that 25 million Americans have no health care coverage. Even so, they are correct to be critical of the Canadian system but they do so the wrong reasons.  In fact, our own system is really a long con.

• The Canadian family of 4 pays $11300 in public health care insurance.
• The cost of our health care system has increased 54% over the last 10 years.
• That is:
• 1.5 x the cost of shelter,
• 1.5  x the cost of clothing,
• 2x the cost of food and
• 1.5x the growth of the average income.

See next week's blog for a fuller discussion

Gender Equity, Corporate Boards and Government Standards

Do Canada's provinces and territories apply the same standards of gender equity to the recruitment of people to their own boards, agencies and commissions that they expect from public corporations?

Effective Dec 31/14 securities regulators in 7 provinces and 2 territories adopted the comply or explain amendments to existing corporate disclosure rules in NI 58-101.

In April 2015, the Federal government announced that it would propose amendments to the CBCA. These amendments would require companies incorporated under the CBCA to disclose their policies regarding gender diversity in executive positions and on the board of directors.

In September 2015, securities regulators in 7 provinces and 3 territories published results on an audit of compliance through Multilateral Staff Notice 58-307. The results were poor.

So, what? Why care?

Because companies with women on boards have:

• 53% higher return on equity
• 42% higher return on sales
• 66% higher return on capital.

So, if it clearly makes good business sense, why regulate?

Because sexism and misogyny still exists.

• recruiters and nominating committees still, for the most part, believe that women do not have enough relevant experience
• boards, in the main, still believe that family responsibilities would hinder women in the fulfillment of the governance duties
• social systems are still gendered
• there persists in society sex role stereo-typing.

See future blogs for more information

Soccer and social engagement?

Getting through the Trump national socialist hangover, are you?
No?

Does "politics" look like a tyranny of the winner?
Maybe?

Try something different.

Try soccer-the art of the possible.

Soccer is the vehicle  for individual and community self discovery; an expression of the uniqueness of both and is an adventure.

• Soccer unites people of different sects, opinions and countries into a common interest
• Soccer teaches diligence, discipline, focus, courage through fair play and team building
• Players who best model these virtues become models for others
• Soccer uses identity politics to brand universality and social responsibility
• Soccer fosters healthy lifestyles and builds networks. It serves to address the social ills of isolation, nativism, elitism. A "Club" becomes the focal point to build community awareness.

Can soccer be a catalyst for change?

To read more look for Jim Murphy's book:

         10 Football Matches that changed the world

or

read Jorge Knijnik

         Play for Freedom

Our Hospitals and the Long Con

Introduction

This week's blog covers the art of the con as it applies to our health care system. We have a good system-if much more expensive than any one else's -except the USA.
But they elected Trump and their system is about to get a hell of a lot more expensive and much less accessible. Take a quick look at whose stock prices improved since 11/9-big pharma!

New Brunswick

For those of you who don't know the province, it is probably the most beautiful in Canada. It is closer to New England than to Toronto and the people have more in common with that regional group being New England than they do with Canadians. Despite being a 1 hour flight from NYC and Boston,it has one of the highest rates of poverty in the country. 68% of youth under the age of 25 see no future in its largest city, Saint John. And yet, the province itself is: bilingual, is on the coast with remarkable vistas of the Atlantic, has pristine forests, clean water , 5 universities, and, one of its cities (Fredericton) has more millionaires per capita than any other place in Canada.
NB is , by the way, great for hospital access with 27 hospitals for a population of 750,000 people and a first rate primary care system.

Health Care in Canada-The Long Con

US politicians have been apoplectic in their denunciation of Canada's health care system despite the fact that 25 million Americans have no health care coverage. Even so, they are correct to be critical of the Canadian system but they do so the wrong reasons.  In fact, our own system is really a long con.

• The Canadian family of 4 pays $11300 in public health care insurance.
• The cost of our health care system has increased 54% over the last 10 years.
• That is:
• 1.5 x the cost of shelter,
• 1.5  x the cost of clothing,
• 2x the cost of food and
• 1.5x the growth of the average income.

Our system underperforms most other western nations with longer wait times and poorer health outcomes. We have more hospital beds than do most other western countries despite the fact that there is no evidence that hospitals necessarily improve a community's health status.

• In fact, Canada spends 36% more per capita than the OECD average.

The Myths

1) We have an health care system.

Uh-Nope

Ours is not a system per se.
It is funded by several different branches of the Ministries of Health . Typically, these branches do not communicate. It is rare that employees of each of these branches know each other, much less communicate. Nor do the agencies programs or providers, for that matter.

2) We deliver health care

nope again

Further, there is no "health" in the system.
Mostly, it pays to treat illness.
It is emphatically not funded to help you, the taxpayer, stay well.
Family physicians, technically the gate keepers of the system are paid only to give you a check up-which you, the taxpayer, are obliged to organize or initiate. The is no government financed eye care, dental care, physiotherapy, OT, meds, home care or long term care. This all privately financed. Where it is not, well, it eats into your assets. In many cases, so that your ill health does not bankrupt your partner, you would do well to get a divorce to save your family assets.

3) Medicare is universal

Sorry but nope again

The Canadian medicare system was designed to pay for the treatment of catastrophic illness so that citizens were not otherwise  bankrupted by the cost of care, which was typically hospital based. Out of hospital physician services are also paid for by the state. Just make sure that you don't need rehab, meds out of hospital and things like that.

4)We need all these hospitals to treat our illnesses

Well, actually, no.

The 5 major illnesses in order of cost to society are:

• mental illness
• addictions
• cancer
• heart disease
• diabetes

Typically, the consequences of these illnesses must be treated by the health care system. However, these can mostly be prevented-or their onset mitigated by effective public health policy.
How you might ask

• Sell cigarettes out of liquor stores heavily regulating access by teens,
• lengthen the school day, thereby reducing the incidence of teen pregnancy
• ban the sale of trans-fats,
• introduce mandatory phys ed and extracurricular activities in schools.
• train managers to manage
• Introduce mental health professionals to a family physician's practice.

These are but a few ideas.

5) Our health care professionals deliver value for money.

Sorry, wrong again. See above

Our health care "system' spends 36% more per capita than the average in the OECD. Our wait times are the longest and our health treatment outcomes are amongst the poorest in the Western world.

So-what is a long con??

And why does it apply to our health care system?
And, who is being conned?

A long con refers to a con which requires:

• planning
• preparation
• a long window of intervention
• with a con artist's target and
• a long time execute

Characteristics

Typically, a long con requires a large crew to relieve the mark of his or her cash

The long con requires time to slowly draw the mark into the con but often results in large pay-outs

It is elaborate

The long con, like most cons, plays on some basic human frailties

• greed
• desperation

The Players

So, who gets to play in a long con?

The Mark: otherwise known as the intended victim....us

The Grifter: a practitioner of confidence tricks...so who?? Well the people who always benefit from siding with spending in health care are the politicians

The Shill: shills are put in place to encourage the mark to act in a desired way. The shill is an accomplice of the grifter but who has no apparent connection to the con. The most likely candidate is the board chairman and the board members, most of whom join a board to advance their own careers or advance their own standing within a community. So, it is in their best interest to expand the services their hospital offers, irrespective of whether or not it makes any sense. Typically, shills have a close connection to us.

The Roper: a member of the crew who identifies the mark and lures the mark in. (S)he
finds a way to get close to the mark, insinuating him/herself into the mark's life. The candidate for this is the doctor who makes the con look enticing by offering the mark what (s)he seems to want. Examples of this include: drugs/meds, rehab, lab tests, diagnostic imaging exams, an operation, and even an hospital stay.

In any case, his/her job is to keep the mark interested in health care services while at the same time seeming to treat the illness. 

The Roper is often an older man with a distinguished ( a doctor) or wise appearance or is an enticing woman (a nurse, rehab worker)

The inside man: executes the con. So, specialists.

The Fixer: works near -but not close to-the inside man as a backup and coordinates the resources as the con unfolds. So, this is typically the hospital administrator (and assistant administrators). Today, they enjoy the title of El Presidente or Supremo. It used to be that they were older men of sketchy qualifications. But, they had managed to outlast everyone else in the line of authority. Typically well paid, beyond their worth, today, they might be lawyers, failed doctors or other equally oily individuals who post their multiple degrees on the wall-one of which might be a MBA from a degree mill. Their job is to confuse and obfuscate matters that go to the board of directors for decision. They do tend to look good behind a desk, which pleases the mark and gives the mark and the family the impression that the place is well managed.

The Face: a shill, generally an attractive female used to distract or encourage the mark. Typically a nurse, rehab professional etc.

The Outside Man: A Ministry of Health bureaucrat or some such hack who greases the wheel of hospital health care with money from time to time. These are usually public servants. Their skill is to send out memos which provide the Grifter with a firewall called plausible deniability when things don't do well. They are very good at bending the truth or being loose with the truth. The best hacks are under-educated and have no morals but have worked in the public service for a very long time.

Settings: The long con is executed in 1 or 2 settings. A real world setting would be an hospital. For a long con to work, it requires a team of grfters which play a variety of roles.

Tomorrow, we will put names to these characters and describe in more detail what each gets out of the con.

So, in whose interest does our current system exist???

1) Politicians-otherwise known as the Grifters

Their confidence trick is to convince people that our system is the best! And, they are expected to convince their constituents that they deserve more funding-thereby improving their health status, care for their cancers, diabetes, heart disease, their car accidents.

In this way they can shelve any discussion of what really keeps us safe and secure and, by extension improves our health status. These include:

• an effective, accessible and accountable educational system
• decent, secure employment
• food security
• clean water and air
• recreational opportunities
• engaged communities
• public transportation

Lets call him Charles Ponzi

2) Doctors-the Roper

Doctors typically want to have a hospital in which to place difficult patients. To be fair, they are not given many options. As an example 30% of a family physicians time is spent treating marks with mental illness. This garners 5% of their income. And, they have no support from surrounding programs. Treatment of the elderly, particularly in the last few years of life fall into this category. Lots of time for no remuneration.
Hospital is mostly not just the last the resort. It is the only resort. Then, of course they deal with marks who are their own worse enemies. These include:The obese, the unfit, smokers, etc.

Lab tests, diagnostic imaging tests, a trip to the specialist to deal with diabetes, heart disease, respiratory illnesses and a trip to the hospital to try to undo-or mitigate the impact of these self inflicted wounds. These tests and treatments usually satisfy the mark's morbid sense of dread and makes them feel like the victim.  

But, they make decent money. So, lets call them:

Victor Lustig

3) The Medical Specialists-The Inside Men

They oversee the delivery of those services which the mark needs to satisfy his or her sense of dread and victimisation. These services are offered without any consultation with the Family Physician, thereby ensuring that all tests are repeated once the mark is returned to the care of that roper. This ensures that no one knows what is going on with the mark and helps to fuel costs, fees nd increases the chance of re-admitting the person to hospital. This continues to fuel the mark's sense of dread and makes him or her feel a lot better about continuing ill health. It helps that the mark's family is on the outside, wringing their hands and bemoaning the mark's ill health. They help drive the demand for more staff and better services.

This cycle also helps the grifter sell the idea that additional and more sophisticated health services are needed in the community. If successful in his advocacy for more useless services, the grifter is assured of re-election.

Call the inside man Frank Abignail

4) The Hospital Staff-The Face

The hospital staff are the shills who distract or encourage the Mark (you). The nice nurse, physio etc who do the bidding of the specialists. It helps that they admire the specialist as a demi god, incapable of  erring.

Call the hospital staff Big Bertha Heigman

5) The Hospital Administrator-the Fixer

The Fixer coordinates the resources as the long con unfolds

call him Soapy Smith

6) The Civil Servant-The Outside Man

Typically, this is the health care bureaucrat who sheds crocodile tears at the amount of money which is spent on the hospital health care system. He writes memos discrediting the work of the administrators and professional staff. This provides plausible deniability to the senior politicians when they pretend to implement austerity measures. It is good that the outside man is under-educated and amoral.

7)The Board (Chairman)-The Shill
As noted, this is typically a self interested person who has pretensions about being a community leader. Having a phony interest in the mark and the welfare of the community, the Shill is always ready to cut  deal with the  Roper and the Grifter even if it means throwing the Fixer under the bus.