Tom Keane

Playing chicken

Rejecting Chick-fil-A is a good power play for mayor

Boston Mayor Tom Menino wants to keep fast-food chain Chick-fil-A out of Boston because the company opposes same-sex marriage. Legally, Menino may in the wrong. Yet he is also completely in the right. The dustup has been portrayed as a First Amendment issue. In truth, it’s more about smart politics, mayoral power and — like it or not — Menino’s ability to make the city in his own vision.

Chick-fil-A founder Truett Cathy is reputed to have invented the chicken sandwich; his first Atlanta store in 1967 has grown to a multi-billion-dollar empire with over 1,600 outlets. Finding a Chick-fil-A in New England is tough, however. There are just three, and the chain is now looking to expand north.

From a gastronomical standpoint, Chick-fil-A is no big deal. (My bucket list includes sampling all major fast-food chains. McDonald’s Chicken sandwich is much better.) But what does make Chick-fil-A unique is the Bible Belt religiosity that suffuses all it does. The family-owned company says its “corporate purpose” is “to glorify God by being a faithful steward of all that is entrusted to us.” Each of its stores is shut on Sundays. And the company spends much time advancing its spiritual philosophy. Some of those causes, such as promoting foster care, are widely praised. Others, including preserving “the biblical definition of the family unit,” have raised hackles, including Menino’s.

On July 20, the mayor sent a blunt letter to Chick-fil-A decrying its anti-gay stance and telling it to “back out of your plans to locate in Boston.” Both the left and the right have assailed him for this, seeing it as an attack on free speech. Where does this end, they ask? Will the city now stop someone from opening a store because he’s, say, a Yankees fan?

Except, of course, that Menino isn’t suggesting that such foolish reasons should factor in deciding the businesses Boston welcomes. He’s talking about something much more serious, a basic civil right (one, admittedly, not all agree with). Put in a different context, if Chick-fil-A supported a return to the days of Jim Crow, my guess is a lot of folks now lambasting Menino would react differently.

Then too, while the First Amendment prohibits government from censoring speech, it doesn’t make one immune from the consequences of those remarks. Leominster, for instance, just fired a cop who targeted Red Sox outfielder Carl Crawford with a racial epithet. The slur was protected by the First Amendment, but racists shouldn’t be on the police force, either. The same with Chick-fil-A. It can say what it wants. But those words do have meaning, and they cause many to worry how they translate into action. Will Chick-fil-A treat married gay employees the same as married straight employees? The way the company deeply intertwines business and religion raises a reasonable doubt.

But all of these are legal niceties, irrelevant from the viewpoint of a politician like Menino. His attack on Chick-fil-A is, instead, an illustration of the effective use of power, something the mayor learned long ago. As acting mayor in 1993, he imposed a freeze on water and sewer rates. His opponents mocked him, noting mayors don’t control an independent agency. The laugh was on them — not only were residents grateful that someone was at least trying to do something, but he also got his way. The bully pulpit has power; the hikes were deferred.

So too, last year Menino was ridiculed for his efforts to get Niketown to remove profane T-shirts from its windows. Would the city have won if it went to court? Probably not. But they were removed anyway.

And to what end is this power used? A hallmark of Menino’s tenure has been his effort to remake Boston’s image from a backward place of small-minded bigotry into a modern city that is inclusive, diverse, and civil. If that means lashing out at companies such as Chick-fil-A, so be it. Were Chick-fil-A to sue (unlikely, since the mayor has clarified he wouldn’t hold up permits over the issue), odds are Menino would lose in a court of law. But in the court of public opinion — 19 years and counting — he’s winning.

This column originally appeared on the Boston Sunday Globe's op-ed page on July 29, 2012.

The quiet hospital

Patient satisfaction is directly linked to a good night’s sleep

My father is of that certain age and condition where he is now a regular guest of hospitals and, much like the man who eats not just at McDonald’s but samples the wares of Burger King and Wendy’s too, his frequent trips to some of Boston’s finest have made him a discerning consumer. And so recently while at Beth Israel Deaconess Medical Center he was struck, just like Sherlock Holmes in “Silver Blaze” (“the curious incident of the dog in the night-time” — the animal didn’t bark), by something that didn’t occur.

During the night, no one woke him up.

If you have had the pleasure of a stay in the hospital, you know exactly what I mean. Patients rarely get any sleep. Every hour or so the overhead fluorescents flash on as a nurse makes his or her rounds. Pagers sound, machines beep, alarms blare, and cart wheels squeak. Room doors are open and the sound of staff chatter filters in. One eventually leaves the hospital exhausted.

Indeed, one’s malady aside, the experience of being a patient can be miserable. It isn’t only the sleep deprivation. The food can make grade-school cafeteria lunches seem gourmet. New teams of physicians pop by routinely asking the same questions over and over (a problem especially in teaching hospitals). The revolving cast of healers makes it hard to figure out who is in charge and at times impossible to understand what is going to happen next and why. Roommates can be unpleasant; Kardashian-like family dramas are played out bedside. And far too many of the hospital staff treat patients as commodities; subjects to be poked and probed, not individuals with families, jobs, and dignity. My father recounts a recent incident (not at Beth Israel) where his roommate was screaming in pain as the staff — ignoring his protestations — tried to adjust him in his bed. “Stop!” he bellowed. “I am somebody!

None of this is to discount the clinical excellence of Boston-area hospitals. They rank tops in the world; US News & World Report, in fact, just named Massachusetts General Hospital the best in the nation. But those ratings don’t look at patient satisfaction, a concept that seems almost alien to the culture of health care.

That may be changing, as evidenced by my father’s experience at Beth Israel. Just over two years ago the hospital hired Anissa Bernardo, its first-ever patient satisfaction coordinator. My father’s uninterrupted sleep is a direct outgrowth of her work, a program billed “Quiet at Night.” First piloted in one unit, Bernardo worked with the floor staff to institute numerous changes, some large, some small. Instead of turning on room lights to check on patients, for instance, staff members now walk around with small flashlights. During newly-designated quiet hours — 9 p.m. until 6 a.m. — pagers are set to vibrate, and staff members are urged to keep their voices down. Cart wheels are oiled to stop squeaking; keypads are beep-free. Room doors are shut (unless otherwise medically required). And to top it off, each patient gets earplugs.

The pilot project went well. Bernardo says survey results of patient satisfaction improved markedly, and the program last year was rolled out across the hospital. She concedes it’s been difficult at times. Staff members understand the whys, but making nights quiet often requires changing decades-old patterns of doing things.

The push for this comes, interestingly enough, from the much-maligned Affordable Care Act, or Obamacare: Beginning in October, the law ties a portion of hospitals’ reimbursements to patient satisfaction. So too, there is increasing evidence that one’s state of mind affects morbidity and mortality. Help patients feel better about themselves and outcomes also improve. As Beth Israel itself says, “Silent Hospitals Help Healing.” As a result, Beth Israel is not alone in its newfound interest in customer service.

Still, it’s remarkable it’s taken so long to figure out something almost every other business knows implicitly: Customer satisfaction matters. I point out to Bernardo that a reputation for great customer service could give Beth Israel a marketing edge in the intensely competitive Boston market. They’re not there yet, she says, but perhaps soon. One hopes. Patients want good results, but they wanted to be treated decently too.

This column originally appeared on the Boston Sunday Globe's op-ed page on July 22, 2012.

In the dumps with the American Dream

We used to be ambitious and enthusiastic; now the new normal is malaise. Shouldn’t we strive for more?

In 1979, then-President Jimmy Carter told the nation he had detected a malaise in America, “a crisis of confidence ... that strikes at the very heart and soul and spirit of our national will.” That malaise arguably lost him reelection, with candidate Ronald Reagan forcefully rejecting the notion that America’s best days were behind it. Reagan’s optimism bested Carter’s pessimism.

Might the same storyline play out again this year?

It’s not President Barack Obama claiming malaise. Politicians have learned well the lesson from Carter’s loss: Voters will blame leaders, not themselves, for such talk. Nevertheless, as suggested by a fascinating recent poll from Anderson Robbins Research, the Great Recession of 2008 has exacted a terrible cost on the country, one measured by Americans’ feelings of confidence and hope. Anderson Robbins calls it the “New Normal”: a dramatic resetting of our sense of what, exactly, is the American Dream.

The national survey, conducted this spring and commissioned by local communications firm Solomon & McCown, asked what respondents thought were the most important elements of the American Dream. Where once economic success and upward mobility would have ranked high, they ranked last in the poll. Respondents said they increasingly valued things such as good marriages (83 percent) and “a long and healthy retirement” (77 percent).

In other words, we just want to be happy.

And what’s wrong with that, you may ask? Nothing, really. It feels very European, a kind of inward-turning mindset where people get out of the rat race and focus on being content. But, to be blunt, America historically never was about being happy. For us, it’s been “the pursuit of happiness,” a phrase that is all about striving, not attaining. The American Dream required ambition and taking risks; it was about fame, fortune, and making things better for the next generation. No more, it seems. We’re all a bit frightened and ready to hunker down.

One can easily understand why. The 2008 recession was unlike any since the Great Depression. Vast amounts of wealth were lost, including homes and retirement accounts. And despite Herculean federal spending — and predictions of a much quicker turnaround — the recession’s effects have lingered. Unemployment and underemployment remain high; many people have simply given up, dropping out of the workforce altogether. Fifty-five percent of Americans feel personally scarred by the recession: 41 percent in Anderson Robbins’s survey say they “still have a ways to go,” while 14 percent say they may never recover. Indeed, the pollsters found that in general Americans now feel more “thrifty,” “determined,” and “worried.” Perhaps not surprisingly, we also feel a lot less “hopeful,” “charitable,” and “lucky.” Most profoundly, fully 59 percent believe that the next generation of Americans will have even fewer opportunities for achieving the American Dream.

The New Normal sounds like malaise to me.

One sees, perhaps, an opportunity for Mitt Romney. Pulling a page from the 1980 election, Romney might well seize upon Americans’ new-found gloom and blame it on the incumbent. “Are you better off now than you were four years ago?” was Reagan’s famous question, and one suspects that the answer to that question today would also be negative. If Romney could convey an attitude as buoyantly upbeat as Reagan’s, he might well capture the votes of those distressed at this new version of the American Dream.

On the other hand, where in 1980 the impression of America’s place in the world was defined by the ignominy of the Iranian hostage crisis, Obama can point to dramatic successes such as the killing of Osama bin Laden. Moreover, much of the power of the American Dream resonates not for those who already have done well, but for those at society’s margins. That includes immigrants, gays, minorities, and even women — and Obama seems rhetorically far more in their corner than does Romney (and especially the version of Romney one saw during the primaries).

Of course, all of this assumes that Americans really don’t want the “New Normal.” I hope they don’t. Europe is a pleasant but dull place. I’d rather the excitement, spirit and — yes — frustration of the old American Dream than a timid world where we’re all just grateful to get by.

This column originally appeared on the Boston Sunday Globe's op-ed page on July 15, 2012.

Citizens United critics take a dim view of the electorate

November’s Presidential election is not only a test between two candidates but also a test of democracy. How much, really, does the Supreme Court’s ruling in Citizens United v. Federal Election Commission undermine the electoral process?

Citizens United is the controversial 2010 decision that, by a 5-4 margin,struck down a number of federal campaign finance restrictions. The court concluded that not only did citizens individually have a right of free speech, but so did associations of citizens — meaning unions, non-profits, and, the ultimate bogeyman, corporations. And since they had those rights, significant limitations on speech — including restrictions on spending — were not allowed.

That verdict provoked a furious reaction, including a State of the Union drama between President Obama and Justice Samuel Alito (with Obama decrying the ruling from the podium while Alito mouthed, “Not true”). Former MSNBC anchor Keith Olbermann said at the time that the decision would “have more dire implications than Dred Scott,” the court’s infamous pronouncement that African-Americans were not citizens. Fred Wertheimer, the long-time president of Common Cause, predicted “unprecedented opportunities for corporate ‘influence-buying’ corruption.” Opposition wasn’t only from the left. Senator John McCain (“I’m ashamed of the United States Supreme Court”) and Maine Republican Senator Olympia Snowe (a “serious disservice to our country”) have been adamant in their disagreement.

After all of this criticism, many had hoped that perhaps one justice, at least, might reconsider. But just last week, in a case overshadowed by the court’s upholding of national health care, the justices had such an opportunity — a Montana state law — and turned it down. The campaign-finance reform crowd was infuriated. One Washington Post columnist branded the Supreme Court “of, by, and for the 1 percent.” Calls now mount for a constitutional amendment.

Why all the anguish? The thinking of those appalled by Citizens United is not especially complimentary to the electorate. With corporations (unions and nonprofits are for some reason exempt from their ire) now able to pour as much money as they want into advertisements, they will in essence control the nation’s democracy. The will of the people will give way to the will of the boardroom.

Of course, the only way that this could be true is if, in some fashion, voters were unable to resist the siren song of advertising. That seems to be the theory, however: Voters are easily led and easily bamboozled, pushed this way and that by whatever ads they happen to encounter.

Maybe that’s true. Many folks I know agree with that sentiment, although curiously I have yet to hear them admit that they are so easily manipulated: It’s just everyone else that’s the fool. If so, then democracy is in danger not from too much money, but rather because its core assumption — that people have the intelligence to make decisions about their own governance — is untrue. If that’s the case, perhaps we’d be better off returning to the days of kings, queens, and other autocrats.

Personally, I don’t yet despair for democracy. Granted, the ads are annoying and pervasive, but that doesn’t mean they dictate results. Indeed, in past years, it has been remarkable to watch the degree that people — especially those who think of themselves as ideologically “independent” — agonize over their decisions as an election approaches. They listen to candidates; watch debates; talk to friends, co-workers, and neighbors; and scour news from all sources (which increasingly include blogs, tweets, and postings).

Then too, the power of advertising is oversold. With ad-skipping features readily available, it gets ever harder to reach people with TV ads anyway. But even when people see the ads, they aren’t credulous dupes. Viewers know that just because Pepsi says it’s better than Coke doesn’t mean it really is. And they know as well that just because one super PAC calls a politician a fraud, liar, or crook doesn’t mean that too is true.

Granted, if current polls hold, on Election Day about half of us will be deeply unhappy with the outcome. If I had the money, I might even take out ads labeling those who disagreed with me as idiots. But that wouldn’t really mean, if you get what I’m saying, that they really are.

This column originally appeared on the Boston Sunday Globe's op-ed page on July 8, 2012.

Massachusetts should do away with price stickers

NEW JERSEY and Oregon won’t let motorists fill up their own gas tanks. They’re the only two states with that prohibition, and regular TV viewers can guess why. The folks depicted on “Jersey Shore” don’t seem to have the intellectual oomph to be able to manage the task, while the Oregonians in “Portlandia” are just too flaky.

Massachusetts, thank goodness, thinks better of its drivers, but when it comes to us as shoppers we are, apparently, idiots. Walk into most grocery stores and you’ll find that each item is labeled with the price. For good reason — the law is both expensive and useless — no other state in the union requires this. But here in the Bay State, even as the original rationale for the rule has disappeared, self-styled consumer advocates have fought to keep the item pricing requirement. Legislation repealing it is now before the governor. Like blue laws, Sunday closings, and excessive licensure requirements for trades like hairdressing, this one deserves to go.

Item pricing has been around for decades and originally made much sense. Back then, cashiers had to rely on memory and lengthy lists. Labeling items helped ensure all consumers were charged the same amount. But then scanners came along, with the now familiar bar codes that recorded prices far more accurately than cashiers ever could. At that point, item pricing should have disappeared. Instead, Massachusetts in 1986 actually made it a requirement, pushing it as a way for consumers to be sure that scanners (a new and scary piece of technology, apparently) were working.

But the law is in tatters. For the most part, item pricing now applies only to grocery stores. Other retailers are exempt as long as they have scanners that let consumers check prices while shopping. And even in supermarkets, it’s a crazy-quilt mess. Some items, such as milk, eggs, frozen foods, and greeting cards(!), are exempt. Other provisions of the law allow more exemptions depending on the number of cash registers in a store (and no, this doesn’t make sense to me either). At the same time, the state’s retailer association cites studies showing that, when required, item pricing boosts prices by as much as 10 percent.

So why is an outmoded, inconsistent regulation that increases consumers’ costs still around? Almost every rule government writes creates a constituency. That’s why it’s proven so hard to let supermarkets sell beer and wine: Package stores benefit from their quasi-monopoly and don’t want the competition. So too with item pricing. Those who spend their days applying labels to canned goods would be out of a job and thus have a strong interest in the status quo. And there is, to boot, a very strong whiff of paternalism. In the world view of consumer advocates, retailers are rapacious villains, while Bay State consumers are witless patsies.

Even if that stereotype was true in the past, the tables have turned: Consumers rule, and retailers are back on their heels. Where once competition was genteel and discounting rare, shoppers now have a wealth of choices and stores compete fiercely on price. Retailers also face competition from other sources, including Internet-based outlets such as Amazon and home delivery services such as Peapod.

Consumers, too, are in a stronger position. Far from ignorant, shoppers now have vast amounts of information at their fingertips. Prices can be compared online or instantly in stores by scanning bar codes from a smartphone. Customers post their experiences on websites such as bizrate.com or planetfeedback.com. A retailer who dares to try to cheat someone — even one who inadvertently offends — will find its name quickly trashed. A popular store one day might well find itself empty the next.

Perhaps recognizing the inevitable, some advocates of item pricing — such as MassPIRG and activist Edgar Dworsky (who claims credit for Massachusetts’s original rule) — belatedly offer up alternatives: heavier regulation, stepped-up inspections, more barcode scanners around stores. Some sound reasonable, but they are expensive, and the crowds who flock to warehouse stores such as BJs (which hardly ever labels items or has aisle scanners) suggest that consumers regard these measures as unnecessary. The world has changed and with it the need for the state’s heavy hand.

This column originally appeared on the Boston Sunday Globe's op-ed page on July 1, 2012.