A Sickness of Change Revealed in the Healthcare Debate

The US is currently debating health care reform. And after listening to the President’s national address on the issue, realized a common ailment that exists in most change initiatives.

Although, it is widely agreed that there is a need for healthcare reform in the US., Americans are generally happy with the healthcare they receive. Which in fact is among the best healthcare in the world.

So, the problem and therefore the focus of reform should not be in the service, but in access.

Access to healthcare is primarily limited by cost. The very little that we know about the Health Reform Bill that the President is pushing is that it will increase access to healthcare by lowering cost to the public.

So what’s the problem?

The problem is a sickness that pervades most development/reform/change programs around the world. There is an addiction in development in treating the symptoms, rather than working on cures. Is it not about WHAT will be done, but about HOW.

The symptom in healthcare is high cost. Therefore the solution should include ways to deal with the REASONS for those costs. The current bill does not. It merely addresses the issue by simply finding more creative ways to pay for it. In other words, a glorious way to simply throw money at it.

Problem solving, healing, and real change means getting to the core of the problem, and dealing with it at its source. Can one deal with poor education by lowering test standards? If one gets a rash on their skin, should they just cover it with make-up? If there are problems at home, is it solved by drinking? You and your spouse are fighting a lot, is the answer simply not speaking? If you’re over-weight, should you just take a pill? (although, that would be nice)

Once, I was involved in a program to deal with drug problems among teens in a local community. After research, I proposed a program that dealt with core issues: a lack of role models, a lack of future prospects, lack of constructive activities and support in which to develop strong social skills, coupled with cooperative law enforcement. It was cost affective, used resources currently available in the community, sustainable and therefore long term. However, the plan was rejected because the quota was for an anti-drug program rather than a community development program which mine appeared to be.

On a separate issue, I was asked to work on development for a crime-laden area. After research, the proposal came back as a socio-economic development program for the entire region. But again, rejected because the quota was slated for dealing with the “problem people” and my program dealt with the community at large.

In working to improve educational standards in another developing country I was met by resistance from educators who simply didn’t want to do more work.

Recently, a friend kept complaining about her weight, yet refused to do anything about it that constituted sacrifice or sweat.

Change is a good topic, but the sickness lies in the denial to do what is really necessary. Why? Because real reform takes work, real growth comes from pain, real change means removing that which currently holds power. It is not always nice, it is not comfortable, it is never easy.

If the President is really serious about Health Care Reform, it should address malpractice lawsuits (tort reform), rising insurance costs, separating medical insurance from work, and encouraging healthy lifestyles.

Want to increase an economy? Encourage companies to invest and grow and limit government to regulation.

Want to improve education? Deal with the teacher/education unions and keep teachers accountable.

What to lose weight? Adjust your eating habits and EXERCISE!

Involved in community development? Do the research, instead of simply copying a program from another culture.

Unfortunately for most development, instead of doing the work, it’s a lot easier and more popular to take it easy and just throw money at the symptoms.

The Importance of "k"

Imagine playing in a league where wins and losses are not determined by performance but by the size of bribes for referees and players.

Imagine going to a school where grades are given not by competence with the material or completion of assignments, rather on the teacher’s feelings toward the student.

Imagine running a business in a market where agreements are not respected and success is determined, limited or usurped.

Imagine being in a relationship with a daily fear of being abandoned.

Imagine living in a country where the rule of law fluctuates on the whims of the powers that be.

This is the reality for many in the world today which is caused by the lack of a quality constant.

The constant is basic principles from which values are made, that determine right from wrong, fair from unfair and most importantly, no matter what happens and regardless of what powers have influence, does not change. And on this, development and progress can be based.

Without the constant, there is no order, there are no standards, and values, performance, rewards and success are arbitrary. People without a constant are reduced to hedonism, which leads to anarchy, which leads to chaos.

The constant determines the identity of a person, organization, culture, or nation, and therefore is the basis for decision-making.

The Constant varies in different situations. The following are constants for healthy societies:

· For a school, the constant would be the catalogue registered under.

· For a business it is a contract.

· For competition, a rulebook

· For a nation, it’s constitution

· For Christianity, the Bible

· For Catholicism, the Pope

· For Capitalism, the local market regulations under the principle of profit over loss

· For a couple, a commitment to the bond

· For a person, that constant rests in faith, family or community

Because of the importance of the constant, it is usually held as sacred and therefore protected and nurtured and explains why there is such outrage and reactions when people’s constants are threatened.

This is why appointments for the US Supreme court are taken so seriously and why conservatives are questioning whether Jud. Sotomayor will treat the constitution with respect or be an activist judging on racial issues. This is also why the US is wrong to not support the Hondurans in removing their democratically elected President who tried to unlawfully change their constitution.

It explains why there is uproar with U.S. Government playing and involving itself in the markets beyond regulation.

It explains why referees typically get most of the negativity in sports.

Since the constant controls decision-making, values and opinions, real change happens on two levels. The strength of an entity is a direct result of the quality of its constant. So the first level regards the constant itself. Documents like the Bible and the US constitution are held as solid and therefore sacred, so changes to either are met with incredible resistance. Sports rules and school catalogues change all the time, but require consistency of those rules at minimum through the end of the term. Faith and Commitments are on a personal level and subject to education, maturity, and accountability.

The constant is a set of principles, not issues, on which one chooses to exist. Therefore change on this level is the hardest thing to do, and should be done carefully and rarely. It is not something to be done on a whim or urge, in a 5 minute conversation with a stranger on the street, based on a political agenda, or done just because it feels right.

The second level of change then builds off the principles included in that constant and regards the entity’s ability to live according to that constant.

This is why a nation the role of a supreme court and law enforcement, why there are managers, why people follow religion, why we hire coaches and trainers and why, for many, a wedding is much more than a piece of paper.

This is also how we can measure and keep in check those who are in charge of our development, (educators, pastors, politicians, leaders) to make sure they are leading us according to our established principles and prevent manipulation, indoctrination, or being misguided.

Therefore, a stable entity, be that anything from a person to a nation, needs to ask itself a few questions:

Do we know what our constants are?

Are they solid and based on firm principles?

Do we believe in them?

Are we actively protecting and nurturing them, or even prepared to defend?

And finally, are we living or attempting to live according to them?

Vision vs. Change

Bob went away on a weekend Men’s Retreat. While there, he engaged in discussions about work, family, relationships, on being a good father, husband, co-worker. He came away from the weekend, refreshed, energized and ready to be the man he decided he wanted to be.

Alice is finishing up her last week at the rehab center. Alcohol had controlled her life for almost a decade and is now preparing a new life with a new perspective.

After two weeks working with Street Children in Romania Claire and Tom return with a new vigor on life and a new perspective on what is important. They walk in their lavish middle class home, disgusted at the plethora of clothes and shoes in their closets, the abundance of food sitting in their pantry and begin to clean house. Meanwhile a group of Romanian kids gather in the playground trying to recreate the games they played with foreigners over the past two weeks.

Significant events have happened in each of the lives of the people above. But did change happen?

Learning occurred, perspectives influenced, but in each case, more times than not, there will be a change in behavior for a short time, a few days, maybe, but rarely a couple of weeks. Then behavior will return to what it was before. Bob will go back to old habits, Alice will continue to struggle against her temptations, Claire and Tom will replenish their clothes and the street kids will return to the streets.

What is happening here is not change but learning. Each were given a new perspective, insight, or a vision of what could be and for some reason, we accept that as change.

Yet, unless the conditions that helped create the former situation are dealt with; unless support structures are put in place to guide the change from vision to reality; unless discipline is instituted which provides accountability to reinforce the change, change will NEVER happen.

Everything is the way it is because conditions support it to be that way. Your special relationship claims change, the government claims change, even you claim change for yourself, but unless steps are taken to destroy the infrastructure that created what is, and replaced it with a new one to support what will be, it will never work, regardless of intentions.

That change would be seen in severing relationships, creating a new social network, changing daily routines, giving new authority to existing relationships, and committing to new behavior until it becomes habit.

Whether your change is personal, relational, organizational, communal, or even national, don’t fool yourself; vision is not change, but a pre-cursor to it.

Change is not merely a decision, it is a full restructuring process.

On Growing Up American

The United States, the most successful economy in the history of the world, is THE Land of Opportunity. It is different, not because of money, not because of military, but because of people.

The US by make-up is a nation of immigrants who left their homes, their lives, their comfort, venturing out into an unknown in order to seek a new life, a new path, a better opportunity.

Most have come with little to nothing, and built one of the most successful nations in the history of the world. We grew up with stories like “The Little Train that Could.” “The Bad News Bears”, “The Mighty Ducks,” stories of the common and non-special doing the extraordinary. We cheered with “Rocky,” and the “Karate Kid” and dared to share their dreams.

We dreamed as kids of being sports stars, astronauts, presidents. We grew not afraid of risk nor failure.

We are resilient, competitive, progressive. We don’t think of ourselves as the best, but compete as if we were.

We don’t wait for someone to tell us what we can do. We go until we’re told we can’t

We look for opportunities; we don’t wait for hand outs.

The US is a country where:

· Dreaming is encouraged

· Creativity is seen as a blessing rather than a lack of discipline

· We are motivated and put energies into rising above the competition rather than bringing it down

· Discrimination is confronted and dealt with rather than ignored and suppressed

· Opportunity is limited to your performance not your station, certification or special relationship.

· We learn to compete from an early age, and understand chance, loss, and winning.

· Performance outweighs relationship in competition.

· People are not afraid to hope, not scared to shoot for the stars, and willing to raise the bar.

· Culture supports opportunity, because if we don’t take it, someone else will.

· Individuality is celebrated.

So when our leaders create policies of penalty rather than opportunity; when they believe the people serve them, rather serving the people; when they believe the people want hand outs rather than choice, when they believe were satisfied with arbitrary distribution rather than fair competition, when they think we will simply give up after failure rather than push on and persevere, and when they think we NEED them…

It is clear….they are not American regardless of what their passport says, they don’t think American, and don’t understand the American spirit.