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.

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.