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?

Next Generation Leaders

Changing times mean Changing Approaches

World leadership is changing. Throughout history, the leaders were those who were the most effective in utilizing advancements of progress: the philosophical Greek societies, the might of Rome or the dominance of the British fleet. The leaders of this past century, the industrial age, were those who dominated through productivity. However, today, the production centers of the world have shifted to cost-shaving developing countries, without a corresponding shift in leadership. This means, once again, we are entering a new age and those who lead will be those who choose to embrace it.

The industrial age was sparked by the advent of the Assembly line. In the early 1900’s, a movement was started focused on the application of efficiency. Among the members was a young man by the name of Henry Ford, who eventually implemented principles of the movement into his automobile business. The result was the modern day assembly line, which was so successful it gave his company Ford Motors almost 50% of the market within a few years.

The efficiency of the assembly line led to greater productivity in less time at lower costs. By dividing production into simple tasks, it allowed the company to hire, train, and replace an unskilled workforce with very little effort. Management became an issue of control thus leaving the need for only a few hard-to-find and expensive talent in selected positions at the top.

The model was so successful that it was adapted to many other industries including clothing, restaurants, hospitals, even schools.

Today, the production centers of the world have moved to more developing regions, leaving leadership in the hands of those who embrace what is now the Information Age, and understanding the principles of the Knowledge-Based Society (KBS). Dominance by productivity has been replaced with innovation.

Today, information which was once held by scholars, experts and books, is readily available anywhere, at anytime, by anybody. So, although finding information is important, it is what is done with it that makes the difference.

The competitive edge from the division of responsibility in Assembly line production is giving way to a pooling of resources that comes from team-learning innovation. Whereas before employers poured through workers with focused limited skills managed through control, competitive companies now struggle to retain creative holistic experience managed through facilitation. Conservative companies with top-down authoritative structures are losing market share to living organizations generating bottom-up ideas.

Whether a country, company or an individual; being competitive comes down to being creative. The leaders are those businesses, hospitals and especially schools which embrace this new age by taking advantage of the advancements which support it. The times are changing, will you?