Archive for October, 2009

Change Lessons from Obama’s Mistakes in Health Care Reform

Thursday, October 8th, 2009

I think there are few people who would disagree with President Obama’s view that America needs its healthcare system reforming, especially all those Americans who can’t afford health! The US system costs roughly twice that of those in Europe or Canada and is far less efficient. A medical degree seems to be a license to print money rather than to heal; Pharma and Healthcare industries seem far more concerned with profits than health.

Apparently 50 million Americans do not have health cover, so it is clearly and issue. Michael Moore made a film “Sicko” all about the inequities of this system. So all-in-all this appears to be a worthy cause for a new president to pick for reform, however nearly 9 months into his presidency, why does he appear to be getting nowhere with it?

Obviously this is a very complex issue and system and it is always hard to tackle something so big. There are a lot of strong feelings about this issue, both pro and anti, but these are complicated by the equally strong fears about high taxation and interference from government.

So where has it gone wrong? In I-Change we use a simple 5 step model to analyse change:-

  1. Need: There must be an unmet need, which is perceived as compelling
  2. Belief: You must be able to believe that Change is possible.
  3. Willingness: You must be prepared to do what it takes or make the change.
  4. Readiness: You have to have the necessary resources [time, knowledge, capability, budget, skill, experience etc.] to make the change happen.
  5. Action: You then have to do what it takes to make the change real, and having done so, ensure that it is maintained and that people don’t backslide.

So, how does President Obama fare against this map?

  1. Need: There is clearly a pressing need when 50 million Americans have no cover. However has the need been correctly identified? Do they need to just offer healthcare to these people or reform a system that is already costing 16% of the US GDP at $2.1 trillion?
  2. Belief: Apparently 54% of Americans don’t believe this bill will be passed this year. Failure to create a plausible target de-energises the reformers and gives heart to opponents 
  3. Willingness: Here is, I believe, the biggest obstacle. $2+ trillion represents a huge investment in the status quo; doctors, pharmaceutical companies, insurers and private healthcare facilities are all very rich, powerful opponents of any change. Without neutralising this opposition, or creating an equal and opposite body of opinion he cannot move forward. Presumably there are those who might be prepared to see the system reformed but do not want him to gain the political kudos for doing it. He has to somehow find a win:win solution when faced with this level of opposition. Here is where he has stalled.
  4. Readiness: I don’t believe he has marshalled the resources he needs to push this through and I have read that the bill will add $239 billion to the deficit, which would make it unfundable.

Every business I work in has its challenges with communication and usually this is a key element in what has gone wrong and also in moving forward. I don’t know how one of the great communicators has somehow failed to get this right, but perhaps any bill which is not only 1017 pages long and written in incomprehensible terms is doomed to fail.

It seems to me that there needs to be a root and branch reform of not only the system for paying for health but also on the principles and values that underpin it. What is more important the wealth of a few or the health of the many? Does America want to be a civilised country that shines as an example to others in the way it cares for its citizens or just be the country with the biggest, shiniest toys?

If you can’t show the people there is a simple, believable way forward, then they are unlikely to follow you, even if you are the most powerful man in the world! So remember that for your change programme to work you need to follow this simple roadmap to success.

“Give me your tired, your poor, Your huddled masses yearning to breathe free, The wretched refuse of your teeming shore. Send these, the homeless, tempest-tost to me, I lift my lamp beside the golden door!” Inscribed on the Statue of Liberty

“Nobody can go back and start a new beginning, but anyone can start today and make a new ending.” Maria Robinson

                                                                                                                                          © I-Change Oct 2009



The best laid plans…

Tuesday, October 6th, 2009

Often go astray wrote Robbie Burns, and I had just such a start to my week.  I had a long list of things  I wanted to do this week, but on Sunday I contrived to put my back out so had to take things very easily yesterday.  Today, I had to attend to some family chauffeuring first thing that kept me from having the early start I had wanted.  It then took me several / hours just to clear through the mail and make a couple of calls.  Suddenly it was gone 1pm and I hadn’t stopped.  A useful morning but hardly the one I’d hoped to have.

I find I need to clear my desk (both literal and electronic) before I can start one creating something new.  I know that I could then have ‘begun’ my day, but by that stage it felt as if the metaphorical tide was out.  I know that sometimes one simply has to do what needs doing but increasingly, I find that I try to follow the flow of the energy.  I know some of my time management expert friends out there will have another perspective on this but doing things at the right time seems to have a value.

Plans are valuable and vital, but there is a less talked about skill of working with what comes up, and finding the middle path between these two approaches is a key success factor.

“The best laid schemes o’ mice an’ men
Gang aft agley,”  Robbie Burns

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BIG Change

Monday, October 5th, 2009

Here is a fantastically simple little video, with a very powerful message.  A young lad with a big challenge for all of us.  It is one of series of videos on 1minutetosavethe  The idea is to give people a voice and a chance to make a big difference; it is a true example of empowerment.

Apart from the global significance, it is a good example of Change in action.  It starts with a need for things to be different, and an idea of how to move forwards.  These ideas then have to be communicated clearly and powerfully  in order to build some momentum / support.

Clearly I hope that the World listens to this, but I think it is a great example of how a small voice can be the seed of something very different.

The missing puzzle piece

Friday, October 2nd, 2009

I had an interesting perspective on the work I did the other day and talked about in my earlier blog.  We were talking today and they said “I think the reason that it worked was it finally gave me somewhere to put my feelings.”  They had tried to let these feelings go for a long time, read many books, tried counselling and yet none of them worked.  Of course, I didn’t know this was what they needed at the time, but I thought it fascinating how sometimes one simple ingredient makes it all work.

Perhaps a good question, if what you are doing isn’t working for you, is to ask “What might be missing?”  After all, without yeast, the bread won’t rise.  What might catalyse the change for you?

“I’m not a complete idiot, some parts are missing”

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Points of View…. or… The Camera Doesn’t Lie?

Thursday, October 1st, 2009

Regular readers will remember that I have spoken quite often about how the truth is much less clear than people commonly think.  We all experience things differently, and to some extent we all inhabit our own individual universes, which we are naturally the centre of.  This is one reason why people have arguments, and why witnesses in court often report different versions of the main event.  We all make certain assumptions, and have differing values and ‘no go’ areas.

As I mentioned in an earlier blog, I recently had to watch some CCTV footage and try and decide what was happening, and who, if anyone, was the injured party.  I obviously won’t go into the details but individually both versions were plausible.  Clearly, the ‘truth’ was a more complex amalgam of both stories.   In this episode, the camera was just another spectator, and certainly not the recorder of the ‘truth’ either. 

The thing is, in families, relationships and companies, there are all these people, all with points-of-view and feelings, all in a hurry, all wanting what they want and merrily pursuing their own ‘business’, but from time-to-time, there is inevitability a breakdown.  If we assume that there is only one ‘truth’ and that we are the sole owner of that then there is nowhere for the other parties to go.  You have to take the time to find out what the other person experienced and compare and contrast it  your own and then allow that the other person’s view is as valid as yours.  Try to be clear about the facts, and then discuss the interpretation.  It is a lot of work, but this work is really an investment in the relationship.

“No matter what our achievements might be, we think well of ourselves only in rare moments. We need people to bear witness against our inner judge, who keeps book on our shortcomings and transgressions. We need people to convince us that we are not as bad as we think we are.”   Eric Hoffer