During a recent radio program, I heard a couple of politicians talking about healthcare reform. “Can we pay for it?” was the question that one of them asked the other. I immediately thought of the days when I was a young. On multiple occasions my father said to me, “If doing anything the correct way is too costly, then you definitely can’t afford to do it the wrong way. If you are not going to do it right, don’t do it at all!” I learned very early in life that doing things correctly is less costly than doing them incorrectly, where many times the costs are hidden or delayed. Automobiles purchases are a good example of this. Skipping key steps when purchasing a car can lead to unsustainable costs after taxes, insurance, maintenance, gas and repairs kick in. Dad’s message stuck with me and continues to guide my decision-making approach. When it comes to our healthcare system or more accurately our ‘sick care’ system, most of us agree that it is not operating correctly. So, “Can we pay for it?” isn’t the question that should be asked. “Where are the cost savings”, “How much are the cost savings”, “How should we invest the cost savings” and “How do we get there?” are more appropriate questions.
I have experienced the same questioning to change in business. Through their own admission, employees and managers alike, will allude to the pain and dysfunction that is experienced while trying to get work done. When a solution is presented, someone (usually the holder of the purse) will ask, “Can we afford this?” My generic response is, “if you can afford to do it incorrectly, which is the current mode of operation, then how can you not afford something that is going to improve quality, reduce costs, and thereby save you money?” The question that eventually surfaces is “How do we get there?”
“Can we pay for it?” is code for “How does this change affect me?”, “What’s going to happen to my position?”, “How am I going to get paid”, and other similar concerns. Because the details behind change are not always clear, these are valid concerns for the people involved. The leaders in a change initiative should anticipate and account for these concerns. Care must also be taken to keep the resources focused on well-defined goals, otherwise, some who prefer to push an unrelated personal agenda through this change could undermine the implementation of ideas that meet the goals and produce the largest savings.
Interestingly enough, healthcare will reform. If nothing is done, it will eventually collapse. It’s widely known that the current system is not sustainable and doesn’t serve our collective needs. At that point, there will be no choice but to create something new, hopefully learning from the pain and dysfunction that preceded the collapse. If a band-aid approach is taken to healthcare reform, the system will collapse, maybe some years later than the scenario where nothing is done. Failure in this manner will also provide an opportunity to implement a highly functioning system, after the fact. My hope is that personal agendas will be mitigated and concerns are addressed, so that we can begin to ask the pertinent questions that stimulate the critical thinking and problem-solving required to guide healthcare reform from indecision to cost savings. How all of this might play out should not be a mystery and is completely dependent on our collective actions. The businesses that have failed during the past year, did nothing or applied a band-aid approach to their previous challenges. Actions taken or not taken, now or in the future, will mirror results of the past.
