Oblique influence

I just finished a long section of Getting Health Reform Right about the role of regulation in health care that was, to say the least, eye-opening. And as usual, I want to leave aside discussions of health reform and talk more about the implications for leadership generally.

My biggest take away was that changes in health care can rarely be legislated directly: if you want to lower the costs of services, it’s not feasible to just mandate lower costs; if you want more people to seek preventative care, you can’t make a law that they do so; if you want better providers in under-served communities, you can’t just tell them to go there. This kind of direct approach will ultimately fail, either because the link between cause and effect is too complex or because compliance with the law is difficult to enforce.

Leadership and the feasible

Although I’m still only early on in Getting Health Reform Right, there’s food for thought in every section. The following quote is from their chapter on the politics of reform, and although the political context of health care reform (particularly in third world countries) is an animal unto itself, this quote got me thinking about what makes a successful first-world corporate leader.

Talented political leaders, like talented generals, can win battles and campaigns that would overwhelm those less able or less energetic. So, asking if a policy is feasible is, in part, asking a question about the advocates of reform, especially their creativity, commitment, and skills—and about their opponents. (Getting Health Reform Right, p. 6)

The execution cycle

I’ve cracked the next book in my quest to better understand the health care problems facing the U.S.: Getting Health Reform Right, by Roberts, Hsiao, Berman, and Reich. This is another long one, so a dedicate review is a ways off, but I came across an interesting framework in the opening chapters, one that, with some slight changes in emphasis, could have applicability beyond government policy to include corporate decision-making.