There is No ‘I’ in Healthcare Reform

Anyone who was worried about imminent changes to U.S. healthcare for the elderly can relax—sort of.

According to the New York Times, Republican lawmakers in Congress have backed away from efforts to privatize Medicare. But the problem of runaway healthcare spending remains. And while most Americans agree that the rising cost of healthcare is a serious problem, many organizations (insurers, doctors, hospitals, other businesses) have an interest in opposing many of the possible solutions being fashioned.

In many ways, this is a byproduct of what Peter Drucker called “the new pluralism,” in which myopic institutional interests frequently clash with the common good.  “Each institution in a pluralist society sees its own purpose as the central and most important one,” Drucker wrote in The Ecological Vision. “Indeed, it cannot do otherwise.”

But if organizations aren’t careful, Drucker warned, “imposed political solutions” are likely to follow. “When, for instance, the healthcare institutions in America . . . did not take responsibility for spiraling healthcare costs, government imposed restrictions on them,” Drucker noted, citing earlier Medicare curbs on treating the aged. “These rules clearly are not concerned with healthcare at all and may even be detrimental to it,” Drucker added. “They are designed to serve short-run fiscal concerns of government and employers, that is, designed to substitute a different but equally one-sided approach for the one-sided, self-centered approach of the healthcare ‘interests.’”

Seen in that light, proposals such as the Republican’s privatization plan were inevitable. So, too, were many provisions of the new healthcare laws passed under President Barack Obama.  All were “imposed political solutions” to a system in which the management of interest groups has failed to rein in their excesses.

“This must be the outcome,” Drucker wrote, “unless the managements of the institutions of the new pluralism see it as their job to reconcile concern for the common good with the pursuit of the special mission for the sake of which their institution exists.”

How does your organization deal with issues of self-interest versus the common good? What steps are you taking to bring the two imperatives into balance?