Leadership crosses all business lines; no organization can flourish without proper structure, management, vision, and implementation.  Most of the posts on this blog have concerned themselves with global leadership principals, this one is going to go a little off that track and talk about leadership in a particular business arena, healthcare.

            Healthcare is not thought of by many as a business, but regardless of the country you live in, in a modern society healthcare is most defiantly so. Be it the National Health Service (NHS) in Great Britain, the system under the Canada Health Act, or the fragmented system in the United States all these systems have one thing generally in common, they are a business that needs great leaders.

            This particular sector is currently a very hot topic in the US, with the highest per capita spending, and poor outcomes, healthcare has come to a head in this country over the past few years. The 2010 passage of the Patient Protection and Affordable Care Act (PPACA) and it’s currently implementation issues show how leadership (or a lack there of) plays a direct role on the business of healthcare. Before I talk about the issues we are seeing in the PPACA, lets talk about the topic of healthcare leadership more globally.

            Leaders in healthcare are often thought of as hospital or healthcare organization CEO’s, unit managers, or organization executives who oversee the daily operations and strategic planning of their particular organization. Others may see that regional collaborations and those in the c-suite of those organizations play a large role in the health of the populations they serve. Maybe it’s state governors who are the real healthcare leaders in their states, leading their state legislatures to improve funding or access, appoint members to certificate of need (CON) committees, place public health officials in office, and the like. Then there’s federal leadership, the CDC, National Institute of Health, Health and Human Services all play a role in the healthcare system we have in the United States. Finally, there is congress and the President of the United States. Are they all healthcare leaders too? My answer is yes, and let me explain why.

            The United States has a fragment payment model and care system, a mix of local, state, and federal programs and facilities who compete or augment both private for and not-for-profit healthcare organizations. It is not a free model system, but a hybrid system that in reality doesn’t work very well. Because of this mixed provider and payment model, the elected officials of the country should be leaders in the healthcare industry; unfortunately we are not seeing this currently. 

            The PPACA is partially in effect, with major components of it set to be implemented on January 1st, 2014 (although it seems that many of these set dates are being pushed back).  Many aspects of the law are popular, including the exclusion of pre-existing conditions, removal of lifetime caps on coverage, and the increase in children’s eligibility on parental plans to age 26. How is it then when asked about the law generally we are seeing the following:

  • 36 percent of Americans want Congress to expand or keep the health care law while 39 percent want Congress to repeal it – the highest percentage seen in CBS News polls. The poll also found a majority of Americans – 54 percent – disapprove of the health care law, 36 percent of Americans approve of it and 10 percent said they don’t know about it.”…” The poll also found just 13 percent of Americans say the health care law will personally “help me” while 38 percent said they believe the law will personally “hurt me.” (CBS NEWS Poll-July 2013)
  • From what you have heard about Barack Obama’s health care plan that was passed by Congress and signed into law by the President in 2010, do you think his plan is a good idea or a bad idea?  Good Idea 34%, Bad Idea 47%…” (WSJ Poll July 2013)
  • “If you were given the opportunity to vote only on whether to keep the 2010 health care law known as Obamacare in place or repeal it, how would you vote? Keep the Law 40%, Repeal the law 53%…” (Fox News Poll July 2013)


            So why is there such a disparity between aspects of the law people like and the overall disapproval of the law?  I believe it is all to do with the total lack of leadership on this issue. We are not seeing anyone be a leader here, typical of Washington, but very disappointing on such an important topic. From the political leaders all we get is posturing, empty comments, false promises, and rhetoric. From our healthcare executives across the country we are seeing nothing much. A few major organizations have taken a stance on the law, from most we are hearing crickets. With no leadership in D.C., really nothing coming from our healthcare leaders, and the state politicians breaking down party lines (regardless of any facts about the law being presented to them) it is no wonder why the American public is confused, disheartened and uninformed. 

            This is not a political post, it’s a leadership (lack of leadership) post about a very large sector of the U.S. economy, a major employer and provider of services, that is being mislead by those who seek to lead. Someone needs to stand up and put truth to words, inform all of us of the real issues in healthcare, and lead us into the 21st century of healthcare in this country. It can’t be done by fiat, law, or taxes, it takes people to lead. Step up!




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