Three Leadership Lessons from Health Care Reform

Posted 08.17.2009

As I wrote last week, the health care reform debate is, unfortunately, full of important lessons for leaders on how not to drive change. Admittedly, it’s a lot easier to observe what seems to be going wrong when you’re watching the process instead of being in the middle of it. Still, it seems like President Obama’s reform process is running off the rails. The White House spent last week playing defense on the health care reform town halls and the latest example is this morning’s confusion (as reported on Politico ) about whether or not a public insurance option is still on the table.  

How did we get here?  I think there are three lessons from how the President and his team have handled this that anyone who is responsible for leading dramatic change should pay attention to. 

Define What’s In and Out of Bounds:  While good leaders stay open to input to stakeholders, they just don’t throw everything open and essentially say, “What do you want to do?”  Instead they set the parameters of the debate by stating some clear principles and defining, from their point of view, what’s in bounds and out of bounds. From the outside looking in, it doesn’t seem like the White House did that in framing the health care reform process. Instead, the design responsibilities were left to different committees in Congress. That’s left the President with four different bills at this point and the inability to say what exactly is and isn’t involved in reform. The White House took more or less the same approach with the $780 billion stimulus bill earlier this year and probably got less immediate impact and more pork out of that process than they hoped for. Leaders of change, especially when they have as much political capital as the President had earlier this year, need to set a clear purpose, picture and plan for the change.

Clear the Decks:  There was a lot of commentary in the late Spring and early Summer (including on this blog ) that the President was cramming too much onto his agenda. It seems like the impact of focusing on too many things at once is playing out now. For something as defining for the country and his administration as health care reform will be, it doesn’t feel like enough time and attention was given up front to the design, coalition building and communications strategies needed to lead something so complex. It seems like the decks weren’t cleared up front and now the White House is reacting to events rather than shaping them. When you’re changing something big and important, make plenty of time up front to do the prep work.

Tell Compelling Stories and Give Clear Answers:  As Howard Gardner writes in his book, Leading Minds: An Anatomy Of Leadership effective leaders have a core story that they shape so different groups can relate to it based on what they care most about. What most groups are going to care most about is “What’s in it for me?”  It’s only been in the past few weeks that the President himself has invested a lot of time in communicating the story behind health care reform. From what I’ve seen, it’s only been in the past few days that he’s started telling the stories of real people and what health care reform would mean to them. Yesterday’s guest Op-Ed by Obama in the New York Times is a decent example of telling a few illustrative stories and making a few key points about how what you’re trying to do will help make those stories better. The biggest problem with the article though was that it ran in the New York Times instead of Parade magazine.  When driving change, leaders need to tell stories that reach people where they live and then clearly state how what they’re doing is going to lead to a better story.

What leadership lessons are you gleaning from the health care reform process?