You may have noticed there are a lot of foot-draggers in Washington lately when it comes to healthcare reform. Call them Blue Dogs, obstructive Republicans, or whatever you want.

The reason they can get away with it is because of growing public fear and uncertainty about the changes healthcare reform will bring.  Paul Krugman paints a clear picture of it in his op-ed “Healthcare Realities” for the New York Times.

Leading Change Step By Step

Unfortunately the seeds for this growing fear were able to be planted because of a key missing link. John Kotter, the Founding Father of change management, holds the key in step 4 of his 8 step process to leading change:

Establish a sense of Urgency

Create a guiding coalition

Develop a vision and strategy

Communicate the changed vision

Empower broad-based action

Generate short-term wins

Consolidate gains and produce more change

Anchor new approaches in the culture

Creating a Vision

Kotter holds Vision as a central component of all great leadership and claims it is essential in breaking through the forces that support the status quo. Throughout years of supporting hospitals and health systems in developing a clinical vision upon which to transition to electronic medical records, I also came to realize how critical Vision truly is.

A US Airforce Academy cadet details frequently encountered issues during this step in his review of Leading Change. See if you can see our nation’s leadership (which I define as the White House and Congress) in here:

One of the interesting factors that Kotter describes as “difficulties inherent to the process” is the internal struggle and doubt the guiding coalition has with change.  He says that there are many questions that the guiding coalition has to answer in their own minds before they can effectively implement the change… 

That would certainly define the multiple competing bills and complex in-fighting we have seen on Capitol Hill this year. Creating Vision takes clarity, a lot of time, and communication. 

Communicating The Vision

In Leading Change, Kotter also outlines the 7 key elements in effective communication of Vision: 

Simplicity

Metaphor

Multiple forums

Repetition

Leadership by example

Explanation of seeming inconsistencies

Give-and-take

Well, Mr. President, you have given the American public the last 5 elements in spades. What we’re missing is the first two. Tim Foley provides some very helpful hints in his post “TV Could Make Health Reform Real—Here’s How”. He suggests merely the White House East Room, a camera crew, and four people.

Four People and a Vision For Healthcare Reform

Who are these four people?

1) An uninsured single mom
2) An employer-insured relatively high-income man
3) A small business owner
4) A Medicare recipient who hit the donut hole.

Foley suggests letting these people summarize their current financial and insurance situation, and telling them—very simply—what their future looks like with healthcare reform.

That’s it. A four-prong Vision addressing the major patient and small employer stakeholders. The fascinating thing about Vision is that it creates excitement and removes a great deal of uncertainty. Which is exactly what the American public needs to demand change in unison.

The public voice is badly needed, because meanwhile Republicans are trying to destroy Kotter’s first step to change, Urgency, by letting the issue languish during their summer vacation. I’m sure they’ll be spending plenty of time recreating with their healthcare lobbyist friends, beefing up their donation kittys.

And you? Well, you will be holding onto your health insurance (if you even have it) by a string. Let your Congressional representatives know it today.

©2009, Actively Fused LLC