Irving Wladawsky-Berger

History in the Making

I have been transfixed by the long health care reform debates in the US, which finally culminated with the House of Representatives passage of the health care reform bill on March 21, and which President Obama signed into law two days later.  The House also passed the reconciliation bill which the Senate subsequently approved on March 25.  The health care reform bill is now the law of the land.

This bill joins other landmark social legislation, like President Roosevelt’s 1935 Social Security Act, and President Johnson’s 1964 Civil Rights Act and 1965 Medicare and Medicaid Acts.  And, like those previous bills, you cannot analyze their pros and cons in purely tactical terms.  You have to focus on the impact of such landmark legislation on the long term evolution of the country.  You have to look at the 2010 health care legislation as history in the making.

There is no question that this legislation is imperfect, perhaps considerably so.  But there is also no question that health care in the US has been frozen in decades-old models that no longer work.  As many have pointed out, despite expenditures that are significantly higher than those of other industrialized countries, US healthcare performance has been declining relative to these countries on just about all key indicators of health, including quality, access, efficiency and equity.  Unique among industrialized countries, over 15% of the US population lacks health insurance, which according to several studies, is responsible for tens of thousands of unnecessary deaths every year.

The status quo was unacceptable.  Something had to be done.  Most of us would agree that, the US is better off for having passed social security in 1935, and Medicare and the civil rights act in the mid 1960s.  The key question we must now ask is whether years from now, our country will be better off as a result of our having just passed these health care bills.

The National Broadband Plan, Jobs and Economic Development

On March 16, the Federal Communications Commission (FCC) released to the public and delivered to Congress the National Broadband Plan: Connecting America, “. . . an ambitious agenda for connecting all corners of the nation while transforming the economy and society with the communications network of the future - robust, affordable Internet.”

In a recent Washington Post OpEd, FCC Chairman Julius Genachowski explained the driving forces behind the National Broadband Plan:

“Universally deployed broadband networks can be America's engine for enduring job creation, economic growth and tremendous improvements and savings in education, health care and energy conservation.”

“This vision of world-leading 21st-century broadband networks and their benefits will not occur spontaneously.  While the United States invented the Internet, when it comes to broadband we have fallen behind as other nations have raced ahead.  Some studies show us to be as low as 15th in the world in broadband adoption; others have us higher, but none puts us even close to where we need to be.”

The Healthcare Reform Debates

The ongoing US healthcare debates - or is civil war a better description? - remind me how incredibly hard it is to bring about disruptive transformations of any kind. 

In my experience, organizing disruptive transformational efforts is very difficult.  I learned this first-hand at IBM with efforts like the Internet initiative in 1996 and the Linux initiative in 2000.  Given that the organizational complexities go way, way up with the size and scope of the initiative, I am not surprised how incredibly difficult it has been to try to bring about the badly needed transformation of healthcare across the whole country.

A transformational initiative is subject to very different organizational dynamics from more incremental ones.  With incremental initiatives, you are looking to improve something that already exists in the marketplace - e.g., better products and services, higher customer satisfaction, increased overall efficiency.  Because you are improving something with a history, there is lots of information that can be analyzed to estimate the impact of the improvements on the business.  You can make a case for the improvements based on quantitative, fact-based, rational arguments.

Not so for initiatives based on disruptive technologies or ideas.  Disruptive transformations are, indeed, disruptive.  They are a break from the past, either because past approaches no longer work and are getting us into deep trouble; because a new technology or idea now offers us much better opportunities; or both.  But, while the changes might be absolutely essential, it is important to keep in mind that you are asking people to move from something that, while imperfect and flawed, they are familiar with, into unknown, most likely uncharted territory.

Business Management and Holistic, Critical Thinking

In early January I read an excellent article in the New York Times - Multicultural Business Theory.  At B-School?.  The article was about the efforts of Roger Martin, the dean of the Rotman School of Management at the University of Toronto, to transform business education.

About a decade ago, Professor Martin began advocating “what was then a radical idea in business education: that students needed to learn how to think critically and creatively every bit as much as they needed to learn finance or accounting.  More specifically, they needed to learn how to approach problems from many perspectives and to combine various approaches to find innovative solutions.”

“Learning how to think critically - how to imaginatively frame questions and consider multiple perspectives - has historically been associated with a liberal arts education, not a business school curriculum, so this change represents something of a tectonic shift for business school leaders.  Mr. Martin even describes his goal as a kind of liberal arts M.B.A.  ‘The liberal arts desire,’ he says, is to produce ‘holistic thinkers who think broadly and make these important moral decisions.  I have the same goal.’”

Martin’s ideas may have been radical ten years ago.  “But even before the financial upheaval last year, business executives operating in a fast-changing, global market were beginning to realize the value of managers who could think more nimbly across multiple frameworks, cultures and disciplines.  The financial crisis underscored those concerns - at business schools and in the business world itself.”

The “Professionalization” of Service-based Industries

I spent several days in mid-February at Imperial College in London.  I was a speaker and panel member at an event sponsored by Design London, the multi-disciplinary innovation initiative between the Royal College of Art and the Imperial College engineering and business schools.  The event - The STEM of Service Experience, - focused on the role of Science, Technology, Engineering and Math (STEM) on innovation in services. 

The following day I conducted a seminar on Technology and Innovation in the Service Economy with doctorate candidates in the Business School.  We had very stimulating discussions on the impact of STEM on service-based organizations, in particular, how increased access to information and sophisticated analysis and modeling tools can help managers make better business decisions, especially those concerning highly complex problems. 

One of the students raised the question of whether, as service-based industries have better information and tools at their disposal, we should expect their management to become more professional in the way they make decisions, much as has been the case with engineering as it matured as a discipline over the decades.

It was a very intriguing question that has stayed in my mind since.  What does it mean for a company and its management to be more professional?  How is professionalism related to the scientific and technology underpinnings of the company, as well as to its use of information, analysis and modeling tools?