Being under the weather the last two weeks got me thinking about health care reform in the United States and what passes for informed public dialogue these days around the subject. In this (still for a while at least) richest country in the world, we are the only industrialized nation that does not guarantee medical care to every one of its citizens. The insurance and pharmaceutical companies, who have enormous sway in writing or thwarting legislation, will almost certainly benefit no matter what happens. Most Americans support the individual provisions of the bill the administration is trying to pass, though far fewer support the bill itself. Almost everyone agrees we are overextended militarily around the world but few elected representatives want to talk about cutting military spending to fund health care.
We spend a lot of time arguing with one another over a scarcity or a stratification of medical treatment in this country. We look at models of other countries or past successes and failures to bolster our points of view. What would happen if we opened the discussion to encompass all those things that would truly make us all optimally healthy?
Practically speaking, as a society, we want all Americans to have access to safe, competent, and affordable care because when we are in a state of well being--physically, mentally, psychologically and spiritually--we are no doubt stronger and happier people, families, communities and we have more collective potential as a nation. Most of us understand that much of what is needed to bring about well-being cannot be found in a hospital - in fact, hospitals often can make us sicker - but in far less expensive pursuits including alternative medicine, therapy or simply healthy lifestyle choices. The money saved in one area can be used for more serious or unavoidable expenditures elsewhere.
Instead of looking for consensus on already politically programmed talking points and seeing if we can forge legislation out of a lot of random and special interest detritus, we could instead identify a high level goal that would be easy for everyone to agree upon - or at least make it difficult to attack- something like "Universal Well Being for all Americans." And then set about figuring out how we would accomplish that goal - collaboratively.
At our social entrepreneurial venture, URSULAproject, we are engaged in creating business intelligence tools that achieve just such outcomes, so we took U.S. health care legislation for a test drive. URSULA stands for Unified Rating System Universal Lifecycle Assessment and is designed to score and rate anything and everything against a standard that serves all life on earth. Since the technology is allows us to set any goal we like, we walked it through a theoretical exercise; we began by stating the goal: Create Universal Well-Being for all Americans.
We then broke down the steps required to get us to our goal. This involved recognizing different states of well-being and categorizing them accordingly; then listing the many sub-steps needed to achieve each level of well-being and the sub-steps needed to achieve those, etc., in a logical sequence. As we walked through the exercise, each step received an importance weighting, based on established financial, social and medical facts. Eventually we had created a taxonomy that acted as a roadmap with many paths to get to our high level goal.
Once we did this, we could take any actionable efforts, policies, procedures or expenditures - things we could put a numerical value upon - and tie each to the weighted set of facts to give it a relevant context and meaningful score. Using simple math to establish values for any suggestion in achieving any part of our goal of Universal American Well-Being, we could get a relative ranking for how well any idea addressing our high level goal would rank in terms of how well it served the over-all goal of serving everybody.
The process of weighing different plans and steps did not shy away from tough questions such as discrimination against people for being sick, rate hikes, government run programs, or drugs from Canada - but approached them in an objective fashion.
As we walked through the exercise, we realized that so long as we had an interested, engaged and diverse community of people who were willing to work toward a goal they all agreed upon, and willing to base decision-making on facts, we could achieve an actionable plan and consensus--one that puts us ahead of the status quo--where today we allow corporations and unions write legislation for elected representatives to fight their rivals across the aisle just ahead of the mid-term elections.
Technology has fundamentally shifted the way democracies are capable of working, now and in the future. We are more connected, have access to more facts, and are capable of transcending old models, built for a different era, that no longer serve. Well-being for everyone is in all our enlightened self-interest. Imagine if we led our leaders by trumping the contentious political process and gave them a new way forward.