Screen-Shot-2012-08-20-at-6.17.36-PMWhen America’s thirty-fourth president, Dwight D. Eisenhower, began his administration, he instructed his aides and his executive assistant that there should be only two stacks of papers placed on his desk in the Oval Office. The first would be a stack of those things that were urgent, and only the extremely urgent. The other was to be a stack of the important, and only the extremely important. Years later, Eisenhower commented his bewilderment at how many things were extremely urgent, but never very important.

I think of Eisenhower as I close my time helping to implement parts of the Affordable Care Act. Due by October 1st, Healthcare Insurance Exchanges across the country are estimated to enroll 7 million new healthcare applicants by March 0f 2014, with 24 million new recipients total by 2015 or 2016. In short, that’s a whole lot of new members in such a short period of time.

Of course complications have occurred throughout my tenure on this project. Failures have occurred on all leadership levels. Texas, Arizona, Alabama, Missouri, Oklahoma and Wyoming have all notified the federal government that they will not be policing the health law.

Missouri has prohibited active involvement by most state agencies. If you’re in Missouri and want information on the health insurance exchange, good luck in finding it.  Missouri also requires insurance counselors to get state licenses before they can help people search for health plans on an online marketplace. The counselors must be trained by Oct. 1, but the state has no regulatory framework to license the insurance navigators. Even if it can quickly create a licensing structure, the law bars insurance navigators from recommending specific plans. Additionally, if Missouri insurance regulators decline to approve any exchange health insurance plans because of concerns about the anti-exchange law, it’s not clear what plans an HHS exchange will be able to sell in Missouri.

In Texas, John Greeley, a spokesman for the Texas Department of Insurance, said his agency cannot enforce regulations tied to the federal insurance exchange or market reforms because it is not authorized to do so. Texas, along with Arizona, Alabama, Missouri, Oklahoma and Wyoming have notified the federal government that they will not be policing the health law.  Texas’ decision will create an “administrative burden” for insurance plans and could result in confusion for Texans who purchase health insurance under the federal exchange.

So when I think of all this, the conflict between the urgent and the important is inescapable. It is common for us to think that by staying busy and working hard to implement something important, leadership fails. Our ego and rarely represents the things most important. And therein lies the reason so many people today feel such a lack of satisfaction after working so hard for so many people. When we substitute the urgent for the important work, exhaustion replaces satisfaction.

Urgency is a dance. In horizontal perspectives of Texas, Arizona, Alabama, Missouri, Oklahoma and Wyoming, urgency of the ego has taken center stage. Yes urgency of the ego is popular. But rather than solve problems, it’s intended to drain time, energy and attention. It’s an all-too familiar voice in everyone’s life.

For Texas, Missouri and others like them, it is important to remember virtue, good conduct, morality needs to be based upon the key fundamental principles:

  1. The principle of equality. That means all living entities are equal; and
  2. The principle of reciprocity: This is the “Golden Rule” in Christianity — to do onto others as you would wish them to do onto you. It is found in all major religions.

For those caught in the urgency, “Are you really following the “Golden Rule.“” What is the voice to whom you listen?