MSNBC’s Brian Williams opened his Friday’s show with an interesting comment, “… both Trump and Ryan saved the Affordable Care Act.” To be fair, Williams claimed the quote wasn’t original, that he acquired the verbiage from the Associated Press or another news media organization. Regardless, the statement was perfect.
Regardless of political view, there are many wonderful lessons for all project managers.
First failure was the lack of vision. All projects require vision and the Project Sponsor must be able to effectively communicate that project. Anti-Affordable Care Act (ACA) proponents had nearly seven years to prepare for and repeal the ACA. Estimates vary on the exact number of repeal efforts, but the current count is well over 60. So one would figure the American Health Care Act (TrumpCare) would have a solid foundation, with critical review and bipartisan support across both political and healthcare professions.
Unfortunately, TrumpCare was conceived in weeks, created from a high-level 6 page outline. TrumpCare was hidden, where one could neither read nor contribute to policy discussion. The White House failed to sell TrumpCare and Americans rejected the plan. Various news reports indicated the lead Project Sponsor (i.e.,the President and shelf promoted dealmaker) failed to break through Washington’s gridlock in his first major policy initiative. There was no education as to how TrumpCare was better than the ACA. In the end, not many thought it was better.
Second failure has to be project staff and advisors vacationing during project delivery. Prseident’s Trump’s key advisors, Jared Kushner and Ivanka Trump were vacationing while TrumpCare flopped. I simply can’t fathom key leadership would allow their principle advisors to leave during implementation week. Of course one could speculate Kushner and Ivanka Trump knew TrumpCare was destined to die and said “Screw it babe! Let’s get outta Dodge.” If you’re part of management, you have to be present during both good and bad.
Third failure. Where was Ivanka Trump during TrumpCare’s development. In January, Ivanka Trump professed a wanton desire to push policies benefiting women and girls. Accordingly, she sought the advice of female executives and media stars and the transition team supposedly courted congressional staff on childcare policies. This was an area Ivanka urged President-elect Donald Trump to prioritize. However, did we read of any single contribution from Ms. Trump during TrumpCare’s formation? Did we hear Ms. Trump promoting the positive benefits of TrumpCare for the working poor, single mothers and children? Maybe Ivanka worked behind the scenes. Still, TrumpCare’s key components were never publicly promoted by either Ryan’s team nor the White House.
Fourth failure. Borrowing Stephen Covey’s second principle from “7 Habits of Highly Effective People,” it’s unclear if anyone began with the end in mind. Did they really understand 20+ million could lose health care as end? Accordingly, TrumpCare would have hit millions of Trump supporters the hardest. And who are those supporters? Older people. People in the west, Midwest, and Appalachia. Technically speaking, political projects are supposed to reward supporters and stick it to enemies — not the other way round.
So what’s the end result? What’s our takeaway?
As someone whose worked in healthcare industry for years, health care policy is extremely complicated. Politicians and project managers over simplifying complexities via grandiose vision fail. There’s always a significant gap between solution and implementation. How well the solution positively impacts your customers is dependent upon the planning. TrumpCare suffered from faulty planning.
Maybe America will benefit in the wake TrumpCare’s failure. Sure the ACA is flawed. Like everything, maintenance is critical. Hopefully leaders from all spectrum of health care will come together and add a little Obama, add smidgen of Ryan, a dab of professional ethics, the heart of clinicians everywhere and the will of all constituents and create something beautiful and wonderful.
We must begin with the end in mind.