The Clinton Plan and Change Fatigue

In all initiatives for change, it is bound to reach a stage where the change stalls, regardless of whether the change has focus on comprehensive organizational change or the proposed change has a specific purpose. At this stage or point, the will of the leaders begin to wilt and the workers start to switch off. As a result, proper understanding of how and when to initiate mid-course adjustment by the drivers of change would give the change initiative a new lease of life, as Beaudan (2006) remarked. Clinton’s Proposed Reforms in Health Care;

In the early 1990s, health care reformers in the U. S strongly believed that conditions for health care reforms were ripe in the country. This was due to the high-and-still-soaring cost of health care as well as the continued growth of population with no health insurance in the country, a situation which led to massive public dissatisfaction with the health care system in the country. With Democratic majorities in both House of Representatives and the Senate, President Bill Clinton took office in 1993, and the nation was poised to unavoidably implement health care reform (Oberlander, 2007).

The Clinton Plan sought to build on as well as transform the nation’s mixed private-public health care system. The plan called for a system of universal coverage, and in which all employers were to contribute to the insurance premium costs of their employees. Multiple private insurance plans were to compete for Americans’ enrolment, with the expectation that the health care market would further shift in the direction of managed care. The government would then regulate insurance practices on strict terms through the regional purchase pools, for instance by prohibiting cherry picking and ensuring community rating.

A ceiling would also be put in place to check the growth of premiums of health care insurance in order to achieve cost control (Oberlander, 2007). However, just one year after the introduction in Congress, The Clinton Plan was effectively dead. What went wrong with the reforms? Beaudan (2009) terms change as a difficult business. For the case of failure of The Clinton Plan, it was not the traditional causes of failure of change as noted by Hay (2006) (e. g. unclear communications, insufficient resources, lack of a burning platform, and/or executive support that is half-hearted) that were the cause.

As a matter of fact, the plan was very popular in the public domain in addition to attracting majority backing in congress-since it was envisioned as a synthesis of conservative means (it managed competition among insures) and liberal ends (advocated for universal coverage). Further, the plan had a wide political appeal among the American public since it was built on employer-sponsored insurance system that was familiar, left Medicare intact, retained private insurance, avoided new broad taxes, and promised to bring both health security as well as choice.

What happened, according to Beaudan (2009), is that, just like in any other processes that an initiative of change is introduced, paralysis or “change fatigue” set in. Symptoms of change fatigue observed; After one year of implementation of The Clinton Plan, The National Federation of Independent Businesses came out and briskly fought against the mandate on employers (Oberlander, 2007). The plan also continued to reel under immense pressure as The Health Insurance Association of America strongly opposed cost controls imposed by the federal government as well as the regulation of health insurance.

Congressional Republicans aggravated the situation by denouncing the plan in its entirety as “too much government”. Moreover, middle-class Americans who are usually well-insured became alienated by the federal government’s embrace of delivery-system change as well as its embrace of managed health care insurance competition. They as a result lost their confidence in the plans’ promise to make their health security more secure, as Oberlander (2007) observed. Getting Change Back on the right Track;

Once one realizes that their initiative for change has stalled, or is about to, there are strategies they can use to get the change initiative back on the right course. There is no a cure-all though, but four strategies have been found key to sustaining change over time. The following critical questions have to be asked in the first place; Beaudan’s critical questions that should have been asked at the mid-course phase; 1. Resistance: “Who is opposing the change and why? ”

The Clinton administration would have been able to identify the major sources of opposition to the plan as the Republicans, Middle-class Americans, The employers’ umbrella body as well as the insurance companies 2. Focus: “Which other initiatives or priorities are diverting our attention from completing this change? ” At the time, the Clinton administration was distracted by domestic political scandal as well as foreign-policy crises. 3. Energy: “How can we renew people’s enthusiasm for change? ”

The enthusiasm that Americans had shown towards the health care reforms in its initial stage could have been revived through renewed and more energetic campaigns to sell the expected benefits the plan would have brought. 4. Casualties: “What are the unexpected side effects the change caused? How can we acknowledge and minimize these? ” The major unexpected change that the reforms caused was a unified, strong resistance from the main stakeholders who initially supported the reforms. 5. Speed of Change: “How can we safely accelerate the change process?

” The plan sought to introduce very many changes to the health care system (controlling insurance costs, regulating insurance companies, and introducing universal coverage), all at a go, which was unrealistic. 6. Sustainability: “How can we make sure the changes we’re introducing will become institutionalized? ” Acceptance of the initiated reforms by all major stakeholders is the most critical aspect of ensuring institutionalization of the changes (Hay, 2006). Strategies for Getting Change Back on the Right Path;

I would take the following actions in order to get change in the right course; a). Rethink change goals and expectations; The Clinton Plan had many goals which made it too ambitious. I would concentrate on one plan at least in the near-term, and may be come to think of pushing for the other goals later. My preferred starting goal would be introducing universal health care cover. b). Change the speed of implementing reforms; A slower pace would be adapted, as it helps to keep all stakeholders on board as well as give them enough time to adjust to the new changes (Worley and Lawler, 2006).

I would also take some time to evaluate the progress of the reforms in order to determine which health care policy is working and which is not. c). Add Excitement; I would carry out more rigorous campaigns to drum up the expected benefits that the health care reforms would bring. I would seek to actively engage in public debates with the opponents of the plan and hope to prove them wrong. Conclusions: Leaders need to know that the early change podium they build is valid for a short time only.

They need to preserve their energy to tackle the challenging issues that are bound to arise from both submissive resistance and the impulsive side effects that are created by change itself (Worley and Lawler, 2006). In addition, effective change leaders have to recognize the indications of change fatigue and avoid reclining into a terminal stall once the early support as well as enthusiasm for change start to fade. Importantly, leadership that is visible serves as the fairy dust that sustains change for the long-term. REFERENCES: Beaudan, E. (2006, January/February). Making change last: How to get beyond change fatigue [Electronic version].

Ivey Business Journal. Retrieved August 11, 2010, from http://proquest. umi. com/pqdweb? index=14&did=983077891&SrchMode=1&sid=4&Fmt=6&VInst=PROD&VType=PQD&RQT=309&VName=PQD&TS=1218579717&clientId=29440 Hay, G. W. (2006). New partners for strategic change and organizational transformation: The combined effects of market research and organization development [Electronic version]. Organization Development Journal, 24(4), 55-61. Retrieved August 11, 2010, from http://proquest. umi. com/pqdweb? index=15&did=1173416691&SrchMode=1&sid=4&Fmt=6&VInst=PROD&VType=PQD&RQT=309&VName=PQD&TS=1218579717&clientId=29440

Oberlander, J. (October 25, 2007). Learning from failure in health care reform [Electronic Version]. The New England Journal of Medicine. Retrieved August 11, 2010, from http://www. nejm. org/doi/pdf/10. 1056/NEJMp078201 Worley, C. G. & Lawler, E. E. (2006). Designing organizations that are built to change [Electronic version]. MIT Sloan Management Review. Retrieved August 11, 2010, from http://proquest. umi. com/pqdweb? index=11&did=1145080661&SrchMode=1&sid=4&Fmt=6&VInst=PROD&VType=PQD&RQT=309&VName=PQD&TS=1218579717&clientId=29440

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