The Thomas Harris best seller I’m OK, You’re OK: A Practical Guide to Transaction Analysis (Harper, 1969) sold 15 million copies in the 1970s and was on the New York Times Best Seller list for 70 weeks. Its premise is simple: When organizations or individuals negotiate, both must come away as winners. And to achieve that, each party must have a positive regard for the other.
It’s a particularly relevant theme in the economy today as global opportunities and the advantages of bigger scale drive consolidation in almost every industry.
And in organizations, it’s just as relevant as leaders restructure their organizations to facilitate the new direction they wish to pursue.
But in the health care industry, “I’m OK, You’re OK” positioning is foreign to its key players. Each seems prone to think the other subordinate or of lesser value. More commonly, “I’m OK, You’re NOT OK” is the starting point in discussions. And for the main players, their positions are firmly entrenched:
- Physicians seem to believe patients are incapable of making decisions on their own, regulators overbearing, hospitals theirs to run, and health insurers void of clinical aptitude adding administrative costs but no value.
- Health insurance plans seem to view hospitals as inefficient and wasteful, physicians incapable of managing money, and the system woefully flawed needing their expertise and competence more than others.
- Drug and medical device manufacturers seem to view doctors as customers, regulators as barriers to market entry, and all others unwelcome guests in their transactions.
- And hospitals may feel like they’re ok, but others may feel in better shape to survive. After all, no other sector is required by law to accept everyone without regard for their ability to pay! And no other sector is on the frontline of running a capital-intense, labor-intense business wherein state and federal laws are extremely complex.
This presumptive suspicion about the roles of other players in the health care industry is central to understanding the formidable task of reforming the health care industry amidst such feelings. Simply put, it is an industry where “I’m OK, you’re NOT OK” is standard operating procedure, and reasonably a root cause for some of its lack of coordination, efficiency, transparency, and sub-optimal effectiveness. Many business leaders understand the need to find common ground: Health care leaders are prone to think otherwise.
So in coming months, as the impact of the Patient Protection and Affordable Care Act plays out, and as the industry’s value proposition comes under more intense stress due to costs, it is incumbent upon business and community leaders to develop relationships with the health care industry leaders with the expectation that the rule of order should be “I’m OK, You’re OK.” Otherwise, the health care system will likely become mired in its own dysfunctionality even further.