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17 June 2009 • 11:33 am

Talking about Strategy

An excellent predictor of the effectiveness of the change program in any organization is how that organization’s members talk about strategy. Leaders engaging in a change program tend to spend far more energy in developing their strategy than they do in ensuring that the message of strategy is effectively communicated throughout the organization. This isn’t surprising: talking about strategy doesn’t come naturally, but it is essential to the success of the change program.

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11 June 2009 • 6:22 pm

Required Reading in the White House

The New York Times reported this week that a recent New Yorker article on health care spending has become required reading in the White House, and that President Obama referred to the article in a briefing on health care reform with Democratic senators. The article, which is a lengthy but very worthwhile read, was written by Atul Gawande, who is both a staff writer for the New Yorker and general and endocrine surgeon at Brigham and Women’s Hospital in Boston. Along with President Obama, I recommend this article to anyone interested in the likely changes to U.S. health care policy that is on the political horizon.

Gawande’s article follows his curiosity and research into regional disparities in health care spending; why some places spend far more (per Medicare enrollee, an approximation of overall spending) than others, without significant differences in overall public health or patient outcomes. His research focused on the town of McAllen, Texas, “the most expensive town in the most expensive country for health care in the world,” where annual Medicare spending per enrollee (in 2006) was around $15,000, almost twice the national average.

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16 May 2009 • 11:21 am

Numbers, Perception, and Motivation

Reading a post on the excellent political blog fivethirtyeight.com, I was reminded that how we look at numbers really affects how we consider the rationale for a proposed change. Congress is currently considering legislation to provide consumers with vouchers of up to $4,500 to scrap their gas-guzzlers and replace them with more fuel-efficient cars.

Here was an excerpt of the proposal:

Light-Duty Trucks: The old vehicle must get 18 mpg or less. New light trucks or SUVs with mileage of at least 18 mpg are eligible for vouchers. If the mileage of the new truck or SUV is at least 2 mpg higher than the old truck, the voucher will be worth $3,500. If the mileage of the new truck or SUV is at least 5 mpg higher than the old truck, the voucher will be worth $4,500.

Wow. It sounds like a windfall for a very slight improvement in gas mileage. But it may be because we are looking at fuel efficiency backwards. Americans evaluate fuel efficiency different than how those do in most other parts of the world.

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