Change Management and the Health Care bill!


This is not a political post and I am not trying to convince you of my position on the Health Care bill.  There are however, a number of parallels that can be drawn between the strategy, tactics and process that the Obama administration deployed in securing support for the bill and the discipline of Change Management that all of us are familiar with (at least the TMG alumni 🙂 ) as it relates to Strategic Sourcing/Supply Chain Management.

I found this very detailed description of how the bill was passed and while on it’s own it makes for very interesting reading (for those of us who cannot get enough of political theater), it is striking in the way that you could replace the Health Care bill with any large complex Strategic Sourcing category with multiple stakeholders.The similarities are eerie.

Let me give you some examples and see if you agree with the parallels that I see with the Strategic Sourcing/Change Management process.  Feel free to add other parallels that you may see.  The relevant passages are in italics and my comments are in bold.

Sam Stein | HuffPost Reporting

Barack Obama, Campaign Manager: How The 2008 Playbook Passed Health Care

Shortly before 11 a.m. on a Sunday in mid-December, Senate Majority Leader Harry Reid was driving through Washington D.C. when he received a nervous phone call from one of his trusted deputies, Sen. Chuck Schumer.

Schumer wanted to know if Reid had seen Sen. Joseph Lieberman’s comments on “Face the Nation” that morning. “Lieberman (a key Stakeholder) seemed to draw a line in the sand,” the New York Democrat relayed. “You should check in with him. He seemed to rule out supporting the bill if it has the Medicare buy-in.”

Reid immediately called a staffer to get a transcript and find out if Schumer had it right. He did.

“Alright, I’m headed to the Capitol,” the Majority Leader told the aide. “See you in half an hour.”

A nearly year-long effort to shepherd comprehensive health care reform legislation through Congress faced a crucial hurdle. Throughout the past week, Reid and Schumer had worked with a group of ten Democratic Senators (five progressives and five moderates) to craft a compromise proposal in place of the public option — the government-managed insurance plan that had proved too controversial to get past a filibuster. Lieberman had been part of that group. And while in the closing days he had been sending a staffer to negotiations in his place, he had given both Reid and the White House assurances that he’d support an alternative plan that would allow people over 55 to buy into Medicare.

Now, suddenly, Lieberman was announcing on national television that he “would have a hard time voting” for the deal even though he didn’t know exactly what was in it.

Making his way toward the Capitol, Reid phoned White House Chief of Staff Rahm Emanuel to discuss the news. “You need to come up here. We need to talk,” he said. The hyper-energetic Emanuel, who was in a car as well (driving his son home from his bar mitzvah class) told Reid to hold steady for the time being. “I’ll be over to your office soon.”

By noon, Emanuel had arrived at the Capitol, dressed in blue jeans and with a cup of coffee in hand. Sitting in an office close to the Senate chamber, Emanuel, White House legislative adviser Phil Schiliro, as well as Reid and Sen. Max Baucus laid out the options (Schumer would arrive from New York City shortly). They could go back to Sen. Olympia Snowe, the one Republican who had offered support for reform. But that would require a dramatic restructuring of the bill.

“He just wasn’t honest with me,” Reid muttered at one point.

Also en route to the Capitol — at the summoning of Reid — was Lieberman, a Senator who once stood in line to be the party’s vice presidential nominee but now found himself on the outskirts of his own caucus.

The Senate Majority Leader wanted to call Lieberman’s bluff, bring the bill to the floor and force him to vote it down. Dare him to be the one to kill reform, the thinking went.

But before it could happen, Emanuel stepped in. “We need to get it done,” he told Reid, according to multiple sources briefed on the exchange. The end game was clear: the Medicare buy-in or any other iteration of a public plan would not get in the way of legislative progress.

(In the face of adversity, it was clear that Rahm was focusing them back on the end result – the vision. This is a very powerful technique to make sure that while obstacle may be there, we cannot lose sight of the end point – The Vision!)

When Lieberman finally arrived at the office, Emanuel spoke to him just as directly. “Find a way to get to yes,” he said, before insisting that if the objectionable provision was dropped, Lieberman would have to get off the fence.(Getting a stakeholder to state their objection and then forcing them to agree to that as the decision criteria allows you to secure that stakeholder’s commitment  and ensure that the stakeholder cannot then squirm out of the decision. Probably one thing that Harry Reid did not do?)

A deal was reached. Health care reform survived.
* * * * *

Months removed from the debate, aides still recall those tense hours on December 13 as one of the clearer illustrations of how the Obama administration attempted to move health care reform through Congress. Over the course of a year, the president had pursued a lawmaking philosophy that was, at once, hands off and reactive, comprehensive and flexible. It was a tack unique to recent presidents. Whereas Bill Clinton viewed Congress as a house of pawns that needed to be massaged and maneuvered, often against their will, and George W. Bush saw his role as ideological compass around which lawmakers united or revolted, Obama seemingly took a hybrid approach. He provided rules of the road but avoided, at all costs, overbearance. (This is a classical Change Management technique for a sponsor – provide the broad strategic guidelines and let the rest of the stakeholders churn over the details – then come in when they get stuck and move them along)

What exactly the president’s overarching theory of governance was, however, remained largely a mystery. To this day, actually defining the Obama legislative doctrine is a difficult task, in part because different people have different interpretations. Not everyone, in fact, is sure an actual doctrine exists.(This is the beauty and elegance of effective Change Management – the ones impacted don’t know what impacted them!)

But in more than two-dozen interviews with key negotiators, lawmakers, strategists and White House officials, a common theme did emerge. For the President and his key staff — many of whom had been with Obama as he plotted his political trajectory years earlier — the legislative process was derived primarily from the approach they took to electoral politics. The headquarters were different (the West Wing instead of Chicago). And the campaign dealt with a massive piece of domestic policy rather than an actual candidate. But the game-plan came from the same textbook.

“It’s having a long-term strategy and working backwards from that,” explained Communications Director Dan Pfeiffer during an interview in his West Wing office.
(This is again classical Change Management stuff – I think that President Obama must have been through some TMG training in his youth – start with the end goal – the Intended Consequence)

Success would be premised on building blocks. Moving the health care bill through the complicated committee process would be the equivalent of winning the Iowa caucus (necessary, as both were, for at least keeping Obama’s prospects alive). Persuading lawmakers to back the bill throughout 2009 would be like the delicate chase for super delegates in 2008. The final vote, in turn, was Election Day.

The tactics, likewise, were similar. There were core messages designed to appeal to moderates and activists alike (deficit reduction and expanded coverage) (Effective Communication Strategy based on a comprehensive Stakeholder Analysis). There was a clear invocation of this historical nature of the effort. And when presented with a numerical value for success — in this case, 60 votes in the Senate — the president and his team relied more on calculated maneuvering than big sells. Instead of pushing the entire caucus behind health care reform, they worked with individual members based on their relevancy to the process. It was the difference between trying to win every primary election and prioritizing states with strategic delegate yield. (This is again based on identifying key stakeholders, understanding their motivations and then addressing those individually as opposed to trying to win them all over at the same time)

More than any other mindset borrowed from the campaign, however, was the sense that politics is a sport of transactions. Handed a political landscape of broad competing interests, the best way to navigate is to offer a broad but concrete goal and jump hurdles. The only thing not to be compromised is success itself, in part because failure would prove so crippling. (Beautiful….just beautiful!! Just the way it is laid out in theory)

“First and foremost, passing health care defined the ability of us as a country to govern ourselves,” said Neera Tanden, a domestic policy adviser for the White House throughout most of the health care battle. “People forgot that when we face an imminent disaster this country actually could act.”

Over the course of a year, tension-filled negotiations, expletive-laced meetings, and stubborn lawmakers with provincial demands would put this legislative philosophy to a test. But when health care reform was signed into law — with Vice President Joseph Biden underscoring to the president just what “a big fucking deal” (no comment on Joe’s language or whether it was a good bill or not BUT, it clearly was a BFD!!) it was — the close circle of Obama advisers viewed it as a decisive affirmation of their legislative doctrine.

“There were places along the way that people would take a step back and say ‘do we need to revisit our assumptions,'” former Communications Director Anita Dunn told the Huffington Post. “But the overall strategy… has basically been confirmed by events.” (I’m telling ya…they went through some TMG training along the way….check your assumptions but DON’T compromise on the strategy)

Are you interested in learning more about how The Mpower Group uses Change Management to ensure the success of a Strategic Sourcing or Supply Chain initiative?  Drop me a line, I’ll be happy to discuss and send my thoughts on the topic!



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  1. Pingback: Could a Stakeholder Analysis have Saved the World Cup? - News You Can Use

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