Small Wins and Health Care Reform

Karl Weick, author of "Small Wins: Redefining the Scale of Social Problems," an article that appeared in the January 1984 edition of American Psychologist, wrote:

"The massive scale on which social problems are conceived often precludes innovative action because the limits of bounded rationality are exceeded...People often define social problems in ways that overwhelm their ability to do anything about them."

In order to solve social problems, Weick argues that we define them as a series of smaller problems that can then be affected by small wins. He refers to small wins as a "series of concrete, complete outcomes of moderate importance [that] build a pattern that attracts allies and deters opponents."

Whenever I teach leadership to college students, especially those in fraternities or sororities, I introduce Weick's concepts and they are almost universally accepted. It makes sense to take a huge problem and break it down into manageable chunks.

And now, our nation is having a fevered debate on reforming health care and health insurance. Can Weick's ideas apply? From my view, they explain everything.

The President and congressional Democrats have been struggling in recent weeks, largely because the solution that has been proposed shows up as a 1000-page bill that tries to do everything at once. The problem is daunting, and the proposed solution has become equally so. If people cannot get a firm grasp of the problem and an even firmer grasp of the proposed solutions, they are much less likely to support the leader's proposals.

I am not a health-care expert, or a politician, but I wonder if the reform measures that are being lumped all together in once giant piece of legislation had instead been approached one step at a time, would this debate be different? What if congress first passed tort reform, then lifted the ban that disallows individuals from buying insurance out-of-state, then develop nonprofit co-0ps that strive to provide a low-cost alternative, and so on. Each step along the way, the effects on cost and coverage are evaluated. We can then see the plans work in pieces (or not work) and subsequently make better, more informed, decisions.

Perhaps health care reform is the latest example of what can happen when we ignore the power of small wins.