Universal Health Care Confronts the Nuclear Option

The Nuclear Option (just for those of you who are stilled mired in Bush-speak, it is pronounced “new-klee-ur” not “new-cue-lar”).  In this case I’m not talking about the U.S. Senate rule called “reconciliation.”

No, in this case I’m wondering what is going on in the minds of those who have so adamantly and vociferously have opposed Universal Health Care in the United States.  Yesterday, Paul Krugman New York Times columnist, wrote in his blog,

Yes, we can

Get more or less universal coverage, that is. The CBO scoring on an incomplete bill sent everyone into a tizzy — and also led to an avalanche of bad reporting, with claims that it said terrible things about the public option. (There was no public option in the bill.)

Now the real thing has been scored — and it’s OK. Something like 97 percent coverage for people already here, at a total cost somewhere in the $1 trillion range. Bear in mind that the Bush tax cuts cost around $1.8 trillion over a decade. We can do this — and have no excuse for not doing it.

In the minds of the opponents of UHC, however, nothing has changed.  That’s what worries me.  In fact, as the evidence mounts that assuring every American has access to health care can be a reality and not doom the economy (as they have so desperately hoped), the opponents are realizing the End-Game is upon them.  They are losing.  Not only has every traditional method of obstruction not worked, or not worked well, the vast majority of Americans are solidly against them.  Heard any good anti-health care spin from Rush, Karl, John Boehner, or Mitch McConnell in the past couple of weeks?  If they were gaining ground with their argument, neither the election in Iran or Michael Jackson’s death could drown them out.  Not even South Carolina Governor Sanford’s adventures in Wonderland would diminish their clarion call for Big Medicine.

Their voices have faded to background static.

Do not assume for a micro-second they have given up.  They are preparing the Nuclear Option.  One all-out attack on universal health care, with no regard for collateral damage, just the health of America.  In the Board Rooms of the Insurance Megacorps, Big Pharma, Corporate Hospitals, and dozens of other stakeholders firmly anchored in the Status Quo, they are planning to bring this down.  Once and for all, to obliterate the very notion of universal health care so completely, that  it will never threaten their companies and profits again.

Am I paranoid?  Well, even if you are not paranoid doesn’t mean they’re not out to get you anyway.

I’m not paranoid, actually.  I’m well read in organizational theory (it was the corner stone of my doctoral dissertation in educational policy and management), and I understand how organizations respond in unstable ecologies and economic turbulence.  When resources are threatened, the people running the organization will tend to react in predictable ways.  When the operational environment changes more quickly than expected, or in ways unanticipated, the predictable management responses are more and more stressed.  If those responses lack the ability to guide the organization through transformational change (like, oh, General Motors), the likelihood of the company failing is very high.

Keeping all that in mind, when the entire global environment, e.g., the country’s health care system, begins to collapse because of a rapid set of ecological changes so powerful the only way to survive is to change transformatively (an analog of the evolutionary concept of “punctuated equilibrium”), only those institutions that have the capacity to change at the same rate and direction required for survival will likely survive.

How, then, does the Nuclear Option fit in this model?  Organizations use their resources to influence and improve their ability to survive in the existing ecological conditions, and eliminate competition for both the resources they need to exist and to improve their chances for greater access to those resources.  But here’s the rub: Organizations are “communities of fate.”  They are actually aggregates of individuals whose investment (personally and professionally) in the success of the organization varies from person to person.  In a corporation, those who have have highest investment are typically the Board of Directors and the Shareholders.  But they have to rely on managers and workers, to both produce and protect their investment.

The managers and workers have a much different perspective on the degree to which they consider the company their community of fate.  When the organization encounters increasing turbulence in its environment, the willingness of the people actually doing the work to cast their fate to ensure its success is much less certain.  If the situation worsens to the degree the survival of the company is in question, the confidence the managers and workers have in the Board’s decision making ability to, specifically save their jobs, can change very quickly.  Some workers will leave the company and look for more stable employment.  Others will stick with it until the bitter end, if it comes to that.  But if you work for an Enron, the house of cards can collapse on top of you regardless of your loyalty.

The pressure on the Board and the managers to keep the organization both alive and solvent can increase rapidly, especially in the situation where the environment and resources are changing at a rate unprecedented in history.  Even organizations that survived earlier transformational evolutionary changes may not survive the current one.  Because of the anxiety generated by the environmental turbulence, the shareholders put more pressure on the Board and managers to preserve their investment and continue to pay dividends.  The workers who are loyal to the company also put pressure on their supervisors to help preserve their jobs.  But loyalty to the community of fate by the worker is always much riskier, because the Board and the managers can, at  any time, cut positions that can eliminate the most loyal employees under the stated intent of protecting the viability of the organization by reducing personnel costs.  This trauma to the community of fate, however, is no guarantee the organization will survive the changing ecology.  It may, instead, guarantee its demise.

Now, here’s the part, as I build the case for the Nuclear Option, that I as an organizational theorist suggest sets the stage:  The critical decisions of the Board over time to adjust to the turbulence is a not a function of taking the most conservative stance in context, but is a function of the individual members of the Board and the Executive Managements’ ability to manage their anxiety in the midst of the turbulence, and at the same time abandon the mimetic* solutions traditionally used to control that anxiety across the organizational or industrial environment.  [*mimesis: from “mime.”  A concept in organizational ecology that says Company A will observe Company B, and adopt a successful process to “avoid reinventing the wheel.”  Over time this mimed process may become an industry standard.  The down side is that when the environment changes, continuing to adopt the mimed process may limit innovation and increase the chances of organizational failure.]

Therefore, if the individuals on the Board and the Executive Management fail to manage their anxiety about the turbulence and the implications of transformative change in motion, and as they realize their historical resources for influence (i.e., lobbying) are waning, they will tend to take the most conservative stance to defend the survival of the organization, and that stance will tend to be to preserve the status quo at all cost.  As organizational rigidity increases, adaptibility and innovation are stifled.

The door for the Nuclear Option is now open.  Why?  Because the real-life environment to which we are applying my theory is not  just one company; we are applying it to a multifaceted industry that has for decades successfully resisted and obstructed the move toward universal health care.  And they know that by conspiring together and pooling their resources, they can potentially create a huge wall of resistance.  This strategy has a flaw, however.  A significant percentage of companies in the industry are supportive of UHC, and are already changing the practice of their organizations to successfully ride the transformative wave.  This fact only serves to increase the opponents’ anxiety.  Who has the most to lose?

The portion of the industry that opposes UHC has powerful political and social connections.  The Republican Party, although reduced in its influence at the last election still has significant resources at its disposal, as well as a core of voters, who for numerous reasons at least state they don’t want to pay for UHC.

This set of circumstances, powered by huge finances, politics, ideology, and desperation creates the possibility that those who have the most to lose as they perceive it are going to try and “drop the bomb” on the universal health care.  Whether they make their move before the Congress acts, or, have a strategy to destroy it even after it has been signed into law, I can’t tell.  But I believe they are well into their planning and will indeed act.

A final note.  Another principle, not from organizational theory, but from psychohistory, is also undoubtedly in play in this situation.  Speaking not literally, but figuratively:  “Violence is the final refuge of the incompetent.”

Fiat and Chrysler Merge??!! Will NASCAR run the Mille Miglia?

Header Photo: 1960 Fiat 1100B.  Notice the “suicide” front door handles.
One May Love Beer and the Other Wine, But, Oh, Do They Love Their Automobiles!

Americans May Love Beer and the Italians Wine, But, Oh, Do We Love Our Automobiles!

Holy MOPAR, Batman!  Fix It Again Tony!  If I had been asked to guess which international automaker the Obama administration would instruct Chrysler to join forces with to survive, perhaps to one day again be profitable, I wouldn’t have guessed the legendary Italian carmaker, FIAT (I use caps here, because, it originally was an acronym of  Fabbrica Italiana Automobili Torino: Italian Automobile Factory of Turin).  Fiat has been around for a long time, being founded in 1899.  Fiat has been always been known for its small cars, even though it does have a major truck division, along with with major farm implements, etc., etc.

Over the years, Fiat has produced some fine cars of note, even if they were only known in Europe.  They withdrew from the American market in 1983.  Between 1967 and 2008, Fiat was awarded European Car of the Year thirteen times.

Of those cars, I find the 2006 Alfa Romeo (Fiat’s sport division) very attractive.  Small, but well styled:

Alfa Romea 156 Selespeed, 2006 European Car of the Year

Alfa Romea 156 Selespeed, 2006 European Car of the Year

Once word of a Chrysler/Fiat merger hit the international media, this announcement, of course, or should we say thank the Stig, did not escape the notice of the guys at Top Gear:

With operations throughout Europe, Asia, Africa and South America, Fiat has vast resources and small car expertise. The Fiat 500 is one of the hottest cars in Europe, winning European Car of the Year for 2008, and the company wants to bring the car to our shores; initial reports indicate that Fiat plans to retool existing American Chrysler plants and sell it here. We say “non vediamo l’ora” and bring us the Abarth!

Fiat 500 Abarth 2008

Fiat 500 Abarth 2008

The Abarth is a performance model of Fiat 500. The 1.4L engine with IHI RHF3-P turbocharger is rated 135 PS (133 hp/99 kW) at 5500 rpm and 180 N·m (133 lb·ft) (206 N·m (152 lb·ft) in sport mode) torque at 3000 rpm. It includes 5-speed C510 transmission, low ride suspension, dualdrive electric power steering with SPORT setting, 6.5 x 16” aluminium alloy rim with 195/45 R16 tyres, 4-wheel disc brakes (front ventilated). Interior includes turbo pressure gauge, Gear Shift Indicator, aluminium foot pedals, Blue&Me MAP with Telemetry monitoring and GPS system.  Source: Wikipedia

Okay, I look forward as much as the next gear-head to the Stig (some say that he secretly keeps a ’70 Plymouth Superbird under a tarp in his garage and that he made Jeremy promise to never call it “rubbish.”) blasting around the Top Gear track in a hot set of wheels with a Five-Point star stamped into the valve covers of it’s 5-Litre motor putting out 600 brake horsepower getting 35 miles per gallon.  Let’s just hope it does not, and I mean DOES NOT look like the Fiat 500 Abarth.

Now, it’s disclosure time.  I owned a Fiat.  Yep, Lorette and I bought a brand-spankin’ new 1979 Fiat 131 Brava while we lived in Fort Worth, Texas, my last year in seminary.  Two liter, twin overhead cam engine, five speed, and a snappy clutch.  I loved that car, especially because it replaced a 1974 Ford Pinto station wagon with “country squire” fake wood vinyl siding.  When you shifted from fifth to third, and put your foot in it, something actually happened “accelerationwise” with that pretty Fiat exhaust putter that sang all the way up to the redline.

Fiat Brava 1979 Ad

Fiat Brava 1979 Ad

The ad above was a cleverly disguised code that only the likes of Ralph Nader and Joan Claybrook believed during the dark years of the 55 MPH national speed limit.  Relaxed?  In third gear, the engine wasn’t even breathing hard when it blasted through 55.  Fourth redlined something over 80.  Relaxed, my….

Yeah, baby.  Here’s what my Brava looked like, with the “champaign” paint job:

Fiat Brava 4D 1980

Fiat Brava 4D 1980

The only difference I can discern, between my ’79 and this 1980, is the wheels.  If I actually can dig out a picture of my Brava, I’ll replace this one.  It’ll be like old times.  Replacing part after part after part, like the time the distributor cap cracked in Tillamook, Oregon on a trip with several other ministers to check out a site for a church camp.  On a Friday afternoon…but that’s another story.

Anyway, in the real world, only time will tell if this is a match made in heaven or if our esteemed colleagues in the White House should have chosen BMW, Audi, or even, believe it or not, Hyundai.  I’d love to see Chrysler survive (not to diss Ford or Toyota, by any means).  I just hate to have to watch those snooty Chevy commercials every time one of their cars wins a NASCAR race.

By the way, 30 years later I still like cars with names that are acronyms:

Vorsprung durch Teknik  audi-rings-wet-copy