The Long Term View – Systems Thinking and Beyond

CDG -> IAD

At the user end of a systemic failure

Waking at 4:30 a.m. from the effects of jet-lag this morning, I tackled some admin work which led me to this unexpected result – a little systems story to frame my passion around what I teach in workshops: communication and systems thinking.

I am an independent contractor with my own business. I HAVE to buy ‘Affordable’ Health Care Act insurance.   I am required also to report address changes  – but not directly to the insurance company – no.  I found that was not possible. I had to report via the healthcare.gov website, and had anticipated it would be a quick ‘address change’.  A day before my departure for a trip to Europe, I embarked on this fascinating address change journey.   What I discovered to my shock and horror was that I was going to be REQUIRED to change health plans mid-year.  Why?  Because apparently the high end plan I had bought at my old address 10 miles south would NOT be available at my new address.  Why? No one could say initially – the guy on the end of the phone line at the old health plan put me on hold to go do some research. He found that only a small carved out geographic area near my old home had access to that plan.   My head started spinning. I had JUST reached my deductible for the year, meaning higher per visit coverage (less out-of-pocket expense) for the rest of the year.  Wait!!! Change plans?  Yes: Return to Go.   Start over.  From scratch.  Sadly, what’s available at the new address are plans with much higher deductibles. So, I am back to square one.  At least I live in a geographic area that HAS plans, I suppose. I see the silver lining, yet muse about how broken the system is. I feel momentarily powerless.

Just now back from my trip abroad and tackling the admin work early this morning, I look for any sign of mail that has my new health plan ID cards. None.  Searching emails. Ok, here it is in Junk mail.  Click on links – ah – yes, I will create a new account.  And then Wham!  I am stuck with an incredible FLAW in the registration process.  No matter what I put into the field for username I get the same error.   I can’t register for an account.  The system says: if you can’t register, ‘just’ call.   Well, it is too early for that.  I pause the task at hand and start writing in frustration.
This is a different sort of systems issue.  Surely I can’t be the first one to report this… Yet, Aetna has taken no action.

My part in fixing the larger mess

I can imagine that both the policy flaw that was surfaced by my address change, and the error in my registration – although vastly different in their origination – might have been avoided with good systems thinking and communication. These are precedents and prerequisites for agile success.

We no longer need problem solvers who only see their accomplishments as  check marks on the issue directly  ahead of them. We need workers who can question everything and say no with integrity and congruence when pressured unreasonably to deliver crappy policies, regulations, and software .  We need to create safe environments where people can speak up their truths without fear.  We need folks who can see both the details and the big picture, work collaboratively and creatively to solve immediate problems with a long term view.

Organizations are under pressure to rapidly create new systems (policies, programs, applications, websites), and to learn rapidly changing technologies, so they sometimes neglect to understand that the starting point of failure is a lack of systems thinking and excellence in communication.

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