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« Nursing Shortages, Retention and Diploma Schools | Main | Come Out of the Closet »

February 21, 2009

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Kim Hollon

John, I could not help but think of the healthcare industry as I contemplated leadership without accountability. We have markets in the country where non-profits place hospitals and services in the backyards of their competitors, clearly increasing over time the cost of healthcare. This is not being done in the name of access, but in the pursuit of profit share at the long term cost to the consumer. The leaders who are successful are often celebrated for their brand expansion and development. Will a time come, when we question who worked to ensure the non-profits thought about the impact on the economy and the community ahead of their needs?

One problem with doing this is that it is difficult to tie our individual actions to the impact that comes from many people taking the same action. I recall an economics story from graduate school, that illustrated this. When we walk across the grass on the way to the quad, we break a few blades of grass, but don't see ourselves as being responsible for the dirt path that is eventually worn in the beautiful park. After the path is there, we have ruined the view for everyone. No one really sees their individual trip across the grass as a potential future problem at the time. I think the notion that everyone else is doing it is only half the problem. The other half is that we don't see the impact nor feel accountable of our decisions out into the future. With lending, we will see increased regulation to control the behavior, now that we are in a meltdown. In healthcare we will eventually see more regulation, but we have not had the political will yet to pass the legislation.

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