Path dependent reform

The New Yorker has a fantastic article about the history of universal health coverage across the world.

Set in the context of Obama's health reform bill, of course, it makes the excellent point that where we have come from determines where we can go next:

Every industrialized nation in the world except the United States has a national system that guarantees affordable health care for all its citizens. Nearly all have been popular and successful. But each has taken a drastically different form, and the reason has rarely been ideology. Rather, each country has built on its own history, however imperfect, unusual, and untidy.

Social scientists have a name for this pattern of evolution based on past experience. They call it "path-dependence" ... With path-dependent processes, the outcome is unpredictable at the start. Small, often random events early in the process are “remembered,” continuing to have influence later. And, as you go along, the range of future possibilities gets narrower. It becomes more and more unlikely that you can simply shift from one path to another, even if you are locked in on a path that has a lower payoff than an alternate one.

This is something that all Knowledge Managers (hell, all Managers of any stripe) would do well to remember. The way to successfully implement a change is to identify the path worn by the past, and to harness this rather than fighting against it.

Revolutionary changes can and do happen, of course. But the results of a revolution are almost impossible to predict. So remember, if you opt for the revolution: the results may not match your expectations.

(Hat tip to Matt Moore for the article.)

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Kaye Vivian (not verified) — Tue, 19/01/2010 - 10:44

Stephen, I second your praise. It's a great article. I highly recommend that everyone wanting a clear and meaningful explanation of global context, and even just some of the basic (non-political) issues involved in defining the right path for the US, read this article. Maybe a revolution is not needed at all. Four paths seems to be a wacky-but-perfectly-sane approach to me...

Kaye Vivian

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