Last week, I found myself sitting in a fancy boardroom in midtown Manhattan. A group of about twenty well-dressed white men and two women were meeting with me to discuss matters of corporate strategy, for the nonprofit healthcare system I am consulting with.
As we talked through anticipated state budget cuts to Medicaid and the difficulty of serving that program, I gazed out the window from time to time. Thirty-five stories below us, we could find the people who would be impacted by these decisions. Sure, this was only one nonprofit healthcare system among many. But collectively, we represented the decision makers, and others had to live by our decisions. There was no Medicaid recipient who would speak up for the program; there was no elderly person living in one of the organization's nursing homes would lend their perspective; there was no person from a homeless shelter who could say what they needed, what would help their situation most.
It was seven o'clock in the evening, and we were sipping sparkling water and nibbling on canapes and chicken skewers. The people who this nonprofit healthcare organization served - or could potentially serve - were certainly not having an experience like this. And little were they aware that we were discussing the future of their care.
In nonprofit healthcare organizations, it is typical to have a board composed of professionals who are donors or otherwise well-connected in their industries. They are usually non-experts in healthcare, but are charged with making decisions about what lines of business are served - in other words, who gets care or doesn't get care delivered by the organization in question. And in this case, the board for this particular nonprofit was grappling with financial insecurity - what consultants like to call a "burning platform." It was not sustainable to continue on the path that the organization was on; too much money was being lost due to state reimbursement cuts to Medicaid.
So what resources were needed to do the right thing and to continue to serve the Medicaid population?
As we discussed this issue, one of the board members surprised me by quoting an academic named Edward Tufte:
Yes, I thought, exactly! Everyone here around this table, right now, has the resources to support being ethical, responsible, and kind-hearted. Yet the implication that this well-heeled lawyer was drawing was the exact opposite. He was implying that the nonprofit healthcare organization did not have the current resources to serve these needy populations, and we had to shore up those resources first and get on sound financial footing before we could pursue that goal.
And what are the resources required for us to pursue the right thing on a personal level? Do we need to have more before we can act? If we always think we need more in order to do the right thing, where does that leave us?
Individually and collectively, we must do more for each other. We must think that we have the current resources to support acting in grace and kindness. Otherwise we'll never get there.
As we talked through anticipated state budget cuts to Medicaid and the difficulty of serving that program, I gazed out the window from time to time. Thirty-five stories below us, we could find the people who would be impacted by these decisions. Sure, this was only one nonprofit healthcare system among many. But collectively, we represented the decision makers, and others had to live by our decisions. There was no Medicaid recipient who would speak up for the program; there was no elderly person living in one of the organization's nursing homes would lend their perspective; there was no person from a homeless shelter who could say what they needed, what would help their situation most.
It was seven o'clock in the evening, and we were sipping sparkling water and nibbling on canapes and chicken skewers. The people who this nonprofit healthcare organization served - or could potentially serve - were certainly not having an experience like this. And little were they aware that we were discussing the future of their care.
In nonprofit healthcare organizations, it is typical to have a board composed of professionals who are donors or otherwise well-connected in their industries. They are usually non-experts in healthcare, but are charged with making decisions about what lines of business are served - in other words, who gets care or doesn't get care delivered by the organization in question. And in this case, the board for this particular nonprofit was grappling with financial insecurity - what consultants like to call a "burning platform." It was not sustainable to continue on the path that the organization was on; too much money was being lost due to state reimbursement cuts to Medicaid.
So what resources were needed to do the right thing and to continue to serve the Medicaid population?
As we discussed this issue, one of the board members surprised me by quoting an academic named Edward Tufte:
It is straightforward for me to be ethical, responsible, and kind-hearted because I have the resources to support that.I was blown away by the implications of this statement.
Yes, I thought, exactly! Everyone here around this table, right now, has the resources to support being ethical, responsible, and kind-hearted. Yet the implication that this well-heeled lawyer was drawing was the exact opposite. He was implying that the nonprofit healthcare organization did not have the current resources to serve these needy populations, and we had to shore up those resources first and get on sound financial footing before we could pursue that goal.
And what are the resources required for us to pursue the right thing on a personal level? Do we need to have more before we can act? If we always think we need more in order to do the right thing, where does that leave us?
Individually and collectively, we must do more for each other. We must think that we have the current resources to support acting in grace and kindness. Otherwise we'll never get there.
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