The Art of Fighting the Health Care Crisis

What Bruce Lee can teach us about the President's health care reform plan

Watching President Obama's speech last week on health care, I thought a lot about Bruce Lee.  Okay, that sounds like a non sequitur.  Why should professional fighter Bruce Lee have anything to teach us a complex policy issue?  But that misses the point.

Bruce Lee's ideas - through his martial art and life philosophy Jeet Kune Do - have always applied more broadly than fighting techniques.  He used his empirical experience to develop the most effective mindset to deal and adapt to any new situation involving adversity, uncertainty, and risk, whether or not the situation was an actual fight.  Lee held a degree in philosophy from the University of Washington, and this broader impact of his ideas are most under appreciated, yet have never had more relevance and import than now.

In fact, Bruce Lee's ideas are dedicated to the same goal that our government policy is: finding the most effective and proven techniques.  So in that sense, he can teach us quite a bit.  The question of "what works?" is at the core of Bruce Lee's approach as well as Barack Obama's.  When in his inaugural address the President said "the question isn't whether government is too big or too small, but whether it works,"  he was channelling the same pragmatism as Bruce Lee.

When it comes to health care, however, the similarities end.  Lee recognized the importance of adaptability, individualization, and freedom, values disappointingly underrepresented in the President's health proposals.

Lee rejected "static" patterns and techniques that he saw at the core of the classical martial arts tradition.  He realized that just because a technique might work in one situation did not mean it would work in every situation, and that one must not be bogged down with these questionable roadmaps.  He was a firm believer in adapting one's approach to the unique environment, putting it simply, "the highest technique is no technique."

"The more complicated and restricted the method," Lee wrote, "the less the opportunity for expression of one's original sense of freedom. Though they play an important role in the early stage, techniques should not be too mechanical, complex or restrictive. If we cling blindly to them, we shall eventually become bound by their limitations."

Lee believed that adaptation required openness, and that rigid rules had no place in the dynamic context of fighting.  The consummate philosopher, Lee thought the lesson was universal, arguing a definite path could only guide something "static, fixed, [and] dead", but not "anything that is moving and living."

The President's plan to reform health care is doomed by static approaches - mandated coverage, community pooling, a heavily regulated exchange, and a public option - which only make the problem worse.

The tyranny of static restrictions is already ravaging American health care, as rigid rules and imposing barriers to entry crush aspiring innovators.  In New York City, for example, a doctor named John Muney began offering uninsured New Yorkers unlimited medical care - everything from mammograms to mole removal - for $90 a month and a $10 co-pay.   This great idea was ordered to shut down by the state's insurance regulator, who argued that the good doctor was operating as an insurer without a license.  Amazingly, this is a regulator trying to protect patients and consumers, but it falls victim to the rigidity of its approach.

More often than not, health care innovations are shut down before anyone gets to benefit at all. The FDA's approval process for lifesaving drugs costs billions and takes decades before anyone can be helped.  In many states, new additions to health care facilities - from new hospital wings to entrepreneurial ventures - must first be given a so-called "certificate of need" by an independent board of medical experts.  Of course, these experts also happen to often also be competing doctors in the community, and are keen to squelch new entry into the marketplace.

These static restrictions are hindering health care evolution.   A sculptor "doesn't keep adding clay to his subject," Lee observes, but rather "keeps chiseling away at the inessentials until the truth of its creation is revealed."  Innovation requires discarding what doesn't work in order to find what does.

More options work better than a single public option.  To break through the rigid barriers that restrain health care innovation, adaptive and flexible approaches should be the order of the day.  Policies that empower freedom of choice - such as decoupling the employer-based insurance system, freeing individuals to choose their own health care providers, and allowing providers to freely compete and offer new services - should be encouraged.

There's no reason why specialized insurers could not offer quality services for a unique group of people, as is the case in any other market.  One could imaging young people's insurers, women's insurers, elderly insurers, and insurers for various professions, all offering high quality services for a special market.  Moreover, some people need better dieting or exercise habits, others need preventative check-ups, others need alternative medicine, and others need high-tech procedures.  As Lee believed, personalized approaches are the best teaching methods.

In his speech, the President talked about Geisinger Health Clinic in Pennsylvania, where they've discovered effective best practices, such as evaluating all doctors and nurses based on a patient's whole experience.  Through these practices, Geisinger offers exceptionally high quality and value for patients. Geisinger discovered these best practices by traveling around the country, evaluating procedures, and selecting the most effective techniques for their own use.

In his speech, the President seemed to imply that his public option would be able to do the same thing.  The crux of his health care initiatives involve finding these effective methods and universalizing them.

But Geisinger's CEO argues that public policy can't find a magic "formula or template for all of the reform."  A public option can never emulate Geisinger or any other high achievers, because it will always be a slave to its static limitations.  We must allow free entry of the aspiring innovators trying to be next Geisinger.  Trial-and-error always works better than command-and-control.

President Obama's ambitious attempt to remake American health care is flawed in its static rule-making approach.  The solution to health care requires freedom and openness, not bureaucracy and more rules.  In the end, the best advice for the President comes from the most famous Bruce Lee quote of all:

"Be like water making its way through cracks. Do not be assertive, but adjust to the object, and you shall find a way round or through it.  If nothing within you stays rigid, outward things will disclose themselves.  Empty your mind; be formless... Be water, my friend."