The Tyranny of the “OR”

The current debate over health care has captured the attention of most of the country and with good reason.  Our congress is preparing to take action that will literally “change the way we do business.”  Now, I am not taking any side in this issue.  I believe we do have problems with health care coverage; however, I’m not sure taking a “throw the baby out with the bath water” approach is a good solution.

Congress is trapped in what Jim Collins (author of ‘Good to Great’) describes in his book, “Built to Last,” as the “Tyranny of the OR.”  Collins defines the “Tyranny of the OR” as “The rational view that cannot easily accept paradox, that cannot live with two seemingly contradictory forces or ideas at the same time.  The “Tyranny of the OR” pushes people to believe that things must be either A OR B, but not both.  It makes proclamations as:

• You can have change OR stability.
• You can be conservative OR bold
• You can high cost OR low quality.”  ["Built to Last", Jim Collins, page 43]

What we are hearing today are statements like:

• You can have a public health option OR not
• You can keep things the way they are OR pay higher taxes
• You can reduce the cost of health care OR maintain a high quality of care.

What Collins suggests, as an alternative, is to embrace the “Genius of the AND.”  This he defines as “the ability to embrace both extremes of a number of dimensions at the same time.  Instead of choosing between A OR B, they figure out a way to have both A AND B.”  ["Built to Last", Jim Collins, page 44]

I have been told that there could be millions of dollars in savings if all insurance companies would require the same information on the same form.  How about, “We can reduce the cost of health care AND maintain a high quality of care IF the government were to require the same information to be provided on one common form.”  Or, “We could have a public option AND keep our existing coverage IF the public option was limited to one full preventative medical examine every two years and a total of $@@@@@ in medical costs annually.”

Too many times companies, organizations, government, and teams get into the “Tyranny of the OR” when they could achieve greater outcomes, with more support if they embraced the “Genius of the AND.”  I am not trying to provide a solution to the health care debate; however, I do think we should approach it with the “Genius of the AND.”