Problem solving involves many steps, with each requiring decision-making before proceeding to the next toward ultimately resolving the issue. While each step is important, when problems are complex the most critical is the first because it is among the most difficult. In simple or structured problem situations the issue is quite self-evident, but in complex or unstructured problem situations it is not readily apparent.
The first step in problem solving is to correctly define—that is to identify and delimit—the problem. Failure to do this results in at least confusion about what one is focusing on and at worst a solution that not only ignores the real issue but provides a cover for it, allowing the problem/issue to continue to intensify and expand in its symptomatic effects. Consequently complex problems tend to be recurring problems because they are not structured and well defined.
Hence we see the first step being a misstep with so many of our complex problems, especially our societal problems. Problems of organizational quality, performance and change are quite complex. So too are societal problems of education, crime and healthcare. Consider as illustration the way we’ve defined the problem of healthcare—as we’ve so named it—has caused us to sweep the real issues under the rug leaving us with this monster of a bump in the middle of the room. The bump is problematic but it is not the problem! It would be like lumping automobile design and manufacturing with automobile insurance, with highway design and construction and with driver training and defining/naming it driver safety. Clearly trying to improve this—perhaps as measured by fewer accidents—as if it were one entity would be ill advised and foolish.
In regards to healthcare, each faction (i.e. each special interest group) has its own solution to the bump. As a result the lack of a properly defined problem manifests as disagreement over solutions when the crux of the disagreement is really confusion about the very nature of the bump. So as each faction offers their exact solution for dealing with the bump—which is actually a myriad of problems not yet understood—we are left with ineffective but exact solutions to the ill defined problem.
Imagine if we rolled the rug back to reveal the very nature of this bump we are confusingly calling healthcare. We’d see that we have private medical care & services, we have private insurance for medical services, government insurance for medical services and we have care of one’s health as the major constituents of this bump. This is not one system. Rather these are separate but reciprocally interdependent systems. Thus, if we treat them as one, or as if one is dominant, then we can’t help but to overlook the interdependence and thus fail in our effort to improve the well being of people in society. It should not be surprising, based upon an analysis by Richard Wilkinson and Kate Pickett, that compared to industrialized nations U.S. health expenditure person is among the highest, life expectancy is among the lowest and infant deaths per thousand live births is among the highest.
Each of these systems must be improved toward optimizing their collective functioning—they are, after all, reciprocally interdependent! What we must not do is allow one to dictate their collective functioning—say by maximizing its role or profit gain or by minimizing its internal cost.
So the question is why is there continued effort toward resolving such an ill defined problem? Could it be that those in-charge haven’t a clue about the steps in effective problem solving? Could it be that those advancing their solution will (personally) benefit from the solution they are advocating, especially when the symptoms intensify and expand?