Malnutrition In Vietnam: The Solution to the Healthcare Cost ProblemBack to the Blog »

February 17th, 2010

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In my last post I laid out the 3 key deliverables that we believe every customer wants from their health benefits plan:

• Costs that are 20% or more lower than they are today;
• Annual increases that are less than 5% and more like CPI; and
• Employee satisfaction rates that are 90% or better…

We have a lot of really smart, creative and dedicated folks in our operation trying to uncover a sustainable solution that delivers these results consistently and systemically for our customers.  But while we poke and prod and look for the optimal recipe, we can look to some unlikely sources for inspitration and creativity.

In the most recent edition of Fast Company magazine, there is  fascinating excerpt with some inspiring lessons for all of us searching to solve the unsolvable healthcare cost problem.  In Switch: How to Change Things When Change Is Hard, authors Dan and Chip Heath tell the story of Jerry Sternin and his trip to Vietnam for his employer, Save the Children.  Sternim’s job was pretty straightforward; to find a cure for the malnutrition facing kids in rural Vietnam.

The conventional wisdom was that malnutrition was the result of an intertwined set of problems: Sanitation was poor. Poverty was nearly universal. Clean water was not readily available. The rural people tended to be ignorant about nutrition.

That analysis was, in Sternin’s judgment, TBU — true but useless. “Millions of kids can’t wait for those issues to be addressed,” he said. If addressing malnutrition required ending poverty and purifying water and building sanitation systems, then it would never happen. Especially in six months, with virtually no money to spend.

When we analyze a big, complicated problem — like malnutrition in Vietnam, or a married couple nearing divorce, or a business on the verge of bankruptcy — we seek a solution that befits the scale of the problem. If the problem is a round hole with a 24-inch diameter, our brains will go looking for a 24-inch peg to fill it. So, naturally, the experts on malnutrition in Vietnam wanted to talk about poverty and education and sanitation systems…

But in times of change, this mind-set will backfire….

When it’s time to change, we must look for bright spots — the first signs that things are working, the first precious As and Bs on our report card. We need to ask ourselves a question that sounds simple but is, in fact, deeply unnatural: What’s working and how can we do more of it?

…Sternin’s strategy was to search the community for bright spots. If some kids were healthy despite their disadvantages, then that meant something important: Malnourishment was not inevitable. The mere existence of healthy kids provided hope for a practical, short-term solution. Sternin knew he couldn’t fix the thorny root causes. But if a handful of kids were staying healthy against the odds, why couldn’t every kid be healthy?

To understand what the bright spots were doing differently, the mothers first had to understand the typical eating behaviors in the community. So they talked to dozens of people — other mothers, fathers, older brothers and sisters, grandparents — and discovered that the norms were pretty clear: Kids ate twice a day along with the rest of their families, and they ate food that was deemed appropriate for children — soft, pure foods like the highest-quality rice.

Armed with that understanding, the mothers then observed the homes of the bright-spot kids, and, alert for any deviations, they noticed some unexpected habits. For one thing, bright-spot moms were feeding their kids four meals a day (using the same amount of food as other moms but spreading it across four servings rather than two). The larger twice-a-day meals eaten by most families turned out to be a mistake for children, because their malnourished stomachs couldn’t process that much food at one time.

It’s an absolutely fascinating article, and I can’t wait to read the rest of the book-I just downloaded it to my brand spanking new Kindle to read on my vacation!!!

But as the President and Congress has shown over the last year, it is nearly impossible to solve the healthcare cost problem with a single, comprehensive solution…But we must tackle the problem nonetheless, and I for one am anxious to apply the lessons of Jerry Sternim ASAP!

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Posted by Bill in Health & Wellness