Daniel Henninger, the author of the Wonder Land column in the WSJ, wrote today (10-29-2009) about “Obama and the Old Hat People.” Today’s column is about the current health care reform proposals making their way through the US Congress, and the current emphasis on dramatically expanding Medicaid alongside the much-debated “public option.” Henninger places the thinking behind these proposals squarely in the “old hat” category, calling them “pre-iphone” proposals.
Leaving aside the politics or the persuasiveness of his argument, his use of “old hat” thinking and “pre-iphone” proposals got me thinking about old hat, pre-iphone proposals in human services. In this field we are all too familiar with the Medicaid model and its myriad rules, regulations, complexities, compliance pitfalls, and frustrations. 15 minute billing increments, arcane rounding rules, encounter forms, eligibility change management, concurrent auditing, and much much more are part of the daily lives of human services delivery systems and the people we support. They are also a part of the infrastructure –human and technological–that human services organizations must have to survive. We all have software designed to manage the minutia of the rules.
It just doesn’t get much more old hat than that.
Most human services organizations are moving to service models based fundamentally on the individual being served. We call it person-centered-planning, self-determination, or any number of other names, but we are often stymied by old hat bureaucratic thinking. In this time of technological innovation and social movements based on an increasing ability for individuals to belong to disparate de-centralized groups (social media being a very important example) AND an industry movement toward personal choice, we still haven’t been able to be very new hat, have we?
New hat would be a service delivery and funding model based on individually developed service plans. New hat would be an iphone app that removes the bloat and just delivers the information relevant to that person in that moment. I’m circling back, I think, to an earlier post about the need for innovation in human services.
I want us to be post-iphone.
We need to be new hat.