Transformational Leadership, Policy, and Change

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Leadership, Policy and Change

Julian I

Abstract

This paper will focus on how effective Leadership can influence policy and change in the United States healthcare system. The implementation of new policy, program, and institutional change is often meant to improve the quality of the nation's ever-changing healthcare system. Several journal articles and texts have been selected particularly with a focus on leadership strategies to improve the quality of healthcare, and leadership’s ability to influence implemented changes to the system. The question proposed is; does leadership encourage and influence both public and private initiatives that measure health outcomes, and organize systems to improve health services when new policies, programs, and institutional changes occur? The issues summarized in this paper are supported by scholarly journals and texts that offer several perspectives, including real life examples that will illustrate my argument that effective leadership can impact changes within the healthcare system.

Our great nation has had a significant history of leadership both transactional and transformational throughout its existence. I venture to say that leadership is not just about performing a job: It’s about making a difference. When considering changes to healthcare, whether it is institutional, program, or policy, the importance and ability for leadership to put systems in place that strategically fulfill the goals and measures identified are extremely important. For example, with the passage of the Affordable Care Act, the future of healthcare has become more defined as noted by Baldwin; The Circle Way: A Leader in Every Chair (2011), “To serve as effective leaders, we must understand the context for our leadership roles–namely, the changing health care system and particularly, the impact of the Patient Protection and Affordable Care Act that President Obama signed into law on March of 2010. The Affordable Care Act resulted from months of intense Congressional action and serves as a reminder that fundamental legislative changes do not happen overnight. Congressional tinkering over the 75 years since President Roosevelt attempted to enact national health insurance has yielded little by way of major change in health care programs, except for the addition of Medicare and Medicaid by President Johnson and the addition of Medicare coverage for prescription medications by President George W. Bush“.

The new health care reform law is more than just a big change. It promises to be transformative as suggested by Baldwin, “that the old framework is disappearing because we don’t really know what the new normal will look like, and that uncertainty creates angst among consumers and health care providers in all fields, clearly leadership will play an important role in defining the path more clearly. Examples of the types of leadership needed are transformational and transactional leadership.” The success of health care reform will also depend on collaboration among regulators, insurers, and providers. Success hinges on an approach to regulation that is flexible enough, particularly on antitrust issues, to ensure that these groups can cooperate to pursue the goal of providing access to high quality health care at a cost the public can accept.

As noted by Linsky, Leadership on the Line: Staying Alive Though the Dangers of Leading (2012), “Transformational leaders are driven by a moral or ethical imperative. They forsake a transactional leadership style in pursuit of something that must be done in and of its own right. For the transformational leader, the pain of leadership is exceeded only by the pain of lost potential. Transactional leadership, on the other hand, reflects the political exchange of resources, and is dominated by the coalition that possesses the most resources as measured in the current paradigm. There is a huge price to be paid by the transformational leader. It...
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