Implementing Health Care Reform

Implementing the Recovery Act has been a major challenge.  But it pales in comparison to the complexity facing those implementing the health care reform bill.  Office of Personnel Management director John Berry says implementing this new law will be equivalent to being “the moon shot of our generation.”  Last week, Senator Mark Warner reinforced Berry’s observation, calling it “the mother of all implementation challenges.”

The Obama Administration is gearing up to meet the many deadlines in the bill.  In fact, it’s created a separate website to provide information on this: HealthReform.Gov.

However, there is also a major public management challenge involved as well.  As a result, the IBM Center is sponsoring a separate, new blog (with an optimistic title) – Implementing Health Care Reform — to provide insights into the implementation of this effort.  It is being co-authored by Professor Don Kettl, one of the preeminent academics in the field of public administration, and dean of the University of Maryland’s School of Public Policy; and Jack Meyer, who holds a joint appointment in both the School of Public Policy and the School of Public Health at the University of Maryland.

Be sure to visit the site, and book mark it!

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Australian Management Reform

I got a GovLoop tweet alerting me to a new report, optimistically titled: “Ahead of the Game: Blueprint for the Reform of the Australian Government Administration.” Australia has long served as a source of innovation and inspiration in government reforms, so I eagerly downloaded and read it.

Bottom line:  interesting but not exciting.  It does a good job of assessing the status of the existing public service and offers a set of nine “signature reforms:”

  • Delivering better services for citizens
  • Creating more open government
  • Enhancing policy capability
  • Reinvigorating strategic leadership
  • Introducing a new Australian Public Service Commission (like our Office of Personnel Management)  to drive change and provide strategic planning
  • Clarifying and aligning employment conditions
  • Strengthening the workforce
  • Ensuring agency agility, capability and effectiveness
  • Improving agency efficiency

Many of the recommendations are for studies, not action, using phrases such as “commission project work to develop options for Government consideration,” and “systematically examine,” and “options would be developed.”

The US efforts around “creating more open government” are much further along.  For example, tomorrow all agencies are to submit their Open Government Plans on how they will implement the December 2009 guidance from OMB.  In Australia, they plan to “develop advice for Government consideration.”

However, there are some ideas worth a second look, especially by the US.

The report recommends the creation of a “Secretaries Board” and an “APS 200” leadership group.  The Secretaries Board would be equivalent to the U.S. government’s already-existing President’s Management Council, and the APS 200 would be the 200 most distinguished career senior executives in their civil service (an intriguing idea!).  There is no existing equivalent in the US.

These groups would be called upon by to lead special projects – such as a systematic examination of how to better use technology to improve service delivery — and be champions for cross-government values such as diversity, service responsiveness, and equal employment.

Another task for the group would be done in conjunction with their equivalent to OMB — “to propose a set of shared outcomes across portfolios,” such as homelessness or national security.

However, many of the reform recommendations deal with strengthening the internal capacity of the government – improving strategic workforce planning, revisiting core values, strengthening staff learning and development, and streamlining the hiring process (a familiar issue, for the U.S.!).

Dealing with Poor Performers

The issue of poor performers is a perennial topic.  This topic seems to continually top the list of issues the President’s Management Council – comprised of deputy secretaries – wants to address by streamlining the rules.  But a new report by the Merit Systems Protection Board concludes that it is not the rules, but the managers, who are the problem.

In a story by Federal Times’ Steve Losey, “MSPB:  Managers Lack Skills to Deal with Poor Performers,” MSPB  notes “many supervisors have a hard time with performance management – setting standards for how well their employees must do their jobs and then track their performance.”

MSPB Chairman Neil McPhie wrote in the report’s introduction: “Ultimately, at least part of the solution to the issues of dealing with poor performers may be in educating and encouraging supervisors in the use of better performance management practices.”

MSPB notes that government often promotes people who have strong technical skills, but lack management skills.  Government also tends to not invest in managerial training, either. 

Interestingly, the report said that the necessary laws are in place.  The Office of Personnel Management, according to Losey, has promised to create a new performance appraisal system ”that will make it easier for manager to track how well employees do their jobs.”  But the real issue is recruiting and training competent managers, not better software.  What is needed is a leadership commitment from the top to make this a priority, much like the military does.  Some civilian agencies are better than others.  Social Security and the IRS tend to be better than most.

Investing in better management training, according to the Government Accountability Office, is also a prerequisite to being able to move to a performance-based pay system as well.