When Linear Hope Fails, The Exponential Scramble Begins


Blue Spoon Consulting’s John G. Singer* provides a thought-provoking outline of how the global health economy needs to evolve a new ‘systems framework’ to deal with the complexity and interconnectedness of healthcare today.


We need to unleash a new set of capabilities designed by a different level of thinking

Nature was once a “separate and wild province” from human civilization, wrote Bill McKibben in The End of Nature, his ground-breaking argument that the survival of the globe is dependent on a fundamental, philosophical shift in the way we relate to nature, and to one another. It was “a world apart from man to which he adapted and under whose rules he was born and died.”


But, claimed McKibben, we have effectively killed off this independent sphere.


“There’s still something out there, but in the place of the old nature rears up a new nature of our own devising.” This is a construct where the living and the manufactured are being united into one system, whose purpose is to spawn further complexity. Technology is becoming biological and the biological is becoming engineered. Healthcare and life sciences are emerging as one circuit in a new industrial cortex.


Most don’t understand the nature of this context collapse. There is a general frame of reference that treats the world as inherently disconnected and divided into ever-smaller pieces, which in turn are ‘out there’ in the operating environment somewhere. Each piece is considered to be independent of the other, moving in its own autonomous domain. Each piece is shaped by its own policies and “optimized” by different technical methods and calculations to predict and control how it performs.


Being guided by a habit of breaking things apart to study them, we then intentionally search for the data that proves the correctness for this way of thinking, so that all seems to correspond to a fragmentary worldview. In other words, the operating environment is responding according to the theory with which it was approached.


But the ‘problem space’ has changed.


What the coronavirus reveals is that legacy logic – the linear thinking and embedded assumptions born in the Industrial Age – no longer “works” to guide a world that operates as an interdependent system. Culture itself is passing through a new time. Its manifestation is so novel, so shocking and unparalleled, that it challenges every tradition and form of conventional thought.


We need to invent new actions for the new laws of motion from which it is being born.


A New Orbit for Innovation

Thinking at a system level is not a natural act.


We are essentially linear creatures; Western society fosters and rewards linear behaviour and performance from kindergarten on. Our social programs are designed and executed on it and it drives policy decisions throughout government, non-government and business settings. A linear frame of reference is part of our subconscious bedrock. It forms the basis of our theoretical insights, which in turn form the basis of how we organize (and position) factual knowledge.


We-who-are-the-global-health-economy need a new ‘systems framework’ that can collectively see and harness the creativity and collaboration of multiple contexts, simultaneously and interactively.


It doesn’t matter if the context relates to health reform, business competition, military conflict, climate change or international affairs: the conceptual boundaries and divisions that used to govern how we thought about time, markets, culture, identity and knowledge have evaporated. Everything is connected to everything else in one complex system of behaviour and emergence. The connections and interactions can be so intense and transformative that we can no longer distinguish between actors and their environments, let alone say much about any piece in isolation. That is not to say that we do not keep trying…and failing.


If there’s a lesson to be learned from the system collapse unfolding before us, it is this: the next health care needs to be designed as an economic system organized on outcomes, not inputs. The shift in vision for innovation is conceptual, not technical. We need to move from independent value extraction to collective value creation. From pieces and parts to interactive wholes.


“By the end of nature I do not mean the end of the world,” writes McKibben. “The rain will still fall and the sun shine, though differently than before. When I say “nature,” I mean a certain set of human ideas about the world and our place in it. But the death of those ideas begins with concrete changes in [seeing the new] reality around us. More and more frequently, these changes will clash with our perceptions, until finally, our sense of nature as eternal and separate is washed away, and we will see all too clearly what we have done.”


Leadership teams are struggling to find a new comprehension for a 21st century orientation about the changed nature of competition, and the changed nature of change. Caught in a vortex of stimuli and tornado of technology possibilities, we can’t get in front of the upheaval. We need to unleash a new set of capabilities designed by a different level of thinking.


* John G. Singer advises business and government on health system vision and value innovation. He is the pioneer of ‘big design’ as a methodology to drive large-scale system change.

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