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5 ways a Trump or Clinton Government Could Practice Kaizen to "Heal" Obamacare

Contributor: Martina Simon
Posted: 05/16/2016
Martina Simon
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Donald trump, Hilary Clinton, Obamacare

What is Obamacare?

Obamacare is the media-adopted name for a law passed by President Obama in 2010, to reform the healthcare system in America. Its official name is The Patient Protection and Affordable Care Act (PPACA).

PPACA was born out of the necessity to extend healthcare insurance to an estimated 15% of the US population who are uninsured, namely, the poor and the elderly.

The Act requires all Americans have insurance, subsidizing costs to make it affordable for everyone. It also prevents insurers from discriminating against those with existing medical problems, as they did previously.

Why is Obamacare controversial?

One of the biggest issues is expense. Disappointingly, The President isn’t harbouring a magic money tree in the White House gardens - which means finding the money to insure everyone concerned, also means new taxes which specifically affect high-earning individuals and the healthcare industry...

What is Kaizen?

Kaizen is a manufacturing practice that encourages continuous improvement in workplace culture by eliminating work processes that are overly difficult. The word is comprised from two Japanese words: Kai (improvement) and Zen (good) and first surfaced following a need to rebuild Japan after World War II.

The era saw U.S. business consultants collaborating with Japanese companies to improve manufacturing, which resulted in the development of new management techniques that incrementally changed these businesses for the better.

What does a Trump/Clinton government need with Kaizen?

Although directly linked to manufacturing in its nascent stages, Kaizen has evolved and expanded as a useful tool in a variety of industries including finance, IT and most importantly healthcare.

Are you in the Healthcare Industry?
Download FREE Brochure
OpEx Healthcare OpenHouse 2016 - Register Now!

Perhaps you're interested in connecting with industry vendors sharing individual case studies or would like unique insights into how real world healthcare organizations have improved through operational excellence techniques.

Download the brochure to snag complimentary tickets to this online event - spaces are limited!

Using Kaizen can have the following 5 positive outcomes in business:

  1. Improved safety »
  2. Cost reduction »
  3. Increased productivity »
  4. Improved quality »
  5. Customer satisfaction »


Improved Safety

Process issue

In October 2015,  a study was published in The Journal of the American Medical Association, which shone a spotlight on some glaring issues in the quality of outpatient specialty care. Based on a healthcare “specialist” being either a dermatologist, cardiologist, OBGYN or oncologist –  the study which considered 135 health insurance plans across 34 states, discovered that around 18 plans in 9 states did not provide coverage for access to at least one specialist within 100-Mile radius.

Kaizen solution

Create PPACA-specific training opportunities for healthcare professionals to help qualify them as specialists.


For its sins, the very idea of hemorrhaging even more funds into healthcare can be rationalized, provided the Return On Investment is worthwhile. Without better resource in the number of professionals available to an individual, it is difficult to banish the cruel irony faced by US citizens; that they must abide by the Act for their own good, yet it does them no good if they cannot be confident in the quality of care available to them…


Cost Reduction

Process issue

Compulsory cover for everyone, including the sick – means the cost of everyone’s insurance has increased. The forceful nature of the Act means that Americans are unable to just buy insurance when they need it, and instead must obtain it regardless. Traditionally, some people either saw no need for insurance or were low risk (and so were quoted much less) - but with the Act in place, and ever since the ‘premium hikes’ in 2014 – costs have rocketed for individuals and employers.

Kaizen solution

Review and revive cheaper limited coverage options for low risk groups.


Reabsorbing people that are low risk (those in good health with no pre-existing conditions) into a system that allows them cheaper coverage makes perfect sense. This is similar to how credit score, car insurance and countless other ranking systems are designed and can even be seen as a subtle incentive for people to stay well and healthy…

Productivity

Process issue

The countless health insurance options available under the PPACA can make shopping for coverage  seem complicated. Americans can buy insurance individually, opt in through their employer or may be covered by the government - but all of these options can be overwhelming which can cause consumers to either over-buy or under-buy, not to mention the spotlight it shines on the existing 'caveated' system where “you get what you pay for”

Kaizen solution

Clearly define and simplify the number of available options.


The old adage is true: Less is more. Creating a simplified approach to health insurance without jargon or legal mambo-jumbo, will make it accessible to all. Unlike stocks-and-shares or String Theory, the healthcare industry is one that is actively inclusive of everyone on a daily basis and so a clear understanding is essential…


Improved Quality

Process issue

Minimum essential coverage (the type of coverage you’ll need to avoid being fined for being uninsured), can only be obtained during open enrollment unless one qualifies for coverage during the special enrollment period.

The special enrollment period is like a deadline extension to the regular open enrollment period. One might qualify for this because of unforeseeable life events such as a change in family status or a hardship. The issue is that those who don’t understand how to compare plans due to never having coverage before, could mistakenly buy non-minimum essential coverage like short term health insurance, leaving them unprotected.

Kaizen solution

Update the parameters of Short Term insurance to include essential coverage.

Even though it protects your health, short term insurance won’t protect you from the big, bad fee. Based on Obamacare’s individual mandate, if your insurance doesn't include essential coverage, you’re pretty much ignoring the rule, meaning you still face a monthly exemption, or tax penalty...


Customer Satisfaction

Process issue

Because of the affect the mandate has on employers, some businesses have cut employee hours.

This has caused businesses that did not provide health insurance to employers, to face rises in costs (for extra operation). In addition, lower wage employees are faced with no affordable options for healthcare insurance due to having been offered (and having to accept) the coverage provided by their employer even when oftentimes, there is better value through the marketplace.

This also affects any dependents of those employees, who, under the Act,  are not permitted to receive cost assistance or subsidies for their own insurance if the employer offers what it deems to be "affordable" coverage to its employee.

This is commonly known as the ACA Family Glitch.

Kaizen solution

Review the minimum affordability guidelines with a view to widen the eligibility for cost assistance for dependents.


This issue is erroneous; affordability for employees is being determined on an individual income basis using the same parameter that determine affordability for the employee, for their family members also.
Perhaps finding a way to accurately determine household income would be a step closer to satisfying the consumer gifted with paying the bill.

Are you in the Healthcare Industry?
Download FREE Brochure
OpEx Healthcare OpenHouse 2016 - Register Now!

Perhaps you're interested in connecting with industry vendors sharing individual case studies or would like unique insights into how real world healthcare organizations have improved through operational excellence techniques.

Download the brochure to snag complimentary tickets to this online event - spaces are limited!


Thank you, for your interest in 5 ways a Trump or Clinton Government Could Practice Kaizen to "Heal" Obamacare.
Martina Simon
Contributor: Martina Simon