Sunday, February 17, 2013
Comprehensive Rationality
In times past there was an approach to planning called
Comprehensive Rationality.
According to an e-learning web page published by Freie
University in Berlin, Germany, the approach was “based on instrumental
rationality when analysing and making decisions (goal-rational).” The central assumptions were that:
- There is always a right or wrong way of management, problem solving or development. In a positivistic view this model assumes that it is possible to find this best way, the best solution to all planning
- The environment is controllable by using scientific knowledge and modern technologies (belief in progress)
- There is a common public interest
- Change has to be engineered from the top
The Affordable Care Act (a.k.a. Obamacare) provides for
something called Accountable Care Organizations, which combine all elements of
care – including doctors and hospitals – into single entities, which are offered
financial incentives to improve quality and reduce cost. Various approaches are offered with provision
being made for evaluation to see which ones work best.
This is Comprehensive Rationality in its pure form.
I had been given to understand that the planning fraternity
had long since concluded that the approach didn’t work. Modern organizations are complicated and
nobody is smart enough to compose a manual that will make them succeed.
If my impression is correct, the word hasn’t yet penetrated
health care.
