Answer – The need for infrastructure. Without it, things fail.

The wars being fought globally are all over the news (or any war for that matter). Aside from the fighting force, one thing that stands out is the need to infrastructure to support these wars – and any war. In the military, there are three components: the fighting force, weaponry, and support services: water, food, weapon resupply, etc.

Without these the force cannot do its job. Therefore, this support, what I’d call support “infrastructure”, is critical to military success.

We’re also seeing challenges to wide adoption of Electric Vehicles (EVs) into daily transportation life. Today this technology is in an evolutionary state.

Batteries don’t last long, and this short charge life fails to meet the public’s expectations and demands. There aren’t enough charger stations available at appropriate locations and those that do exist can’t charge fast enough.

The real challenge is a lack of charging “infrastructure” needed to support such use – “execution.”

In health care it’s the same. We can cover more people, but that coverage does not equate to more care. You guessed it, there is not the appropriate infrastructure in the appropriate locations. If we cover more people but fail to have the increased number of needed doctors, then we fail in getting these people access to appropriate care.

Set aside the question of quality-of-care despite the fact that it’s critical for a patient’s selection of the best provider for them. First, we need the doctors in the correct locations.

Unfortunately, in health care, we fail to address this critical “infrastructure” need in virtually everything we do.

We simply do not focus on the “execution” phase of what we want to accomplish. Doing this “execution” is the hard part, not the idea. This is why we fail.

Philosophically, in the Affordable Care and Patient Protection Act (PPACA, or more common, the Affordable Care Act) Congress expanded health care coverage to more folks believing that would result in more care.

At the same time, we cut the Medicare program by $500 million dollars for the first 10 years. How did everyone fail to recognize that they would ultimately need more doctors to treat more people we just covered. Duh!

Getting more doctors doesn’t happen overnight. There is a long lead time to get the right folks, get them through medical school, then through residencies, and then to the correct location (the latter being a real issue in rural communities).

Failing to focus on the execution or infrastructure from the beginning sets a project up for failure in the end. It’s similar to building more houses and not anticipating more traffic.