In the last post, the concept of a System and the key concepts of a System were introduced. Topics to address regarding a System are (1) the Boundaries of a System, (2) Defining the Aim and last but definitely not least is (3) Optimization of the System. Let's look at each of these in a bit of detail.

Boundaries of the System: In The New Economics for Industry, Government, Education, Dr. Deming states "The boundary of a system may be drawn around a single company, or around an industry, or the whole country. The bigger the coverage, the bigger be the possible benefits, but the more difficult to manage." Keeping in mind that the aim of a system is to "become competitive, stay in business, and to provide jobs", system optimizers must decide where to draw the boundaries of the system using the classic "risk versus reward" mindset.

A recent example of "drawing the boundaries" around an entire industry is the current initiative regarding the U.S. Healthcare System. The Executive and Legislative branches of the U.S. Government decided to draw the boundaries of the U.S. Healthcare System around the entire industry. A short, and definitely not comprehensive, list of system stakeholders includes the American public, physicians, hospitals, urgent care clinics, insurance companies, government entities (Medicare, Medicaid, etc.), and various other players in the industry. While the reward of having "affordable healthcare for everyone" is a great social benefit, the current strategy to reform the entire system all at once appears to be too large of a task for the system reformers at this time.

Defining the Aim of the System: Deming states ""It is important that an aim never be defined in terms of activity or methods. It must always relate directly to how life is better for everyone. . . . The aim of the system must be clear to everyone in the system. The aim must include plans for the future. The aim is a value judgment."

Extending the discussion of the current healthcare reform initiative, I believe the "aim" of the U.S. Healthcare System is accurately described for the most part in H.R.3962 - Affordable Health Care for America Act, the bill passed by the U.S. House of Representatives. The bill's aim is "To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes." This aim clearly and concisely states the desired outcomes of the U.S. Healthcare System. The first 17 words of the purpose are well written, however, the last 4 words provide a level of ambiguity that I'm sure Deming would not approve of. While the American public and those elected to represent us in Washington, D.C. may have very different views on "how to achieve this aim", the aim as stated, with the exception of the last phrase, is well written in my opinion.

The next post will focus on "Optimization of the System". That topic deserves a bit more space and time than I have right now in this post.

Let me know what you think about the boundaries and aim of a system by leaving a comment.