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We need a new deal

Updated: Jun 16, 2021

“Mankind to nature: There is no way we can shut everything down in order to lower emissions, slow climate change and protect the environment.

Nature to mankind: Here is a virus – practice!” (price tags)

Most of us – until very recently - were focused on ultimate efficiency. And most of us probably still are. This is true for individuals, societies and economies.

In this context, it is of course easy to finger-point to industry, to all those omnipresent multinationals, even to those who perfidiously proclaim a so-called shared economy.

But hang on a second, didn’t we go along with all of the rush ourselves? Didn’t we put endless effort into optimizing and sacrificing our lives on the altar of efficiency? One of the most striking examples for me always was when I was sitting with some of my friends, talking about their family lives and how they try to arrange everything. Sometimes, the expression “quality time” entered the discussion and always flabbergasted me. Just reflect upon it for a minute: we invented the term “quality time” to justify that we spend too less time with our families and our kids, by simply trying to add more “quality”. What an absurd endeavour.

However, as we all have been witnessing for a while, our high-speed train is beginning to leave the rails and we risk to fall off.

“What can we do to avoid crashing and better preparing ourselves for similar events in the future?”

Let me emphasize here, that a way forward in this context has nothing to do with philantropic dreamery of a better world, but with finding a different approach beyond pure efficiency that still allows us to live in a stable, wealthy and free society.

Let’s look at how we are able to cope well with a situation of pandemic crisis in 2 distinct steps:

  • Step I is dedicated to the efficient management and containment of a pandemic

  • Step II will be dedicated to the question of how we can pave the way to a new deal well beyond efficiency

  1. Efficient management and containment

A lot of effort and subsequent discussion went into the analysis of how successful different countries dealt with containing the current Corona pandemic. It quickly became clear that there is no single decisive factor existing.

For example, it has frequently been assumed that the degree of digitalization and associated medical technology deployed in a healthcare system would make the difference. However, a recently published study has been showing that this is not necessarily true: the 2 countries who came out on top of the list in terms of successful crisis management were Israel and Germany. Israel is a good example for a healthcare system which is well permeated with digital technology, whereas Germany is just the opposite.

It is really a number of variables that have crucial influence on how well a society and country lives through the crisis. I consider them as being the “hygienic resilience factors”:

  • Credible leadership: solipsism seems to be a fertile ground for viruses to spread. Although some countries were too slow in realizing and reacting to the Corona pandemic threat, it looks like a stable and decisive leadership have very much contributed to well manage the evolving challenges. Such leaders base their decisions on facts rather than on political, personal or populistic motives

  • High levels of trust: leadership is worth nothing, if it is not backed by people. A prerequisite for this is a high level of trust among large parts of the population. Only then will people respect and follow decisions, even if a good deal of hardships is involved

  • Broad health coverage: this is often also referred to as Universal Health Coverage (UHC). It implies that good levels of healthcare are available across a whole society and not just for parts or groups of it. This includes the availability of (critical) care resources and contingency plans to mobilize critical care resources quickly when needed. A healthcare system that is based on the principles of UHC is robust, also in times of crisis

  • Broad societal consensus: the more a society is divided on how to deal with the pandemic crisis, the less it is possible to fight the challenges effectively and with “one voice”. A good societal consensus features a balance between economic interests, personal freedom and rights, as well as the protection of peoples’ health and lives. Of course, such a consensus can’t be established overnight, it is something that has to be present within a society well beforehand and is articulated by a sense of self-responsibility in the population

  • Technology at our hands: in most cases, we can only take educated and fact-based decisions if we have the respective needed information available. In an increasing complex world with a plethora of information created every day, a Strategic Health Information System (SHIS) seems to be indispensable to generate data and transform it into information and knowledge, needed for e.g. predictive modelling of viral spreading

  • Consensus on the way forward: as we have experienced, it is relatively easy to shut down substantial parts of the economy or even of our social lives. Opening up again whilst risks are persisting is the far more challenging and difficult task. There a many different interests and stakeholders trying to influence the way and the speed with which we are exiting from the shut-down. What level of risk are we accepting to regain our freedom? To what extent do we want to tolerate jeopardizing the health of our fellow citizens? Which interests should prevail and have priority? Finding answers to these questions may need to result in a “New Deal” – and new way of living together as a society, with different norms, priorities and a new way-of-life

Effective and sustainable crisis management may be split into 5 distinct phases (see illustration below). It is decisive to quickly realize the pandemic threat. As the measures that are taken to contain the virus from spreading may interfere with personal rights and freedom, it is important to honestly and consistently communicate to citizens at an early stage and seek support and trust. The more people are feeling that they are partners rather than recipients of official orders, the better they will adhere to even strict measures.

It is relatively easy to implement restrictive measures and shutting down parts of social or economic life. The challenge for any public administration is the question how to cautiously lift the lockdown measures without risking a second wave of infections and resist the pressure from the public and economic interest groups. Moreover, it will be necessary to prepare the public for a post-epidemic world, which will most probably be different to the one before.

This is why political leaders will need to work on a New Deal affecting many aspects of the way we live.

How can such a New Deal look like?

  1. A New Deal beyond efficiency

Finding a New Deal for post-epidemic times is a great chance to create a stronger society, economy and healthcare system.

The 3 main pillars on which such a New Deal resides are:

  • Society,

  • Economy

  • and the Healthcare System itself

As all 3 depend on each other, there is no “either-or”. This is important to bear in mind, just as we can more and more witness furious and controversial discussions which of the 3 should have priority: shall we take the risk and sacrifice the health and life of people for the benefit of industry and economy? Isn’t it disproportionate to prevent us from meeting with friends, eating out in restaurants or going to the movies? Isn’t the damage that we are causing to millions far too big in relation to the benefits for thousands?

Let’s have a closer look at all 3 to see what we can do to make each pillar more resilient and understand how this results in an overall resilience which is bigger than the sum of the individual 3.

  1. Increasing resilience of the economy – a New Deal for more agile and demand focused value chains

The current crisis has shown that industry needs to alter its structures, processes and ways-of-working to cope with a different environment and to be prepared for coming similar situations. Here are some of the things that should be on their agenda:

  • Establish highly flexible value chains that are able to adapt to changing and individual customer wants and needs, e.g. the tourism industry may want to use and reinforce the concept of “dynamic packaging” to sell more personalized offers online. Industry will need to move from “one fits all” to “bespoke”. This is why the traditional business developer or sales executive will have to become much more of a coach or an expectation manager than a sales person

  • Create new partner ecosystems for developing and offering products or services and creating innovation: a pharmaceutical company partners with health app providers that enable to directly approach and engage with patients, better support them in managing their condition and allowing the company to develop and register new drugs faster or establish additional benefits for existing drugs

  • Knowledge is king: develop information and knowledge platforms that enable you to take fast, flexible and informed decisions. This has a lot to do with digital transformation of the complete business allowing to collect data not only from customers, communities or suppliers, but also from internal processes. To achieve this, digital needs to become embedded in all business processes rather than to be just an add-on.

As Markus Rautert, CDO of Adidas has expressed it recently:

“The easy part of digital is the digital solutions. The difficult one is matching your company’s internal business processes”.

A manufacturer of critical care equipment will e.g. know at any point in time how well and quickly its equipment is available, where there is an installed base, how significant it is and what needs to be done to scale up production without running out of resources. Hence, the manufacturer can well orchestrate and optimize supply and demand of goods and services

  • Make sure to foster modern leadership and company culture: the culture used by organizations in dealing with situations of crisis and disruption may prove to be inadequate. It may well be that such an organization needs to switch from a culture of efficiency and control to one that is based on collaboration and entrepreneurship. This requires a different type of leadership: this features such things as empathy, leading from the front, quick and agile decision taking, good internal and external communication skills and allowing for creativity to thrive. A leadership that is based on control, hierarchy or information monopolies will render it difficult for companies to succeed in turbulent times.

  1. Increasing resilience of the healthcare system – a New Deal for providing crisis-proof healthcare to citizens

The Corona pandemic caused some healthcare system to operate on the brink of collapse, whilst others proved to remain remarkably stable and robust.

What are the reasons for this? What makes a healthcare system able to respond to crisis effectively and safely?

There is for sure not just one single reason for this such as the degree of digitalization or the sheer availability of critical care resources. Resilience comes down to be able to quickly realize and effectively react to a pandemic threat. Here are some items that contribute to achieving this:

  • Become aware quickly and react: it is crucial to realize the occurrence and the onset of a pandemic crisis at an early stage to be able to initiate counter measures swiftly. Essentially, two things need to be in place for this: the ability to perform a fact-based evaluation and judgement of risks and dynamics (respective data needs to be available) as well as the structures, processes and political support to address the threat. If a government or political administration has the objective to cover or play down the emerging crisis, valuable time will be lost to contain a pandemic – which may affect not only a particular nation, but may have repercussions on a global scale. Building resilience in this respect is a global task, not a national one.

  • Lay foundations for a self-regulating and adaptive healthcare system: this is not something which can be brought upon overnight. It has to be carried on the one side by a sense of community and collaboration amongst healthcare stakeholders and providers in the true sense of integrated healthcare delivery. On the other hand, creating such a healthcare system requires the legal and political foundation to support and encourage it. It also implies that stakeholders possess the authority to invest into infrastructure, knowledge or other resources. A healthcare system of this kind can flexibly and effectively respond to changing conditions and epidemiological needs

  • Maintain a diverse and accessible healthcare system: the current pandemic proves that a robust healthcare system has to have the flexibility and capacity to address a range of health conditions and challenges (in primary, as well as in secondary care). A virus never affects just one isolated part of the body, but is a general attack on a number of organs and physiological functions. Having such a diverse system at hand is of course only meaningful and beneficial if people from across all areas of the society have access to it. The less access to care, the bigger the risk that the pandemic gets out of hand

  • Establish informed decision taking: as previously mentioned: knowledge is king. Having an overview of available resources on the one side and epidemiological dynamics on the other side is the foundation for taking educated decisions, especially in the face of changing conditions. This needs to go down to the individual level (inspite of the data privacy discussions - these issues can be solved for sure) to allow for a tracing on a microlevel, as well as for the predictive modelling on a larger scale. The implementation of a Strategic Health Information System (SHIS) is indispensable to achieve this.

“Medicine will become much more of an applied data science”

  • Be prepared and build the capabilities to flexibly respond in advance: efficient structures, processes and ways of working are worth nothing if the necessary resources to execute counter measures are not available. This is true for critical care infrastructure, human resources and knowledge and for medical equipment. It is essential to invest into critical care resources well before and embed them into any strategic and tactical planning for emergency and crisis management

  1. Increasing resilience of societies – a New Deal for a stronger and fortified society

Let me start with a quote from George Clooney in the movie Up in the Air:

“Don’t tell me this isn’t the age of miracles. Don’t tell me we can’t be everywhere at once”.

For any free society, the restrictive measures during a pandemic constitute an imposition (as surely it is the case for George Clooney). Very often, they deeply cut into individual rights and freedom. Leaders need to do their utmost to try and make the population accept, respect and support the restraints that are collectively imposed. At the same time, they have to prepare citizens for a post-pandemic world and seek consensus – and this is the more difficult part. Corona holds up the mirror to us and teaches us that many things will be different in such a world for a very long time, maybe forever.

So, what is it that will need amendment? How will our societal norms and behaviour need to change? Do we need to alter the way we look at our ambitions and goals and at our way of life? And finally, how will this contribute to bring upon a stronger, well-fortified and less vulnerable society?

Every society possesses its own specific vulnerabilities, bur here is some food for thought:

  • There are existential risks - such as pandemics - facing all mankind that must be minimized: we can only achieve this on a global scale, not within individual national or regional borders. It is a dramatic misjudgement and a relapse into the nationalistic and protectionist ages if certain national leaders go down the ego path. And it may cost the lives of thousands of people and jeopardize the well-being of all of us. Inspite of all the criticism, international organizations such as the WHO can play a fundamentally important role in coordinating endeavours to prevent and fight health risks such as pandemics

  • We have to find a new balance between individual possibilities and human fragility: we need to understand that we are all part of the circumstances and the events around it. What affects one person can affect many others or even everyone and everywhere. We are all part of the human species and we need to accept this well above personal or economic status and divisions of race or ethnic backgrounds

  • The future is unpredictable: we have to accept this notion of unpredictability and make it part of our thinking and action. Most of us are educated and socialized in a way that we should try our utmost to plan our lives, to set goals and reach them. Don’t get me wrong here: planning and goal setting are of course legitimate, they are part of our personalities as humans - as long as we are able to take into account and accept events that may completely change our endeavours

  • We need to reflect on our relationship with the environment: this is true for our self-created environment as well as for the natural one. When working together as individuals and citizens we should realize that the well-being and health of the most vulnerable people is a determining factor for the well-being of all of us. If we are not prepared to do this, it will be hard to confront critical or even devastating challenges to our lives and societies

  1. Corona – will the pandemic really create a New Deal?

According to economic historian Walter Scheidel, there are 4 scenarios which have the potential to pave the way for a new order: pandemics, major wars, state failures and revolutions. A new order may manifest itself on both, the societal level, as well as on a global political and geo- economic level.

Epidemics have always shaped history, sometimes in a very positive way. A good example for this is The Black Death (1347-1350). It was a pandemic that crushed the populations of Europe and Asia. The plague was a human tragedy that not only unsettled societies, but also transformed them. The Black Death resulted in wide-ranging social, economic, cultural and religious shifts. These changes, directly and indirectly, led to the emergence of the Renaissance, one of the greatest epochs for art, architecture and literature in human history.

The current Corona pandemic is for sure not as devastating and lethal as the plague was back in the 14th century. Hence, it is debatable whether its effects will be as far-reaching. However, looking at the impacts Corona already has and will have on our personal lives and well-being of our nations, as well as on the geo-political realities, it will at least shake up the world in an unparalleled way since the end of WW 2.

It may well be that the the geopolitical centre of gravity will shift East again and that the effects of the pandemic will reinforce the counter-reaction against globalization.

As for healthcare, there is a high probability that the libertarian models crumble as other people’s health will transparently be an issue of your own health. Therefore, healthcare ceases to be a zero-sum game as there will be the need to deploy more resources to protect disadvantaged and unfortunate citizens.

Depending on how well we manage these emerging unknowns and the shifting realities we will manage to recover from crisis on a global scale. We may see 4 distinct scenarios emerge whereby their edges are fluid and might be overlapping (see illustration below).

In the end, will we learn from the impacts of the current crisis and use our wisdom to change for the better? Will we see more moderate political and economic systems based on tuned and balanced determinants? Or will we fall back into even more egoistic, nationalistic and protectionist patterns?

Well, if it should be the latter it is bad news as then, we will hardly be prepared to confront future serious dares to humanity and our civilizations.

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