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Making Affordable Care Doable

Preventing Obama’s Bay of Pigs – Part 1 - From Resistant to Doing to Listening

JFK: What did we do wrong? How did we screw up?
Eisenhower: What you wanted to do wasn’t wrong, but you didn’t have a process.

A CEO friend of mine related to me how JFK turned to Eisenhower after the Bay of Pigs debacle and asked him a question similar to the above and Eisenhower answered with a response similar to the above (I would greatly appreciate if any of you can verify this and provide an accurate reporting of the episode).

My friend then told me that JFK developed a better process for making decisions in the face of a huge crisis and supposedly used it to manage his way through the Cuban Missile Crisis and by doing so may have prevented a nuclear war.

I don’t care whether you’re a Democrat, a Republican or Independent.  If you are an American I am hoping that you will join me in agreeing that for the richest and most powerful country in the world to take such poor care of its people’s health is shameful and a travesty.

A number of people from Gandhi to Churchill to Samuel Johnson to others have essentially said that the measure of a civilization is how it treats those who have hurt it and are hurting in it. Would you agree?

And the time has come for both political parties to stop being so "pig headed" and keep their focus on correcting this incivility. Would you also agree to this?

What the President needs is a “process” to bring opposing sides together in pursuit of the common goal of providing all people that reside in America, not just Americans, affordable and basic healthcare.

Given the current resistance and opposition, the President would do well to follow the sequence below, referred to as the Persuasion Cycle™*:

He must move the country and especially his opponents and critics:

•    From resistant to doing to listening
•    From listening to considering
•    From considering to willing to do
•    From willing to do to doing
•    From doing to glad they did
•    From glad they did to continuing to do

Currently President Obama appears to be facing a Republican party and Obamacare opponents that are not merely Resistant to Doing (i.e. supporting his plan and its implementation), they often appear even Resistant to Listening.

In this Part of this multipart series, we will describe how President Obama might turn the opponents of his affordable care plan from Resistant to Doing and Resistant to Listening to Listening.

To begin, it’s important to understand what is going on in the mind of someone who is resistant or opposed to doing something or even to listening.

To that end I would like you to imagine the body posture in the mind’s eye of someone who is resistant to doing and resistant to listening to you or me.  Wouldn’t you agree that it would be a person who has his arms crossed and who is looking up at the ceiling dismissively not willing to give you or me the time of day or to even make eye contact?

You might remember the children’s song that had the verse, “the hipbone’s connected to the thighbone.”  In an analogous and fascinating way, our outside body posture is connected to the body posture we are simultaneously having in our mind’s eye when we are resistant to doing and resistant to listening.  If you get someone to uncross their real arms and make eye contact with you in reality, they will do the same within their mind and open it up to you.

So here’s a strategy for moving someone who is resistant to doing and resistant to listening to listening to you.  Get them to make eye contact with you and use their hands and arms to express themselves as they talk to you.  While doing that, they won’t be able to make eye contact with you and use their hands and arms to get their point across to you and be closed to you at the same moment.  That is because at that moment they are trying to drill their agenda and opinion into you, they can’t be drilling into you and closed to you at the same time.

Therefore what President Obama needs to do is to call a private (or maybe public) meeting with his biggest healthcare opponents and critics especially John Boehner, Ted Cruz, Grover Norquist and select Tea Party members, along with some of his own supporters. However, instead of relying on his supporters to speak, the President needs to be the Communicator in Chief during this meeting.

Then when he meets with Boehner et al he needs to say, “Before we enter into this discussion, I need to clarify something for myself.  In principle, do you or do you not agree that our country along with all its shortcomings is still the wealthiest and most powerful country in the world?”

Hopefully, they will agree, and to make that agreement more emphatic, the President should ask, “For my own clarity about that matter, was that a, ‘Yes’ or an ‘Uh-huh?’” Hopefully they will say more clearly, “Yes.”  If they don’t he should ask them to clarify their answer.

Following that the President should ask, “Do you or don’t you then agree that our country has an ethical and moral responsibility to provide adequate or at least basic healthcare to all of its residents including its least wealthy and most powerless?  And furthermore, do you or don't you agree that even if we do not rise to the top of the nations of the world that provide such benefits to their people, do you agree that we have an ethical and moral responsibility to at least be at the median level of such a list?  If you don’t agree, please explain to me your answer so that I might better understand it, and please explain to me your answer in the context of your and my role and responsibilities regarding those whom we represent rather than mainly those who donated to our campaigns or even those who voted for us.”

Regardless of what the President’s opponents say, instead of countering any points that they make, he should utilize what I refer to as conversations deepeners.  What that means is that when any of his opponents use words like “never,” “always,” “awful,” “ludicrous,” “preposterous,” "unrealistic," "fiction," "misleading" or when the inflection of their voice intensifies around certain phrases, the President should respond with, “Say more about ‘never…” (or ‘always…’ or ‘awful…’ or ‘misleading…’ etc.).  Other conversations deepeners are responses such as: “Really!....” (said as a positive exclamation and invitation for them to talk more) or “Hmmm…” (the word that is the therapist’s best friend is getting their patients to talk more).

What the President is achieving with such an exchange is to have his opponents use their hands and arms to convey their words that have an emotional charge on them, when words alone don’t emphatically enough convey their positions.  Also by doing this the President is causing them to make solid eye contact with him.

All the time the President is doing this, he should stay focused on their left eyes, which is connected to their right and emotional brains.  Staying focused in such a way will make their knashing of teeth, grimacing and sternness blur and the President can keep focused on the eye of their hurricane (usually expressed as a dismissive or derisive comment) coming at him.

Now comes the moment where the President will need to show the greatest restraint and respect for his opponents and critics. It's when and where he needs to be less negotiator, less lawyer and more presidentially present.  This is when he needs to say to his opponents and critics, "Given the stalemate and sometimes checkmate that our prior conversations have led to, it is too important at this point for me to have not heard precisely, as in word by word, what you have said and have not understood from your point of view your reasoning and rationale behind it.  So if you will excuse me and not to bait you, I am going to repeat back word by word what you said and then my understanding of your reasoning and rationale behind it.  At that point, I want and need you to correct anything I say back to you.  Would that be okay with you?"

The reason for this most critical step is that it communicates to your opponents/critics that what they said was important enough to be heard accurately and understood fully.  More than that it causes your opponents to have to slow down enough to listen to see if you heard and understood them correctly.  This will then result in cutting down their reactivity and transactional fervor. 

And finally, after they have listened to you and either correcting what you said or saying, "Yes," that you heard and understood accurately, that will orient their brain towards being more cooperative and collaborative.  That is because it's difficult for them to switch from listening attentively to you, saying "Yes" to you and then automatically switching back to a "zero sum/duke it out" position with you.

After being listened to and heard out completly by the President who then repeats back what he heard and understood his opponents to say, this sets the stage for their listening to him and if he communicates effectively, considering what he says.

In Making Affordable Care Doable - Part 2 – From Listening to Considering – we will go into detail about what the President will need to do next to have his opponents and critics both listen and consider what he is proposing.  In other words what he will need to do to gain “buy in” from them.

* Source: "Just Listen" Discover the Secret to Getting Through to Absolutely Anyone (Amacom, $24.95)

Reader Comments (6)

In the spirit of Freedom of Speech and Freedom to Debate (two freedoms that are very important to me) controversial issues such as this, I feel it is my responsibility to share opposing views such as the following comment sent to me via email in hopes that it would free other people who have strong opinions on this topic to share them here, which you may do so anonymously. My only request, which you needn't grant, is that among your comments please share your POV regarding the rights or lack of rights of residents of America to basic healthcare and solutions you might offer. Thank you in advance.


Dr. Goulston, what color is the sun on your planet?

I like you and all, and I think you have a lot of great ideas. However, in this case, I think you are way off.

First, how on earth did you ignore the fact that you are offering support to a marxist, socialist muslim who is also a narcissistic sociopath, fraud and consummate liar? There is absolute proof of this person's fraud gathered by legal teams and law enforcement personnel with decades of experience between them. Several congressmen have already seen the evidence and impeachment is being discussed. He has constantly been caught in lies, lies and more lies. No one believes him anymore except for the low-information crowd who are absolutely clueless to what is really happening in this country.

Then I just remember that you come from California---the land of fruits and nuts who also voted in the treasonous likes of Pelosi and Feinstein (who used their government positions to enrich themselves with insider trading (Pelosi) and getting her husband lucrative government contracts to the tune of a billion dollars for themselves (Feinstein.)

I keep tabs on what is actually going on in government. I am on the mailing list of several senators and a dozen political action committees. I stay away from the biased, controlled-by-the-wealthy-psychopathic elite who own them and manipulate the news to further their agendas with lies. I do listen to several alternative media (Like Newsmax and Western Net Daily, as well as others including Iran's Press TV.)

No, we are no longer the richest country in the world. Since that person has been in office, we have become upwards of 17-trillion in DEBT. Debt is NOT wealth, Dr. G. More than half of his country is on some kind of government dole already. Except for 1% of the population, the remaining half is struggling to keep up and being drained to support the lazy half.

I am not sympathetic to the poor. I come from poor, and I have had to work hard for everything I have gotten. I resent having it stolen from me to support a bunch of lazy and ignorant who will do nothing but live off of others so they don't have to take responsibility for themselves and their own lives-----which is what being an adult is all about!

No one in this world OWES anyone anything. We do NOT owe anyone health care. If people are sick, it's their fault. If people are poor, it's their fault. They should be looking to their Divine creator for their sustenance and not the government.

People (i.e. liberals) who think that all people should be dependent on the government and that the government should be taking care of people is seriously psychologically messed up. God says if a man doesn't work, he doesn't eat. Check your Bible!

What about social security and Medicare? WE PAID INTO THESE SYSTEMS! It's our money, not government handouts! They government has stolen these funds and mismanaged them. And now you want them to manage our health care?

Oh, yes. The government believes in welfare alright-----for themselves! At the tune of serving six years in Congress and getting $174,000 plus salary FOR LIFE, $450,000 plus for retired presidents, and $223,000 plus for Speakers. These people are making themselves wealthy off the labor of our backs. The same people who are forcing O'care on us, are excluding themselves from the same laws. The same laws they force on us---they always find a way to exclude themselves because they think they are so much more above us.

Yes we have a sick population. Our food, air and water are being polluted with chemicals from the geoengineering fraud, excessive use of glyphosate and other pesticides & herbicides because of GMO's, as well as chemicals in our foods that are making people sick. We have a fraudulent system between the FDA and USDA, which have a revolving door between individuals who serve themselves and make policies in their favor and harm the rest of us.

In the last several years, I have not spent more than $100 on "medical care." I knowingly and deliberately DO NOT HAVE health insurance. If I think I need to see a doctor, I pay my own way to get a diagnosis, and then I look for a REAL doctor who tells me how to be well without drugs! My friends ask, "But what if you get cancer or heart disease?" I KNOW I would never allow myself to be treated by "conventional medical means." I have worked in the medical field for several decades and know the kind of fraud, waste, greed, etc that goes on in it, and I am now happy to be out of it. I have already been forced for years to pay into Medicare when I am not even close to needing this, and will NEVER sign up for this.

I am one of those people who RESENT and OPPOSE Obamacare. It's the worst piece of legislation to ever come out of D.C. I am not interested in seeing our country taken over by communism---which is what is happening right now. I supported Ted Cruz, Mike Lee, Rand Paul and others who are fighting against this heinous legislation---- as well as fighting for our other freedoms. I think you are naive as to what is actually happening in this country under this horrible law. We DO NOT need a single-payer government-managed health care system. I also think you are naive as to what is actually happening to the quality of care in other countries as a result of such system. The so-called "death panel" in O'care is very real, Dr. G. The elderly population will suffer more under O'Care because they will be denied care. You need to get a revelation. Already members of Congress are seriously considering FORCING doctors to add O'care patients to their already burdened load---even if it means at gunpoint! (Yes, they would. In Virginia, parents were forced at gunpoint to have their children vaccinated against their wishes.) This is the kind of country you want all of us to live in?

The House Republicans did not cause the shut-down. A temper-tantrum throwing, spoiled brat in the W.H. did this. In fact, he planned the shut-down way ahead of time. This person is out to ruin this country knowingly and deliberately, and it disgusts me that you support him. If you want to live in a communist country, Dr. G. there are plenty of them out there from which you can choose to move. The Republicans did try to compromise and dialogue with the brat in the W.H. He is the one who consistently said he would not negotiate.

I think overall, your article looks like brown-nosing on O'---and I am sure you know what that means. People like me who are well-read and researched on what's really going on in our country are not going to be influenced at all by what you have written here.

I could go on-and-on here, but I'm not. I am, however, forwarding you some information on a psychiatrist with decades of experience in forensics, etc, who has written a book I think you need to read. I think you are well aware that the majority of persons who go into the field of psychiatry do so because of deep personal, psychological problems they are looking to resolve, and I think after reading this article that you need to go a little further in your education. Basically, liberals have psychological problems that cause them to think they have to save everyone to the point of not allowing people to be responsible for themselves.

People for decades have already been getting free health care. There are free clinics all over this country. I do not know of any hospital that has ever turned away a patient in need. Our doctors even go to other countries and give medical care for free. I have worked with doctors for many, many years. I have known them to not charge patients. Even doctors I have worked for have gone to help in other countries for a time. I know a retired family practice physician who volunteers his time now to provide free health care. I have known people to take up collections to help out another person in need of medical services. I know of a Christian service called Medi-Share (look it up) which is not insurance, but the members voluntarily share each other's medical bills.

There have been charitable organizations who have funded children's hospitals and research hospitals and helped people out that way. For example, the Koret Family House in San Francisco (which I have contributed to in years past) provides free lodging and meals to families with a family member getting cancer care in San Francisco. When and where there has been a real need, there has always been help.

We have already had great health care. Letting the government take it over will just #^(! it up. O'care is NOT about health care at all. It's about the government getting in and exerting more control and loss of freedom over all of us. The government will ration the care, and it will not be fair.

Really one of the WORST articles I have ever seen you do. Please get off that bleeding-heart liberal high-horse and grow the hell up already. People need a hand-up to show them how to take care of themselves and not a handout that keeps them dependent and helpless. O'care is ruining health care for everyone in this country---you are just not paying attention.

November 10, 2013 | Registered CommenterMark Goulston

Dr. Mark,
I would think it's difficult for people to deal with the President when he is on record of knowingly saying (over and over) that:
"...keep your health plan..." and "...keep your doctor...'" were both blatant, knowingly UNTRUTHS. (Read: lie.)
Where's the TRUST?
When Republicans never voted for the un-afordable care act from the get-go what's different now?
--other than the 'glitches'?
Since when has 'big government' been better than private enterprise?
Phil Foley

November 10, 2013 | Registered CommenterPhil Foley

To Phil and my prior commenter,

I am not a fan of big government's ineffectiveness or inefficiency vs. that of private enterprise.

My concern is with the values of private enterprise that over and over again demonstrate a lack of caring by rich people for those who have less or at the very least an indifference.

When the gap between the 1 % and 99 % seems to have widened in the past several years despite record gains in the stock markets and wealth of the already wealthy, I have reason to pause who will benefit from those more effective and efficient accomplishments by private enterprise.

I hope you will be able to disabuse me of my concerns.

November 10, 2013 | Registered CommenterMark Goulston

Dr. Mark,
The U.S. has (less than effective) programs in place to serve the people of Your concern.
Obamacare passed the Congress (in part) due to 'untruths'.
To wit: (NBC News, no less...)
That means the administration knew that more than 40 to 67 percent of those in the individual market would not be able to keep their plans, even if they liked them.
Yet President Obama, who had promised in 2009, “if you like your health plan, you will be able to keep your health plan,” was still saying in 2012, “If [you] already have health insurance, you will keep your health insurance.”

Where's the Trust ? (in any conversation with the President)
Phil Foley

November 11, 2013 | Registered CommenterPhil Foley


November 11, 2013 | Registered CommenterPhil Foley

Adjustments are warranted that better represent humanity.

Ideally, what could occur would be those in positions of power to forfeit whatever desires they may have to subjugate alternatively working for the common good. It is fair to say given the status of the political environ we are experiencing that any effort by a president would be compromised however well-intentioned that might be.

Those with political motives are dependent upon winning the favor of those thoroughly entrenched with resources to finance campaigns with the aim of dictating public policy. Capacity for discernment is therefore forgone and possibility for process to be followed through on.

Campaign finance reform would translate into a more wholesome dialogue in relation to health care reform in my opinion. Money does a lot of talking. Once those influences are sufficiently reduced, I think we'll see more listening and actions on behalf of our collective interest.

The ninety-nine percent and the one-percent referred to really need to focus on the whole where it belongs for anything worthy to be achieved.

Strategy, efficiency and effectiveness all have merit so long as representative the well-being of all persons involved.

November 15, 2013 | Registered CommenterMark Johnson
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