Why the U.S. health care debate could kill your international work

davidlivermore | August 19th, 2009 5 Comments

[To my friends and colleagues outside the U.S., my apologies for posting something primarily intended for my fellow U.S. citizens. But I can’t hold back any longer.]

Sick of being called an “ugly American?” All the hard work you’ve done to come across as a respectful traveler or colleague is quickly being unraveled by the inflammatory rhetoric occurring related to health care reform. I’m not really interested in debating the reform itself right now but in HOW we’re having the debate and how that will affect your international work at home and abroad.

As one friend from outside the U.S. asked me the other day, “Since when has socialist become a swear word?” Hang on! I’m all for a healthy debate about whether government-run services and business are a good direction for the U.S. But can we accept that whatever we decide is best for our country isn’t the only worthwhile option for other nations? Do you know how offensive these diatribes against socialism sound to a lot of “conservatives” and “liberals” living in other places.

You might not be in the center of a shouting match at a local town hall meeting or even raising your voice when you discuss this with your friends and colleagues. But perception becomes everything. And the way this debate is getting pitched among the masses is eroding our credibility in our international work as Americans.

You can do everything right in developing a good international strategy, engaging in a different culture, and truly adapting your approach to be respectful and effective in a new cultural context. But fair or not, all that hard work may be easily drowned out by the larger image being portrayed of shouting Americans making disparaging comments about systems used in other countries.

Some of my international friends and colleagues are amused by the sound bytes that keep getting played over and over again. Others don’t waste their time watching. But some are watching carefully.

If you prepare to host clients from Germany this week, think about how they might feel about negotiating a deal if just last night they heard their country described as the epitome of what we don’t want to become. When you cross the border into Canada and get treated rudely just because you’ve come from “the other side”, consider the rant I just received from a Canadian friend:

“How come some “journalists” don’t have to fact check before saying crap like there’s a lottery system in Canada to see who gets healthcare that day? Ever MET a Canadian? We’ve all been to the doctor. For free. On the day we called to make the appointment. Then could come back again the next day. For free again. Then cross the street to the dentist and the optometrist, and get our kids’ free regular checkups. The overriding philosophy in Canada is that no Canadian child will ever go hungry. Sorry, but I can’t call that The Coming Apocalypse.”

By the way, according to a study by the Commonwealth Fund, Americans wait longer to see primary-care physicians than patients in Britain, Germany, Australia, or New Zeeland—all countries with public-health systems. 26% of Americans are able to get same day care. 55% of Germans are and 60% of Dutch are. 25% of Americans wait 6 days or more for an appointment.

I think it’s too simplistic to say this is simply because these other nations have public health plans. There are many factors at play. And my purpose again is not to advocate one way or the other on the health care debate. I’m simply challenging the way we’re having the debate and encouraging us to realize the issue is going to affect how you interact with people internationally. Moments like this mean we have to go into overdrive to demonstrate we aren’t ethnocentric and arrogant!

As a private citizen, I’m very interested in learning more about the reform being proposed, evaluating it and advocating accordingly with my local congressional reps. I’m very concerned about the questions that ask:
• Do we want OUR federal government managing OUR health care?
• How are we going to pay for it?
• Who makes the choices about medical treatments for my family and me?
• What happens to the 47 million uninsured if we don’t do something?

Can we please get back to the real conversation, rigorously debate the issues, and recognize that what’s best for our country might be different than what’s best for another one? Not only will this posture allow us to have a real conversation but it will enhance the way we’re received around the world!

[For more on the implications of socialism vs. capitalism for business, see Chapter 4 in Leading with Cultural Intelligence]

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