For those of us who spend our professional lives trying to figure out how to make the world a better place, our immediate measures of success can sometimes block our view of the future. More specifically, the focus on short-term objectives often hinders our ability to plan for what might await us if we actually achieve them. It’s the proverbial “Now what?” question.

As someone who has been inspired since my adolescence by the leaders of the civil rights movement (particularly Martin Luther King, John Lewis and Thurgood Marshall), I have long wondered about how they perceived the juxtaposition of their enormous triumphs of the 1960s coupled with the continued challenges that face the African-American community.

The New York Times’ columnist, Bob Herbert, shared an important insight in his op-ed column today along these lines:

“James Farmer, who helped create the Congress of Racial Equality on Gandhian principles of nonviolence, once told me that even as the civil rights movement was racking up its stunning successes, its leaders made a grave error.

“‘We did not do any long-range planning,’ he said. ‘So we were stuck without a program after the success of our efforts, which included passage of a civil rights bill and voting rights legislation. We could have anticipated the backlash that followed. We could have asked ourselves what the jobs prospects would be for blacks in the ’70s, the ’80s, the ’90s, and later on. By and large we didn’t do that, except for affirmative action. We should have had a plan.’”

Given the remarkable contributions that they made to society, I could never criticize them for lack of foresight (though James Farmer certainly has earned that right), but it does lead one to think (with respect to health care)…

…Universal health insurance seems so distant and yet we better have a good plan for what that system will look like when we get there…

…Reducing waste in the system means little if we can’t leverage new efficiencies to improve quality and the care experience…

…Ubiquitous adoption of information therapy is a long way off but it’s not enough to integrate targeted health information into the normal course of care delivery…

…I could go on…

For those of us trying to fix our broken health care system, we should be careful about focusing on short-term objectives to the exclusion of what we are really hoping to achieve: a truly safe, effective, patient-centered, timely, efficient and equitable health care system (to paraphrase the Institute of Medicine); and one that results in true health–a state of complete physical, mental and social well-being (to paraphrase the World Health Organization).

What is your answer to the question: Then what?

–Josh