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A valentine for The Lady's leadership

February 14, 2013
by H. Steven Moffic, MD
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" I do not think there is a word for evil in Buddhism . . . There is no evil, just stupidity."

-Aung San Suu Kyi, in conversation with Ivan Suranjieff, Rangoon, Burma, August, 1995

 

"Aung San Suu Kyi is a remarkable and courageous human being. Listen to her voice and be inspired. . . Burma's the next South Africa."

-Archbishop Desmond Tutu

 

I had never thought of stupidity as an alternative explanation to what could be called evil. Religious beliefs? Yes. Some kinds of mental illness? Yes. Destructive gang behavior? Yes. After working in prison part-time, I even concluded that some rare prisoners could only be defined as evil. But I didn't think of them being stupid, even though they were caught and sentenced. Aung San Suu Kyi, the opposition leader of Burma (aka Myanmar), recently released from over two decades of intermittent house arrest, did make this conclusion.

While recently visiting Southeast Asia, I learned much about her, well-known as "The Lady." I also found fascinating similarities, as well as gender differences, to the male leadership of Mandela and Tutu, who I studied for a South Africa trip and presentation, and wrote about in the November 14th blog, "Leadership lessons from Mandela and Tutu."

When one thinks of some of the world's most harmful leaders, like Hitler and Pol Pot of Cambodia's "killing fields," one has to conclude that stupidity, if not an alternative explanation of evil, at least contributed to the failure of evil. Hitler stupidly invaded Russia prematurely, only to be repulsed and defeated. Pol Pot stupidly invaded neighboring Vietnam, fresh from a victory over the USA, and not surprisingly, was repulsed and defeated.

In mental healthcare, the only place I have heard the word evil being used was in reference to for-profit managed care. It was the rallying cry of a former President of the American Psychiatric Association, Harold Eist,  M.D., who railed against profits being put ahead of patients.

However, so far, for-profit managed care has not done anything stupid, and has not been defeated. To the contrary. Under President Obama's healthcare reform, the private insurance companies have received increasing responsibility, although with some new minimal controls and requirements. So, maybe Dr. Eist, in retrospect, had the wrong focus and terminology. Maybe the task is to defeat stupidity, not evil, with something smarter that could not only keep patients as the first priority, but be cost-effective in a smart, ethical way (as I tried to point out in my book, The Ethical Way: Challenges and Solutions for Managed Behavioral Healthcare).

Besides addressing stupidity, The Lady may have other leadership lessons for us. She always tried to be as inclusive as practically possible, as did Mandela, including even the repressive army dictatorship in her future democratic and spiritual vision. 

Similarly, probably the smartest aspects of managed care must be incorporated in future healthcare improvement, say in a not-for-profit managed single payor system.

The Lady also made sure to include all ethnic minorities in Burma. 

Goodness knows, we still have much to do in mental healthcare to improve the care of minorities.

The personality traits she valued the most were stubbornness and courage. She worked to control her temper. She tried to use charm to disarm.

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Steve:

Above, you seem to wonder why the ACA makes for-profit health insurers (described by Dr. Eist as "evil") integral to the process of delivering smart, ethical care that gives patients first priority.

When I wondered aloud to a health economist why the ACA kept a "balance" of public and private healthcare insurance, instead of preferring either a public single-payer or an "efficient" private approach, he took a moment to explain.

To paraphrase, he said that all of one or all of another would lead to excesses. A government single payer, he suggested, might lead to an excess of inefficiency, while a private-only insurance approach could well lead to an excess of profit.

Either, left to its own devices, "would screw it up," he joked.

Dennis,

I'm not sure I understand. What public options or insurance companies are part of ACA? And, I don't think Canadians would tend to agree that an all public, single payor option is not the best.

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H. Steven Moffic

H. Steven Moffic

H. Steven Moffic, M.D. retired from the clinical practice of psychiatry and his tenured...