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“Affordable health care is a right of each citizen, not a privilege for those who can afford it.” The quote refers to the intent behind President Obama's 2010 signature legislation, the Affordable Care Act (ACA). The struggle by the US Congress in 2013, which included the temporary shutting down of Federal Government, was part of an attempt by some Republicans to de-fund the ACA. It came as a surprise, therefore, to see the Government's launch of the ACA website fail spectacularly, for with such a failure to innovate by Government, the citizen still pays as a taxpayer for the failure, making such failures a betrayal of the citizen's trust in Government.
Government departments, like competing enterprises, work in silos, each one trying to defend itself against competing silos in order to secure the best possible future for itself. The market assumption is that if one such silo goes bankrupt because of a failure to innovate, the impact on the wider environment may be ignored. This is not the case where there are systemic interdependencies between the silos, however, as with health care. How, then, can the government be expected not to betray the citizen's trust when faced with such a complex innovation?
The paper uses the case to consider the difference between social defences against anxiety and social defences against innovation, proposing that it was the latter that led to the spectacular failure. The paper's conclusions are on the implications of this difference for working with organisations needing to innovate to survive.