Is Your Organization Ready for the Coming Election?
Spring Street Exchange held its first scenario planning roundtable shortly following the 2016 election. After a brief recovery from my own shock, I started to call colleagues around the country asking about their organization’s plans in the context of the Trump presidency. Many claimed to have some form of inside scoop (incidentally, many of these ‘scoops’ conflicted with each other!), but few organizations had explored how the outcome of the election would impact their patients, members, employees, partners, and communities. This led us to bring together a group of executives to explore how the Republican platform for could impact various stakeholders in our industry. And thus, our annual cross-sector scenario planning forum, now known as Scenario Palooza, was born.
Fast forward eight years as the 2024 election approaches and even more is at stake on the ballot than back in 2016. For most of us, the outcome of this election has tremendous impact for their personal views and hopes for the country. For others, the issues being debated may feel vital to their very being. Rampant disinformation creates an environment with varying perceptions of reality, which can lead to fear and distrust.
The political implications of this election are even more uncertain because the Trump campaign does not issue policy papers that are typical of a presidential platform. Instead, we must surmise the priorities of his candidacy from speeches, social media, from views of right leaning think tanks, and from political leaders whom he may consult.
As healthcare insiders we cannot fix the social climate around us, but we can take steps to prepare our organizations both for election season and for potential outcomes.
1. Preparing for the election: We can provide supports both for employees who are unsure and on the front lines with consumers, as well as for consumers themselves who may be concerned about access to healthcare and safety.
2. After the election: There are myriad possibilities for the results of this election and the policy implications. We consider exploring three.
Biden: We can expect continuity in healthcare policy with continued focus on topics such as coverage expansion, consumer protections, health equity, and cost containment.
Trump: With a Trump presidency, we explore two difference potentialities:
A restrained platform that assumes a shift back toward the healthcare policy platform of the previous administration and shared by right-leaning policy groups.
An unrestrained platform that includes some of the more extreme rhetoric coming to pass, reflecting a radical departure from democratic norms.
As mission-driven leaders, we can remain focused on how to fulfill our organization’s mission in whatever direction the healthcare landscape takes.
Note: The impact of the federal elections could vary by the state and many other factors. Healthcare organizations will want to explore the elections in light of their own political environment.
Preparing for Election Outcomes
A. Supporting Employees, Patients, and Members
Many voters in both parties believe that the future of our country is on the ballot this fall. For individuals who feel vulnerable due to policy positions the outcome can feel like an existential threat. This perspective could be held by people born in another country; racial, ethnic, and religious minorities; those concerned about reproductive health such as abortion, birth control, in-vitro fertilization (IVF); members of the LGBTQ community; those dependent upon government programs for benefits and healthcare; and more. To support these individuals, organizations can focus on support, providing training, and proactive communication:
Listening and Recognition: Acknowledge the environment and the fears that people may help to ease tension. Listening to how the election could be perceived by colleagues and constituents can help an organization to understand risks and help people to manage stress.
Provide Training and Support to Front Line Workers: Those who have direct contact with members and patients may receive questions and interact with people who are concerned. Some could be receiving information from unreliable sources and potentially have inaccurate beliefs about their own risks.
Communication: Share positions on any of the issues that are aligned with your organization’s mission. Communicate about the steps your organization is taking to prepare for the outcome of the election and reflect back the climate people are living in.
B. Managing Conflict and Differing Opinions
The polarized political climate can lead to conflicts among stakeholders, especially when they feel their views or identities are threatened by differing opinions.
Promote Respectful Dialogue: Encourage open, respectful conversations and provide guidelines on civil communication. Highlight your organization's policies regarding workplace behavior and the handling of political discussions to ensure a respectful and inclusive environment.
Create Safe Spaces: Where possible, identify spaces where people can ask questions, address fears, and seek assistance. Support affinity groups and employees who may feel marginalized or threatened by the views of others.
C. Preparing for Potential Civil Unrest
Government agencies are preparing for potential violence and civil unrest both leading up to and following the election. The level of unrest is uncertain and could vary by geography. Expectations range from voter intimidation, to lone actors, to organized movements. Anticipating and preparing for this potential supports the safety and well-being of employees, patients, and members.
Crisis Management Plan: Ensure that your crisis management plan includes protocols for addressing safety during periods of civil unrest, including sustaining healthcare operations and administrative support.
Communication Channels: Establish clear and effective communication channels to keep constituents informed about safety measures and any disruptions to services. Ensure that channels connect with public officials and community partners.
Security Measures: Enhance security measures at your facilities to protect staff, patients, and property in the case of civil unrest.
After the Election
It’s difficult to plan for an unknown outcome, especially because there are many other variables that influence the political dynamics. Luckily, we don’t have to be able to predict the future in order to plan for it. We suggest the following three scenarios as a framework for anticipating what could be coming ahead:
A. Democratic President
If a Democratic president is elected, we can expect continuity in healthcare policy. While we believe that this scenario warrants exploration, organizations pressed for time may choose to exclude this from their exercise.
Policy Continuity: Anticipate continued support for policies that expand healthcare access and protections for vulnerable populations. This could see a continuation of health equity targets built into quality metrics for government programs and a push for national-level protections around reproductive rights, women’s health, and health for LGBTQ populations. It could also reduce the gap between national and local carriers when it comes to community impact.
Shifting Political Norms: Follow political shifts as older members of the voting population are gradually replaced by Generations Z and Alpha and who have different voting priorities.
B. Republican President - Constrained
A Republican president with a constrained administration suggests a shift toward right-leaning policies but with systematic checks and balances in place.
Policy Adjustments: Explore healthcare policy briefs shared by leading Republicans in Congress and in right-leaning think tanks. Identify key variables that could impact your organization and its stakeholders. Define scenarios around these to identify risks and actions that could be taken to mitigate these risks. There may be new opportunities for your organization to meet the needs of your stakeholders.
Advocacy and Adaptation: Engage in advocacy to protect the interests of your organization and its constituents. This could mean shifting more resources toward monitoring policy, engaging in advocacy, partnering in the community, and working with others. Where policy changes take place, be ready to understand the impact and adapt to new regulations.
C. Republican President - Unconstrained
This scenario represents a significant shift towards authoritarian power, with potential threats to various communities and healthcare policy norms. While we do not know that this is a possibility, this scenario speaks to specific rhetoric by the candidate and some of his allies.
Plan for Immediate Steps: While long-term actions in this scenario are unknown, having a plan drafted for the immediate weeks following the election could help your organization to act quickly and mitigate risk. You may want to define positions your organization would be willing to take and an action plan to support those who may feel threatened.
Support for Vulnerable Populations: Increase support for those most likely to be affected by the change in administration. This could relate to policy itself and also to the social and political climate of the country. Organizations can provide additional resources and time for affinity groups, create safe spaces, and offer direct support and encouragement.
Emergency Preparedness: Revisit your organization’s emergency preparedness plans with an eye toward the risks associated with this election. For healthcare organizations, plans could include risk of civil unrest, protections for those at risk of harassment and threat of deportation, ensuring that people have access to needed medicines and care facilities, and putting protections in place for healthcare workers if needed.
Community Engagement and Coalitions: Strengthen community engagement and partnerships to support collective efforts in advocating for and serving those in need.
These three scenarios do not cover all of the potential developments that could take place between now and the election. Either candidate could face health or legal issues that could disrupt their candidacy and there are always additional wild cards on the table. Organizations will want to continue to monitor the environment to determine when additional scenarios are necessary.
Looking Forward
The 2024 election is different than any other election of my lifetime. Professionally, I have led numer scenario planning exercises on policy and elections over the past several decades; this is the first that includes planning for civil unrest regardless of the election outcome. For me personally this is sobering. It drives me to think deeply on my own values and role that I can play in the healthcare ecosystem and in our democracy at large. Like many of you, these thoughts distract me, and the risks we face can be difficult to fully envision. While there is so much to be rightfully concerned about, I remain convinced that we all have much more in common than the loudest rhetoric would lead us to believe. I hope that this optimism is not unfounded, and I also feel compelled to remain active.
How is your organization preparing for the election?
Warmly,
NW