As the Supreme Court debates the fate of “Obama Care,” we should recall the formal name of the law: the Patient Protection and Affordable Care Act (PPACA). Most of the public debate has been about the cost of health care, losing sight of the urgent need to fix the ongoing crisis of quality and patient safety. More health care organizations need to adopt the lean management philosophy to “bend the cost curve” and save lives, as some innovators have proven during the last 10 years.

People in health care know that miscommunications are a major cause of errors and potential harm. A curious incident that occurred during game five of the 2011 World Series illustrated this issue in a very public way: A miscommunication set off an action that ultimately left the St. Louis Cardinals and their (now retired) manager, Tony La Russa, without the right pitcher for a relief appearance during the eighth inning. As a result, the Texas Rangers beat the Cardinals 4–2.

Let me give a big ole’ Texas-sized hat tip to Bob Emiliani for sending me the sad article with the headline  “General Motors Lays Off Workers at NY Plant.” This is in addition to General Motors Co.

Lean thinkers see the waste in health care when they are at the hospital gemba. I think this is true whether you are a lean person who is new to health care or if you’re a long-time hospital person who has learned lean. Experts (doctors) ranging from John Toussaint to Patricia Gabow to Don Berwick all estimate that between 30 to 50 percent of health care spending is waste.