Health care reform planners and wicked problems: Is the wickedness of the problems taken seriously or is it even noticed at all?
OBJECTIVE
The purpose of this paper is to examine the planning of the National Health reform especially the "guarantee for care" reform within it--from the perspective of the concept of wicked problems. This concept asserts that it is of the utmost importance to see the true level of complexity of the problems in order to survive them. The paper tries to the answer the question of how the planners of the health care reforms see the problems they are trying to solve.


METHODS
This is an interview study. A total of 12 people who participated in the planning of the examined reforms at some level were interviewed. The interview method was a semi-structured thematic interview. The research analysis is theory-originated content analysis.


RESULTS
The hypothesis is that the planners of the examined reforms do not focus enough on the complexity of the problems they tried to solve. The research, however, shows that the wickedness of the problems was often noticed. Unfortunately it was not taken as seriously as it should have been. In other words, the planners mostly saw that the problems were very complex, but even then the solutions were only like solutions for tame problems or messes.


CONCLUSIONS
The paradigm shift from Newtonian science--which sees the world as a deterministic system--to a more complexity-endorsing view is on its way. The world is a dynamic and open system, which cannot be controlled. The paper makes its own contribution, from the perspective of health care problems and reforms, to advance this paradigm shift.
University of Vaasa, Vaasa, Finland. harri.raisio@uwasa.fl
Harri
H
Raisio
D003071:Cognition; D003659:Decision Making, Organizational; D005387:Finland; D018166:Health Care Reform / Q000379:methods / Q000458:organization & administration; D006292:Health Priorities; D006293:Health Promotion; D006801:Humans; D007407:Interviews as Topic; D009313:National Health Programs; D019982:Organizational Case Studies; D009936:Organizational Innovation; D011340:Problem Solving