The Cost of Agreement
The premise that fails you is rarely the one you are debating. It is the one everyone around you is paid to keep believing.
We live in a time when information is everywhere. Senior executives can access insights and shape debates easily. Maybe too easily.
Most live in carefully constructed worlds built to agree with a core premise before the conversations even begin. That doesn’t make those rooms useless. Thinking energy put forth in board prep sessions, with personal advisors, alongside current customers, with investors, and with trade peers is time well spent.
They also share the same flaw. None of them is designed to tell you the core premise itself is wrong. The thread binding these rooms is usually a focus on alignment. The strategy is deemed right, and the only work left is to prove it.
In my experience, gaining alignment and building conviction are two different exercises. The test is one question: “When was the last time someone pushed you by warmly debating why your entire premise is wrong?” I'm not talking about the tactics within a plan that’s already decided. This is debating the entire premise willingly.
To get to this level of debate, it takes time with leaders who have nothing to gain from helping you see through a different lens. It’s harder to trust insights that mostly reflect what is already believed.
How have I seen this play out over the years?
Not long ago, there was a leader who was organizing around a hefty consumer-focused technology investment with an internal team and a select number of customers. The strategy was drawn. The investment was scoped and ready to go. He showed up and outlined the problem he came to solve. And then two leaders from disconnected markets sat down with this peer and asked, “What if this is something you shouldn’t be doing?”
Two months later, he calls me and says those discussions helped him uncover blind spots that shelved the project. He thanked us and moved on with his day.
Right now, the debates are real, weighty ones. How will risk instruments serve the small and mid-sized employer effectively in the next five years, knowing that this is a loaded question given the current fragmentation in approaches? And are co-pay style plans the fix network-driven models need, or are they the stopgap that forces larger employers to build their own, controllable plays?
More questions could be named here for public consumption, but the real ones that gain relevance are the specific issues a leader will only raise inside a private room she or he trusts.
Can you name the decision you are carrying right now that has effects that may not be seen for a year or more? Maybe even three to five years from now? Then, can you name one person from outside your organization, whether you personally know them or not, who can help you hit this issue from angles that no one inside your organization can?
When’s the last time you left a room that was impressive with how forthcoming it was, especially after considering who was there, how it was organized, and what was arranged to advantage a pre-determined position? Neutrality is hard to find in healthcare decision making, but the right rooms aim to deliver this to isolated executives with big decisions ahead.
Premises get argued constantly. That is the work of the role. Consultants run the scenarios, the board pushes, the team stress-tests, and an AI model does some of it now. But every one of them is working inside the same incentive, which is to prove the premise that best serves the business. That is not the same as a peer who has no stake in your business telling you the premise itself is wrong or approaching obsolescence.
Many organizations already spend heavily to validate strategy and earn the stamp the board needs. The next question is what it is worth to know the thing you are validating is right before you commit to executing it. Exploring the adjacencies is where the blind spots surface.
How expensive was the last call that went wrong under your watch? Did that approach fail due to execution or something that could not be seen internally when you decided?
Every room you trust is built to help you prove the premise. The exception is built to help you work through whether it is still true. If you recognize the difference, you know which one you have been missing.