Health care reform: through the lens of change.

Change theory concepts--drivers, vision, current and future states, and social buy-in--provide some analytical leverage in understanding current reform challenges. Various contentious issues in the health care reform battle have long served to polarize stakeholders and differentiate conservative and liberal positions. Successful change efforts are led by the development of a compelling vision, which has certain attributes. Change theory postulates that if there is not strong dissatisfaction with the current state, the future state is less feasible. Social systems change theory is another way to conceptualize and broaden our understanding of health policy as a form of social change, how environmental or external forces influence policy design, and how the ongoing media presentation of a policy influences direction of the outcome.