Project managers will tell you there are three dimensions to any project: cost, quality, and time. Out of these three, there can be only one real driver; i.e., if low cost is of greatest concern, than the end-product's quality will inevitably suffer. Want something done top-notch? Don't expect it to be completed right away.
On occasion, you may be able get a second factor to play in your favor. Remember the tragic I-35 bridge collapse in Minneapolis? As a major metropolitan thoroughfare, the city needed a new, sturdy crossing over the Mississippi River, ASAP. They got what is perhaps the world's safest structure nearly three months ahead of schedule. But at nearly a quarter-billion dollars, they paid for it.
The feds told us healthcare reform was about creating a high-quality, affordable delivery system for every American within four years. Not only is that a lofty goal, it's impossibility by project management standards.
Healthcare reform's potential shortcomings haven't been overlooked by the health plan industry, though. In a speech for healthcare leaders at the late-October Nashville Healthcare Council, Karen Ignagni, president and CEO of America's Health Insurance Plans (AHIP), said the focus of the regulation on providing ubiquitous healthcare access has "crowded out cost containment and quality."
Granted, it's not an exact parallel, but the laws of project management may very well keep healthcare reform from achieving all its goals. Perhaps this is why we're now hearing that healthcare costs will rise as sicker individuals enter the healthcare system.