Slicing Up the Task
The job of a leader is to do the tasks only she or he can do and delegate the rest to others. That is what followers want most: They want the chance to do the things that are challenging but doable. And they don't want to be given jobs that are genuinely above their capability level. If the leader hoards jobs that followers can do, the followers don't feel stretched or fulfilled. If the leader hands jobs to followers that followers can't do, the followers fail and blame the leader (not unreasonably) for the failure.
So the answer to the question of top-down versus bottom-up is: It depends. One interpretation is that the tough job was to define the broad design principles; Obama did that tough job and gave to the next level of subordinates the doable task of designing to his specification. And in doing so, he opened the possibility of benefiting from a multiplicity of useful views. An alternative interpretation is that redesigning health care entails the highest degree of difficulty in the portfolio of Obama's tricky decisions and that Obama has delegated that job to those likely to fail because nobody below him has the integrative viewpoint.
I think it is impossible to tell from afar which is the case. The secret lies in the nature of the "broad principles." No decision by any CEO, whether POTUS or a corporate CEO, is the final word on a matter. The high-level decision begets further decisions that are required to bring about action. A CEO can say, "We have decided to invest and win in the widget business," but the president of the widget division, who knows that division better than that corporate CEO, needs to figure out exactly how to bring the CEO's plan to life.
So setting out the "broad principles" is not abdication of decision-making but rather making the first slice of decisions in a long choice cascade. The only question is whether Obama made the first slice thick enough or not. I, for one, hope it was just thick enough.
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