Top Down Healthcare is Killing Your Business and (Literally) Killing You and Me


For hundreds of years, innovation has driven improvement in medicine. Innovation in patient care. Innovation in business models. Innovation in treatment.

Dramatic innovation requires a chaotic marketplace—a marketplace for business as well as a marketplace for ideas.

Conformity is innovation’s enemy.

Now take a look at the following visual:

On the left side, you see the situation before ObamaCare. There are multiple competitors in the market—here, in our example, cardiologists. In order to succeed, they had to deliver a better experience to their referral sources, they had to deliver a better experience to their patients, and they had to develop high levels of medical expertise. This required innovation across the board, not simply doing the minimum required to keep their doors open.

As we move toward the right on the visual, with increasing regulation and, importantly with the increasing pressure to align with hospitals, joining ACOs and even becoming employees of hospitals and their affiliates, there are fewer competitors. Those fewer competitors have less reason, and less freedom, to innovate. In order to keep their jobs they must conform. They are now factory workers in someone else’s healthcare factory. The fact that the funnel-like image can be rotated 90 degrees clockwise and appear similar to a meat grinder is not unintentional.

So what happens to innovation? What happens to excellence?

Sorry, but I don’t believe for a moment that medicine will attract the same level of interest among high achievers 20 years from now unless there is a radical change. It might be possible to make more as a plumber. There certainly will be more freedom.

None of this is good for your business. None of this is good for your health, or mine. But the bureaucrats will be able to measure things. They’ll know whether you gave an antibiotic at the  “right” time. They’ll know how many hours you worked. They’ll measure whether you gave test “A” before test “B.”

The bureaucrats will have exabytes of data on measurable stuff. But the important things, the really important things, will be ignored because they can’t be measured – take, for example, innovation that never occurs.

Over the next several months I’ll post entries on this topic including strategies to opt out of the serfdom that those bureaucrats who (they think) are smarter than you have in store for your future.

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