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By J. Daniel Beckham

Information - information creates, dislocates, and destroys industries. It is true that information is power. Information and power travel hand-in-hand. But information has busted out and escaped from its keepers. It is being democratized. And in this democratization lies the decline of the old information power brokers.

The professional classes that built their prestige and incomes on exclusive information franchises are being washed away. In their place is a new breed of dispassionate toll takers: "Take whatever information you want," they say, "for $20 a month, it's all you can eat!" Health care has been characterized by scant information on either results or price. As a consequence, customers have been ill-equipped to judge value, the most basic prerequisite for establishing and maintaining a competitive marketplace. That will continue to change. As information floods into health care, it will break up the power of traditional institutions and franchises.

James Burke, best known for the popular PBS series he hosted called Connections, described the Internet as a "diversifying" rather than a centralizing force. "It's pretty much uncontrollable." He described the Web as "everybody's broadcasting station. Printing was probably as giant a step in its time as the Web is now, but if you look at the context of printing, it was a small step then because it was available only to the tiny minority of the population who were literate and who had the kind of money you need to make, sell, or have access to it. Printing was easily controlled. All you had to do was grab the nearest printing press and tell the printer what to do, and you were in charge, which of course is what the political and religious authorities did within roughly a week of the emergence of the printing press."

Ideas - ideas are different from information. The temperature in Phoenix at noon is information. Marxism is an idea. An academic medical center and the German scientific model that gave rise to it are ideas. Specialized care is an idea. So is holistic care. The Internet was an idea long before it was a reality. Once they've been articulated and achieved a certain level of acceptance, ideas can bulldoze an industry.

Some ideas transcend into ideals - things worthy of honor and deep commitment. People will die for ideas and ideals. And they will fight for them in industries and in organizations. A vision is fundamentally an idea about the future. It has power when it's able to reach back and move people in the present.

Resources - Resources also have been historical shapers of industries. Of all resources in recent history, few have proved as influential as oil. Wars have been fought over oil and nations built on it. It fueled the growth of the American auto industry and with it a lifestyle based on easy movement.

It also made possible the rapid deployment of what has probably been the most critical resource in health care - highly educated labor. The American labor force has always been highly portable because petroleum-powered trains, cars, and planes made them so. Through this portability, trained medical professionals became available nationwide. And new training centers sprang up to produce more of them.

Economics - Economic forces wash over the landscape of industries with regularity, leaving them transformed. High compensation for specialists begets a surplus of specialists and shortages of primary care physicians. Laws of supply and demand drive shortages and surpluses. And, when left to do their work, these laws generate tendencies toward balance. Competition on the basis of price and quality tend to drive down the former while driving up the latter.

Today's marketing channel is tomorrow's quaint anachronism. I bought my first computer from a store that sold only computers and only one brand at that. I bought my most recent computer on the Internet. It came in a box delivered by UPS. I'll probably never talk to the people I placed the order with again. And I didn't even see the UPS man who dropped it off.

Copyright © The Beckham Company             Future Scanning – Mar. 1997 (Prediction)

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