Unshackle insurance

Corporate America spends more on health care than it earns in profits.

Hadn’t seen that before.  But, for the reason above (and several more), it is striking how much business wants to continue to involve itself in the provision of health care insurance coverage.  It feels like more of a “the way we’ve always done it” sort of conclusion as opposed to a distrust of government, taxes will increase argument.  But health care expenditures go up, up, up and will continue to do so even with yesterday’s announcement.

Insurance coverage that follows people as they job hop/strike out on their own would boost American productivity.  Short-term plans are annoying.  COBRA too expensive.  And individual insurance purchasing not rewarded by employers.

Part Deux: Marketing is everything, especially the “process” stuff

Eric Karjaluoto tells a story about why you should consider forgetting social media.  Agree or disagree; there’s a larger marketing lesson in his story.  It’s a tale of finding a dentist in Vancouver and the importance of s-e-r-v-i-c-e.

The first dentist’s office is ultra-sleek and equipped with all the modern amenities (e.g., flat screen TVs):

My young, impeccably well-groomed dentist (who I have since nicknamed “Mr. Shiny”) finally made his appearance. He greeted me warmly and asked, “What would you like to change about your smile?” By the end of my appointment, I had a work-order in hand for approximately $1,000 in services. They seemed to believe that these were quite pressing matters that should be addressed quickly.

Feeling uncomfortable with the experience, he decided to look for another dentist.  Found was a dentist’s office with imperfect decor and lacking (the admittedly unnecessary) modern amenities:

My new dentist spoke with me for a few moments, and then proceeded to clean my teeth. I’ve never had this happen before; in my experience dentists dart-in and do the “big stuff” leaving the cleaning to an army of bubbly twenty-year-old hygienists. I was rather dumbfounded.

She explained that although this may be a less profitable approach, it helped her better “know” her patients’ teeth. She told me a little about her kids and how proud of them she was; no big sale–just a friendly chat. Along the way she mentioned that although her practice is small, at the end of the day she always feels good about the work she does.

I noted that I likely had work that needed to be done, given the results of my check-up and the procedures that were suggested two years ago. She looked closely at the x-rays and explained that although she’d love to sell me something, I really didn’t need any of it.

This goes back to the marketing is everything, “process” stuff conversation.  Provide excellent service and the “marketing” budget could be slashed; pay attention:

The dentist I finally ended-up with simply concentrated on doing her job well. While so many of us are overwhelmed by the many things we could do to market our companies, I believe hers is in fact a much better way to do so.

Within five-minutes of leaving my new dentist’s office I called my parents to talk about how great the experience was. Since then I have told no fewer than ten people the same story. I’ve even started conversations with friends noting, “Do you have a good dentist? If not, I just found an amazing one!”

The promise is on paper, fingers crossed?

Execution! “The last 98%.”

Groups representing hospitals, health-insurance companies, doctors, drug makers, medical-device makers and labor … will promise to help reduce the growth of national health-care spending by 1.5 percentage points in each of the next 10 years. (Wall Street Journal)

Cynicism aside, it’s a good first step.  Certainly a far cry from Harry and Louise (though even their views have changed).  But remember, a reduction in health care cost growth still means health care cost growth.  The left is optimistic, the right is trying to get organized.

A new normal

Some say that our economy is on its way to a slow recovery.  Well that’s good.  But are we returning to?  How it was before we knew that geeks with formulas were messing with assumptions of risk?  Likely not (help us, please!).  But memories are short

influx asks:

What happens if instead of waiting for normality to return, we are lurching forward towards a new normal that looks nothing like the old one?

Have you thought about that?  The reality of this stuff is staggering (and impactful on already-faltering business models).

influx continues:

The future is not about producing less or more of what you currently make or do, but re-thinking it all.

Now is the time to discover and imagine what those new things could be and there’s probably never been a better time to do this. Across whole categories people are applying a very critical eye and filter to determine what’s wrong and excessive and what feels precisely right.

Familiar concepts like price, value and quality are all in the process of being re-defined and re-thought.

Simply assuming the same old rules apply is naive and misguided. Every single brand should be out there learning and trying to work out what can make them relevant for this new future. For anyone involved in thinking strategically and/or creatively about these challenges, these should be very exciting times.

Everything is marketing, especially the “process” stuff

Yesterday, the groundwork was laid on the importance of the process elements of a hospital visit.  Patients, when evaluating their satisfaction with a hospital visit, evaluate the service (interactions with providers and staff, satisfaction with hospital food, etc.).  They don’t judge the health outcome of their stay.  It makes a whole lot of sense because patients know good service; they’re less likely to know the right way to feel at discharge, unless the outcome is awful.  They evaluate within a familiar frame.

That creates opportunity for health care.  Here it is, From the Head of Zeus Jones:

we like to think that the best marketing ideas are actually company operations that happen to be really appealing or compelling to customers too. One of the many advantages of this line of thought is that marketing is completely integrated into the business and you don’t have to spend money to build marketing programs that then build your business, you simply spend money on building your business.

Integrated marketing allows proper focus on the “process” stuff.  Spend “marketing” money on improving those elements instead of television commercials pushing the brand.  The process is where the (good) (and bad) stories happen and the stories are where the brand is genuinely pushed. Given the power, story works.

Traditional health care marketing is not marketing.  Integrating “marketing” into every operational activity is.

Need ideas?  There are several here.

(link via influx insights)

Strategic Guessing

Serendipitously, the planning quotations keep showing up.  It’s great!  From 37 SignalsSignal vs. Noise blog:

Why don’t we just call plans what they really are: guesses. Unless you’re a fortune teller, long-term business planning is a fantasy. There are just too many factors that are out of your hands: market conditions, competitors, customers, the economy, etc. Writing a plan makes you feel in control of things you can’t actually control.

In fact, you might as well change the name of your business plans to business guesses, your financial plans to financial guesses, and your strategic planning to strategic guesses. Do that and you’ll probably start putting a lot less weight into those things.

That thought inspired by a pair of academics, Ian MacMillen and Rita Gunther McGrath, who amongst other things say, “It’s not failure that companies need to avoid, but rather failing expensively.”  Failure is good.  It’s learning.  More importantly it’s not planning, it’s doing.

“Process ‘beats’ outcome,” hospital food tumblog

Hospitals should be scared of anecdotal stories.  The one time that surgery resulted in a mistake.  The one hospital stay with rude staff/patient interaction.  The one time that a communication breakdown between providers resulted in a longer stay.  Scared because the best (worst!) stories are powerful and they spread (and if it’s happened once, it’s likely happened again).  The “little” stuff matters, too.

Tom Peters, commenting on a Press Ganey survey, accurately writes:

(1) Process “beats” outcome in evaluating an “experience”—even one as apparently “outcome sensitive” as a hospital stay. The positive quality of staff interactions were more memorable than whether or not the health problem was fixed.
(2) Happy staff, happy customers. Want to “put the customer first”? Put the staff “more first”!
(3) Quality is free—and then some. We learned (well, most of us learned) when the “quality movement” dominated our consciousness that not only was quality free—but doing the quality thing right actually reduced costs, often dramatically.

With the attention being paid to patient satisfaction in hospitals today, it is interesting that organizations haven’t launched an all out assault on “process” elements (begging for 5s in Press Ganey’s patient satisfaction survey is far from such an effort).

Taking all of this into account, one might think that if a hospital appears on this Hospital Food tumblog (via Boing Boing), appropriate action would be taken.  Appropriate action, in this case, would be to completely reinvent the hospital food experience.

It’s A-L-L process “stuff” in the patient’s eyes.

Dinnertime: Henry Mintzberg

Today for dinner, the genius of Henry Mintzberg.

Mintzberg in his 1994 HBR article titled “The Fall and Rise of Strategic Planning” (there’s a book by a similar title) (the article is basically an examination on the fallacies of “strategic” planning) describes two types of planners in the planning department: the extremely analytic, order focused, right-handed planner and the more creative, quick and dirty, left-handed planner.  He then writes:

Many organizations need both types, and it is top management’s job to ensure that it has them in appropriate proportions.  Organizations need people to bring order to the messy world of mangement as well as challenge the conventions that managers and especially their organizations develop.  Some organizations (those big, machine-like bureaucracies concerned with mass production) may favor the right-handed planners, while others (the loose, flexible “adhocracies,” or project organizations) may favor the left-handed ones.  But both kinds of organization need both types of planners, if only to offset their natural tendencies.  And, of course, some organizations, like those highly professionalized hospitals and educational systems that have been forced to waste so much time doing ill-conceived strategic planning, may prefer to have very few of either!

In 2008 he sat down with The Globe and Mail‘s Report on Business to discuss the financial collapse.  The problem, as Mintzberg sees it, is too grand a focus on individualism and not enough on community building in organizations.  Hallelujah:

We should focus on building institutions and we should focus on building strong institutions and focus on building those strong institutions through what I prefer to call community-ship. In the United States particularly, they just make such a huge fuss over leadership, it has become an absolute obsession. Everything is leadership, leadership, leadership. It is not coincidental that the more fuss that Americans make about leadership, the worse their leadership is whether it is corporate or political or anything else. Their leadership is dreadful in recent years and with all of this fuss on leadership. Leadership is about individuality, leadership is about me. Even if leadership is designed to encourage and to bring along other people and engage other people, it is still the individual driving it. So, show me a leader and I will show you all kinds of followers and that is not the kind of organizations that we want. That is not the way that we build things up. I think that we need to put more emphasis on what I prefer to call, there is no word for it but I use the word ‘community-ship’, which is the idea that corporations and other organizations, when they function well, are communities. People care for each other, they worry about each other, they work for each other and they work for the institution and they feel pride in the institution.