What's missing from healthcare reform talk

By Scott Kirsner, Globe Correspondent  |  June 15, 2009

Revamping healthcare. Reforming the healthcare system is the debate du jour in Washington. President Obama was in Wisconsin last week to conduct town hall meetings about designing a more cost-efficient healthcare system without compromising quality, and today Obama is scheduled to address an American Medical Association convention in Chicago. Below, Charlie Baker, chief executive of Harvard Pilgrim Health Care, in his blog talked about some often overlooked issues:

"First of all, the problems we face as a nation with respect to healthcare costs and quality are not going to get better until Medicare gets serious about changing the way it does business. I've said this before, and I'll say it again: If Medicare is just Medicare, as it is and as it has been, healthcare reform - with or without whatever reforms are being discussed - will not result in lower costs or higher quality.

"Second, we are woefully underprepared as a nation to deal with the aging of the US population - and there is precious little in the debate about a "public plan" that will address this problem. I was on a panel discussing memory loss last week at my father's 60th [business school] reunion (which means virtually the entire audience was over the age of 80), and we talked quite a bit about whether or not the "system" is structured to deal with the simple demographics of an aging population. As a nation, we have very few gerontologists, fewer and fewer primary-care providers with each passing month, and little focus or attention on interdisciplinary medical researcher cross-functional care delivery models - [all] of which are critical to the success of managing an aging, medically complex population.

"Third, these federal debates almost never talk about diet and exercise - but these two 'preventive' measures, more so than almost any other, can dramatically affect healthcare costs and health status. Everyone is 'for prevention' when we talk about healthcare delivery itself, but when it comes to doing something about the two most preventive measures of all - eating better and getting up off of the couch - we seem to take a pass. Why?"
letstalkhealthcare.org

Celebrating simplicity. Technology entrepreneurs can get so obsessed with adding features to their products that they lose sight of what matters most to their eventual customers: simplicity. Venture capitalist Larry Cheng, a partner at Fidelity Ventures, blogged that simplicity has been one of the guiding principles at "every consumer or mass-market company I have invested in":

"While many competitors try to build in more capabilities, more functionality, more content, more, more, more - the winners tend to be incredibly skilled at keeping things very simple. It plays itself out again and again: You don't have to be first to market, nor the most full-featured, not even the most attractive - you just have to be the simplest. Some examples:

"SurveyMonkey is the market leader in the online surveying space. They have barely touched the product in five years. There are hundreds of online surveying options, but they continue to dominate because they are the simplest.

"Craigslist is drop-dead simple, and I'd argue drop-dead ugly. But they are the market leader in online classifieds because of the former, not the latter.

"I just got the Flip UltraHD video camera. It's the perfect example of out-of-the-box simplicity.

"You can't talk simplicity and not talk about all the Apple products - Mac, iPod, iPhone. Again and again, not the first to market, but just the simplest.

"Over the years, I have come to appreciate that building a product, service, or application that is defined by its simplicity is extraordinarily hard. It takes real talent and ingenuity to create simplicity. And once you have achieved it, it is as real a barrier to entry as a slew of patents or technical secret sauce. Simplicity is that valuable."
larrycheng.com

Phone envy. An Apple event sans Steve Jobs doesn't quite create the same buzz, but last week Apple introduced new laptops and a third iteration of the iPhone. Some current iPhone users griped that the way the iPhone 3GS is priced - starting at $199 - penalizes them in favor of creating an incentive for new customers. Carl Howe, of Yankee Group in Boston, dug into the details:

"A more in-depth look at iPhone 3.0. This next release of the iPhone software will take iPhone applications to an entirely new level. The keynote announced capabilities like 'Find my iPhone,' which will map where your iPhone is and audibly identify it even if it's silenced, and support for new peripherals ranging from blood glucose monitors to pressure sensors. But most impressive were new capabilities such as in-application purchasing, [multimedia messaging], tethering [allowing the phone to connect to a laptop for Internet access], and over-the-air movie purchasing. And of course, there are the 50,000 applications to provide you anything Apple doesn't provide directly. iPhone 3.0 will be available June 17.

"New iPhone 3GS and iPhone 3G pricing. At around an hour and a half into the keynote, many viewers feared that no new iPhone would be announced. Fortunately, [Apple marketing executive] Phil Schiller proved them wrong by announcing the iPhone 3GS, which sports a faster processor . . . auto-focusing video camera, and voice control. The 32-gigabyte iPhone 3GS will sell for $299, the 16-gigabyte model for $199, and the iPhone 3G will drop to $99, all with two-year AT&T commitment; pricing in other countries and with other carriers will vary by subsidy. The new iPhones go on sale on June 19.

"What about the elusive Steve Jobs? Despite much speculation that he'd magically appear . . . he wasn't seen at the event. And while demonstration flubs may have run more rampant than they would have in the typical Steve Jobs show, it didn't matter in the end; the Apple team announced the products, showcased the features, and got the job done well, if not in Steve's inimitable style.

"And that may have been exactly the message Jobs intended to convey."
blogs.yankeegroup.com

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