Joe Flower Speaking

The leading healthcare speaker . . .

... for times of massive change

Are you ready for the future of health care?

Featured keynote talk topics

15 Ways To Make Healthcare Cheaper - by Making It Better

The Rising Tide of the Unremarkable in the Future of Healthcare

By Joe Flower, from Hospitals and Health Networks Weekly, 1/19/10

Below the fold and off the radar, way out of the range of town-hall screamers, talk show ranters and headline writers, and even largely outside the awareness of most policy wonks and health care executives, a growing ferment, a yeasty mix of new technologies, relationships, expectations and business models has been maturing. Health care is changing in ways we may have difficulty picturing, let alone adapting to, or using.

Senate Compromise on Health Care Reform: Genius? Doomed?

Democrat Roland Burris, the sudden senator who replaced Barack Obama in that august body, has now joined those who are pledging to filibuster any bill that does not have a "public option" – joining of course those, like Connecticut's ineffable Joe Lieberman who will filibuster if it does have a "public option," or a Medicare buy-in for 55-64s, or support for long-term care for the frail elderly, or in fact anything that would alter the great and glorious status quo, so clearly fine-tuned as it is for the good of all of us who don’t have a few billion dollars to throw around.

One might think that the compromise that is brewing would have the capacity to turn all such pledges inside out. The compromise would allow 55 to 65-year-olds to buy into Medicare, while letting under-55s without insurance into the Federal Employee Health Benefits Plan, along with mandates to buy in, and subsidies for those who can't afford it. If this does indeed emerge, liberal Democrats in both houses may have some trouble defining what they mean by the "public option" they are so strongly demanding. Is it a "public option" for 55-and-overs if they can buy into Medicare? Sure sounds like it - a government-run plan that people can buy into, in competition with private plans. Is it a "public option" if the federal Office of Personnel Management  runs an exchange called the Federal Employee Health Benefits Plan (FEHBP) setting the rules and transparency for private plans, with subsidies and tax credits for those 54 and under who can't afford a health plan? Sounds close, but not quite. Close enough for confusion, at least.

And that, in a way, is the point. The political intelligence behind the compromise  is precisely that, on an issue where the two sides had come to sharply differing opinions, with both sides digging in their heels, the compromise fuzzes the lines. It replaces the bland phrase "public option," which has come to mean "the savior of the people" for some and "creeping socialism" for others, with Medicare, which politicians regularly praise and promise to save, and the FEHBP, which politicians have often praised, saying that everyone should have one at least as good as Congresspeople and the President get.         
                      
The compromise, like all real compromises, is a kludge and a mess and a camel made by committee, but politically it has a certain genius. If the goal is to get a bill passed, this just might work.

The power to name is the power to frame, as semiotics guru George Lakoff reminds us - Obama should have replaced the bland wonk phrase “public option” with “The American Plan” and let opponents try to argue against that (“Why do you hate the American Plan?”). 

But this particular dollop of re-framing genius didn’t come super-sized, and may be way too little, way too late. The abortion foes are calling the attempts at compromise on that issue “accounting tricks,” Republican Olympia Snowe is maintaining her Olympian distance, and Senator Lieberman seems to be saying, “I say it’s broccoli, and I say the hell with it!”

Democrat Roland Burris, the sudden senator who replaced Barack Obama in that august body, has now joined those who are pledging to filibuster any bill that does not have a "public option" – joining of course those, like Connecticut's ineffable Joe Lieberman who will filibuster if it does have a "public option," or a Medicare buy-in for 55-64s, or support for long-term care for the frail elderly, or in fact anything that would alter the great and glorious status quo, so clearly fine-tuned as it is for the good of all of us who don’t have a few billion dollars to throw around.

One might think that the compromise that is brewing would have the capacity to turn all such pledges inside out. The compromise would allow 55 to 65-year-olds to buy into Medicare, while letting under-55s without insurance into the Federal Employee Health Benefits Plan, along with mandates to buy in, and subsidies for those who can't afford it. If this does indeed emerge, liberal Democrats in both houses may have some trouble defining what they mean by the "public option" they are so strongly demanding. Is it a "public option" for 55-and-overs if they can buy into Medicare? Sure sounds like it - a government-run plan that people can buy into, in competition with private plans. Is it a "public option" if the federal Office of Personnel Management  runs an exchange called the Federal Employee Health Benefits Plan (FEHBP) setting the rules and transparency for private plans, with subsidies and tax credits for those 54 and under who can't afford a health plan? Sounds close, but not quite. Close enough for confusion, at least.

And that, in a way, is the point. The political intelligence behind the compromise  is precisely that, on an issue where the two sides had come to sharply differing opinions, with both sides digging in their heels, the compromise fuzzes the lines. It replaces the bland phrase "public option," which has come to mean "the savior of the people" for some and "creeping socialism" for others, with Medicare, which politicians regularly praise and promise to save, and the FEHBP, which politicians have often praised, saying that everyone should have one at least as good as Congresspeople and the President get.         
                      
The compromise, like all real compromises, is a kludge and a mess and a camel made by committee, but politically it has a certain genius. If the goal is to get a bill passed, this just might work.

The power to name is the power to frame, as semiotics guru George Lakoff reminds us - Obama should have replaced the bland wonk phrase “public option” with “The American Plan” and let opponents try to argue against that (“Why do you hate the American Plan?”). 

But this particular dollop of re-framing genius didn’t come super-sized, and may be way too little, way too late. The abortion foes are calling the attempts at compromise on that issue “accounting tricks,” Republican Olympia Snowe is maintaining her Olympian distance, and Senator Lieberman seems to be saying, “I say it’s broccoli, and I say the hell with it!”

Driving down the cost of health care: What would actually work?

If competition the way it is structured at present actually drives the cost of health care up rather than down, what would bring lower costs? What provisions in a “health reform act” would actually drop costs in health care? Let’s leave aside for the moment all the myriad other arguments - some might be seen as too much government intrusion, some would be cripplingly difficult for providers, and so on - and just focus on cost. Given the real structure of health care markets in the United States at this moment, among the various options available to lawmakers, what could be written into federal law and regulation that would actually reduce cost?

Forward Through the Chaos: The Future Beyond Healthcare Reform

(From H&HN Weekly, November 24, 2009)

It’s not easy being a futurist, but I will make a bold prediction: no clear victory, no simple end. What we will get, one way or another, is years of turmoil, re-definitions, new rules and shifting markets—an industry under great, immediate and chaotic pressure.

This makes plotting a direction for your institution more difficult than ever. Yet the next few years will demand and reward far more active, even aggressive, tactical and strategic management than ever.

By January 1 we may have some version of a “public option” plan enacted. Maybe we’ll get insurance co-ops, or nationwide insurance exchanges, or some kind of universal coverage through mandates and subsidies. Maybe we’ll get some kind of patchwork chimera shambling mess of “reform.” Even if there is no bill at all, or even if President Obama pulls a giant rabbit out of a very large hat, still we face what the elder Kennedy brother called “a long twilight struggle, year in and year out.” This is not over and will not be over for a long time.

We are engaged in a political melee, with a wide array of interest groups willing to cry havoc and let slip the dogs for any advantage. And our institutions, at the center of all this, can too easily end up as just so much collateral damage. Institutions already reeling from the recession, the flood of uninsured, the hammered budgets, could well find themselves further hampered in their fight to simply stay alive and do their jobs.

Health 2.0 Get-Together

Wonks and geeks - that's who we need to build the next healthcare. Wonks (policy types) are in the forefront right now. But the geeks (tech types) are working away, like lemurs in the final age of the dinosaurs, filling the ecological niches that are opening up, building not just disruptive devices and applications, but entire disruptive value chains, just outside of the spotlight, just under the radar. We're 10 days away from the Health 2.0 San Francisco 09 conference, the big confab of the Matthew Holt/The Health Care Blog crowd (THCB.com). Thursday night a little pre-conference cocktail party featured brand-new companies doing sharp things like putting workflows and checklists on iPhones and Blackberries, or using cheap sensors for constant real-time monitoring of children with asthma, bed-ridden adults in danger of bed sores, and other vulnerable people. The party overflowed the mean and lean offices (about big enough for a 4-car garage) of MedHelp.com, a massive online health community claiming 8 million unique visitors a month, and a million registered users tracking their health in over 300 different conditions. If you're looking for the future of health care, Health 2.0 confabs are not bad places to hang out.

Posted via web from joeflower's posterous

Preparing for what's next in health care

Are you waiting for the shoe to drop? The anvil to fall?  Don't.

Whether or not we're hit with "reform," this won’t be over soon, and it will affect you and your organization for years to come and in more surprising ways than you might think. 

So what do you do now to prepare? It’s time to start thinking big and deep about what comes next.

Exactly how it affects you will depend on your sector, your market stance, and your organization, but there is a lot we can say already about the economics, the organizational and market challenges you’ll face.

If you’re waiting, don’t.  It is far from too early.

Some of the affects may be subtle, some may be surprising, but most will be big. 

For a talk customized to your sector, your industry, your organization, tell your agent to get you on the phone with me.

Keynote Topics

Pick one of these topics - or contact me, and we’ll customize a topic for your audience:

Surviving and Thriving Under the Reform

Whatever the shape of healthcare reform in 2009, it will re-fashion your business for years to come, whatever part of healthcare you are in – or even if you are not in healthcare. It will sharply affect workforce issues, choices about retirement and entrepreneurship, the future of unions. Within healthcare, it will re-shape each sector, each market, and each organization differently, depending on the details of the reform, as well as the demographics of your market, and your organization’s ability to react nimbly to complex change. How reform will affect your organization, your members, or your sector is a far more subtle and surprising question than you might suppose. We can tease the answers out of the shape of the reform itself, and the forces arrayed to influence the regulatory atmosphere, and we can pace out how the changes unleashed by reform will unfold over the coming three, five, and ten years. This is a close look, customized to your sector, your business model, your organization.

15 Ways to Make Healthcare Cheaper by Making It Better

The remarkable secret at the core of the healthcare conundrum is that better healthcare - higher quality, universal coverage, quicker access - actually costs less.  The evidence is clear, across the world, in specific systems within the U.S., and in the ways other industries have cut costs and increased quality at the same time. The opportunities are vast. The savings can be huge, and so can the rapid, visible improvements. Joe Flower presents 15 ways to make healthcare cheaper by making it better - with vivid, inspiring examples of organizations that are pioneering this entirely new way of seeing what we do and how we do it.

High Tech, New Tech, Clinical Tech:
The Unfolding Future

Instant genome readings and home-style genome hackers, pig hearts transplanted into humans, stem cell workhorses, personalized cancer vaccines, nanobots and nanocomputers made of DNA cruising our arteries, true bionic prosthetics that “feel,” portable MRIs and re-grown limbs, and maybe even a true end to aging – the range of clinical advances now in the lab or just coming into use is astonishing, intriguing, and heartening.  Combine them with new communications technologies and automation, and we can begin to see healthcare that looks nothing like anything we are used to.  We go beyond the “Wow!” moment to look at what these amazing possibilities may actually mean for healthcare, what we can do for our patients, where, with what tools – and how soon.

Healthcare Samurai: Heroes in Suits and Scrubs

Across healthcare, in the United States and other countries, some people and some organizations are making remarkable changes, casting off "business as usual," asking the hard questions, trying new methods, getting rigorous about what works and what doesn't. These surprising and provocative examples - clinicians, entrepreneurs, top executives, networkers within the organization - inspire us, and allow us all to imagine how much better healthcare can be when we stop doing it the way we have always done it, and start searching for what really works.

Healthcare Better Faster Cheaper

A stunning presentation of the scope of the healthcare problem today and some remarkable news from a futurist who knows where to look: A movement is emerging that can change healthcare from the bottom up based on a new concept of value, new methods of discovering what works and what doesn’t, and new ways of building organizations that learn.  While many are waiting for someone else to make the decision, now, in every part of healthcare, there are clinicians, hospitals, health plans, vendors, investors, and consumers who are taking steps to build a healthcare that works.

The Next Healthcare

In 20 years healthcare may look very little like it does today. We can already see some of the building blocks of that future - from digitization, automation, and the Internet, to powerful new pharmaceuticals and diagnostic techniques, to the increasing failure of our current financing structures - and we can begin to imagine what kind of future they will likely shape. Take a tour of a day in the life of healthcare 5, 10, or 15 years from today.

Borrow My Eyes:
Consumer Power In the Future of Healthcare

What does this Information Age bring us? Well, right now, mostly disruption. More people have more information about what’s going on than ever before. But do they understand it? New data-mining techniques, the “semantic web” and consumer-directed health plans are already ushering in an age of transparency and consumer power unlike anything we have experienced before. Whoever can turn all that data into real knowledge will have leverage in the new healthcare. And that may be the best thing that could happen.

But What About Me?

As healthcare rights itself the workforce will change along with it. Most organizations are paralyzed at the prospect of job loss, but we can’t plan a new healthcare without confronting obsolescence along with the new opportunities. Healthcare will change, but the boundaries around healthcare will shift, too, enlarging the market and the potential for new business models and career paths. In this talk Joe conducts thought experiments designed for and with your organization and your people: How do we imagine our way into the new forms of healthcare? Where will we find new profit centers that can support a new workforce? How might the pieces fit together? Who can we be?

Vectors in the Future
of the Healthcare Value Chain

In a healthcare world that is both consumer-driven and data-driven, healthcare’s “value chain” will be torn apart and re-assembled in a thousand large and small ways. The new value chain will have to build around highest value - not around reimbursement amount - and how that value is defined. Healthcare will live and die by value like any other industry that is subject to true market pressures. A vector is really just a way of focusing on a dimension and its direction and velocity. Vectors might include the aging of the population, new technologies, changes and opportunities in the workforce, Value Based System Design, the evolution of insurance companies and plans, and behavioral health in the new era. Discuss with Joe which vectors best capture the trends of change for your organization. How will those vectors influence the new values and be influenced by them?

ReTooling The Mind of the Organization

Here are key skills your organization needs to become a nimble, adaptive organism. Joe makes tools of the buzzwords: he demonstrates how to plan with scenarios and how to develop what some call the “long conversation.” He gives vivid form to those vague-sounding concepts, such as knowledge management, competency transfer, sense-making, and “lean management,” , getting you the tools you actually do need to solve the core problems so difficult for organizations to wrap their collective minds around. System problems can be hard to grasp, but Joe can explain them and make meaning of the jargon. Formats include a keynote for an overview or a half-day or longer workshop for getting into it

What's the Future for Specialists?

On June 18, SunTrust Bank sponsored a webinar for its physician clients (most of them specialists), in which I discussed the future of business models and care models: How will medical specialists make a living in the future? And how will they care for patients?

Here it is, a 40-minute audio and PowerPoint.

In addition, I have prepared a white paper summarizing the webinar on the future of healthcare for specialists.

Health Care as a Complex Adaptive System

(by Joe Flower, from TheHealthCareBlog.com)

You want healthcare reform. I want healthcare reform. Grandma Jenkins wants healthcare reform.

What is healthcare reform? What kind of animal are we talking about? How would we recognize it if it came up and bit us? What are its markings, its behavior, its habits?

From observing the systems of other countries, from the results of local experiments and variations in the U.S. system, and from serious research over decades into outcomes and comparative effectiveness, we can actually outline what the marks of a better healthcare system would be.

But healthcare in the United States is a complex adaptive system. If we want to capture it fully, we have to take one step back and revisit what we know about the nature of complex adaptive systems and how that knowledge might apply to reform of this system.

Health Care as a Complex Adaptive System - Part 2: Eight Points

(by Joe Flower, from TheHealthCareBlog.com)

We can actually say what a better healthcare system would look like, if we look at healthcare in the United States as a complex adaptive system stuck in a Nash equilibrium.

The ideal reformed healthcare system would be universal, possible, understandable, cheaper, better, market savvy, incremental, and self-reinforcing.