The First Time They Fixed Healthcare
The New York Times just announced that the administration has the votes to pass the healthcare bill. Since I have just finished a book that includes whole sections on another chapter of the healthcare business history I couldn't help but look for commonalities.
Jim Clark helped found Silicon Systems back when. For his efforts (and after he was forced out) he made tens of millions of dollars. To prove he could do it again, Clark made hundreds of millions on the first Internet stock, the one that started everything, Netscape. Of course, as we all know, Microsoft slowly ate Netscape's lunch. So Clark had to do it all over again, with what they started to call Healthscape (later changed to Healtheon because some smart kid already owned Healthscape.com). Now, Healtheon was posed to really shake things up.
Jim Clark had drawn a picture that you can mimic easily on a napkin if you decide to (Lewis, 99). He put four dots on the paper. One was labeled Payers, another Providers, the third Consumers, and the final one Doctors. Pretty simple. You have to remember this was during the Internet boom. You didn't need anything but four dots to go public. So where was Healtheon in those four dots? Right in the middle, taking a portion of the flow of monies for every transaction flowing between the four dots. This was simple to do as this was the Internet. Everything would be automatic.
Healtheon almost made it big, except for one problem: the Russians defaulted on some bonds, sending the whole market into turmoil and sinking many offerings, most forever. Healtheon ultimately sank too.
I promised commonalities between the Obama plan and Healtheon. I guess I won't be wrong if I say they are both big. Healtheon thought they had a simple solution that would work. The Administration may not be convinced that they have a simple solution, but they do clearly believe that they have a solution that will work. I am going to stop right there. All I will say is that something needs fixing in the healthcare mess and that, hopefully, the solution they are about to vote on will start the process of fixing some of the weaknesses. I suspect this will be even harder than we envision (someone told me the bill was more than two thousand pages long - amazing!), but the first step is always the hardest. Good luck to us all.
Reference
Lewis, Michael. The New New Thing. A Silicon Valley Story. W. W. Norton & Company. 2000.