A few months ago, I wrote about how healthcare is poised to segment according to cost and service levels-- and that we will likely begin to see healthcare brands emerge that appeal to price-conscious consumers looking for reliable, basic care. My suspicion was that US healthcare is now facing its "Southwest Airlines" moment, where nimble and lean competitors will soon undercut inefficient legacy systems for market share.
What I hadn't considered is how this segmentation is probably going to squeeze "middle of the road" healthcare brands. That, as with most retail in America today, "value" brands and "luxury" brands are going to thrive while the middle gets squeezed. It's the same trends that have led to the simultaneous growth of both WalMart and Louis Vuitton into the world's most valuable brands over the past decade, just as Sears and JC Penny slowly die.
This insight came to me last week, as I found myself grounded by a pilot's strike at Lufthansa, Germany's national airline.
Regular readers of my blog know that I often look to the airline industry as a harbinger of what might happen in healthcare over the next few years.
Doctors groan when I tell them this: the similarities between healthcare and aviation are significant: both are both inherently risky ventures that need to be aggressively customer- facing. Both feel the competing pulls of regulation versus free enterprise and both are heavily exposed to enormous environmental and business uncertainties, while being enormously capital intensive.
Luftansa's response to its own "middle squeeze" was an inconvenient lesson, for me and other travelers. Lufthansa pilots were on strike for the fourth time in a few months and hundreds of flights had been cancelled. Phone lines were overwhelmed and rebooking was impossible.
The strike, by the pilot’s union “Vereinigung Cockpit” was ostensibly due to a pension dispute, but the story is more complicated. The CBC writes:
The CBC piece doesn’t mention an even more profound disruption that has happened at Lufthansa:
. Going forward, Lufthansa will only serve the Munich and Frankfurt markets in Germany,
. All non-feeder flights, say from Dusseldorf to Stutgart will now be handled by GermanWings, Lufthansa’s low-cost subsidiary. Wikipedia notes:
Lufthansa simply can no longer make a margin selling high-overhead products to price sensitive consumers.
No wonder the pilots are having a meltdown.
So how does this play out in US healthcare? I’d make the argument that we’re about to see real market segmentation in the US healthcare market.
We’ll also see the emergence of
Who's in the flabby middle? Here's a pictogram from the Massachusetts Health Policy Commission's 2014 Cost Trends Report. It reports the average spending for an elective hip replacement in Massachusetts. For hips, prices
At the same time, the report notes
The market can only support so many luxury brands.
as compensation, benefits and work expectations are restructured. I can only imagine what the health care workers of "Vereinigung Hospital" will have to say to the new order. Images: Patrick Feller via creative commons, and the MA Health Policy Commission
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