McKinsey defines the "new normal," post-recession: less leverage, more government, falling consumption levels, centers of economic gravity shifting toward Asia. And an opportunity-rich environment, favoring those with the foresight to see what has changed and what remains the same for markets, consumers and industries.
For health care leaders used to leveraging-up, the days of easy access to debt markets are probably over. Operating margins and retained equity will become the primary drivers of capital spending. Only those with the strongest balance sheets will find welcoming lenders.
And though the Obama administration appears firmly committed to re-making health care, improved access will come at a price: more scrutiny of methods and decisions and, overall, declining reimbursement to pay for the grand plans.
Baby Boomers, too, may slam wallets shut for some types of discretionary spending, but I'm betting their willingness to invest in maintaining and improving their health will continue apace. Here, long-term, the "old normal" stays with us. It's tough to swim against the tides of demography and epidemiology and, alas, bodies wear out. Granite countertops in a McMansion vs. a few more years of vitality - which would you choose?
At the same time, I think there's a marked attitudinal shift underway toward those pesky last 30 days of life, when most of our lifetime health care spending occurs. More and more, I hear my generation opting out of a drugged, ventilatored, catheterized, raving denouement in favor of a kinder, gentler leaving.
I'm not sure what that argues for in terms planners' use rate models or forecasts of bed days-per thousand, but it wouldn't hurt my feelings at all if a whole bunch of ICU beds were made obsolete and hospitals were forced to confront THAT "new normal."
I think the "new normal" could use some "new" forecasting models and assumptions anyway.
For health care leaders used to leveraging-up, the days of easy access to debt markets are probably over. Operating margins and retained equity will become the primary drivers of capital spending. Only those with the strongest balance sheets will find welcoming lenders.
And though the Obama administration appears firmly committed to re-making health care, improved access will come at a price: more scrutiny of methods and decisions and, overall, declining reimbursement to pay for the grand plans.
Baby Boomers, too, may slam wallets shut for some types of discretionary spending, but I'm betting their willingness to invest in maintaining and improving their health will continue apace. Here, long-term, the "old normal" stays with us. It's tough to swim against the tides of demography and epidemiology and, alas, bodies wear out. Granite countertops in a McMansion vs. a few more years of vitality - which would you choose?
At the same time, I think there's a marked attitudinal shift underway toward those pesky last 30 days of life, when most of our lifetime health care spending occurs. More and more, I hear my generation opting out of a drugged, ventilatored, catheterized, raving denouement in favor of a kinder, gentler leaving.
I'm not sure what that argues for in terms planners' use rate models or forecasts of bed days-per thousand, but it wouldn't hurt my feelings at all if a whole bunch of ICU beds were made obsolete and hospitals were forced to confront THAT "new normal."
I think the "new normal" could use some "new" forecasting models and assumptions anyway.
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