Follow up to Gawande's New Yorker article

The New Yorker followed up its article (mentioned below) with a more detailed cut at the issues. Here is a link.

Healthcare Reform - Did Health Dialog exit too soon?

In 1999, I invested in a Boston-based company called Health Dialog (HD). HD's business model was rooted in the research and theories of Dr. Jack Wennberg and the content of the Dartmouth based Foundation for Informed Medical Decision Making (which goes by the unfortunate acronym FIMDM...pronounced 'FIMDIM'). Dr. Wennberg discovered that the way a patient is treated for a particular condition has much more to do with where he/she lives (a proxy for doctor preference) than any other factor; and FIMDM seeks to develop content that allows patients to assert their own preferences into discussion with physicians. HD helps those that pay for healthcare ("payers"- mostly commercial insurance companies and self-insured employers) to reduce healthcare costs and improve outcomes by getting patients more involved in choosing their treatment options and understanding how to take care of themselves. By any measure, HD was a great success, growing from revenue of $3M in 1999 to $250M in 2007...and selling to a large British company for $775M in early 2008.

What has been even more interesting recently, is that principals of Health Dialog's approach are now getting significant attention by policy makers as a key part of the solution to the health care crisis.

Following are several articles to this point:

• This New Yorker story is possibly the most powerful article written about the issue. It is required reading at the White House and has drawn considerable attention.
• Further discussion about the approach in this NY Times post by Elliott Fisher, who runs FIMDM, with some incredibly helpful links.
• Finally, an editorial that captures it all.

While there is a long way between here and the full bore adoption of policies that track against these theories, it does beg the question whether we sold HD too early? Perhaps there'll be a second swing....stay tuned.

Very interesting analysis of how US consumption breaks down.

Here's the original link: http://www.nytimes.com/2008/02/10/opinion/10cox.html

Minimalism

I've been developing an investment theme around what I perceive to be a cultural trend away from over consumption and toward minimalism. I've seen some signal strength in this direction, including the recent Time Magazine cover to the left. I've also invested in a couple of companies that give exposure to this theme (Energy Hub - home energy management system and American Biomass - wood pellets distribution for home heating), but I have yet to find any opportunities that provide direct linkage.

I guess it shouldn't be surprising that it's difficult to profit from a cultural shift towards reduced consumption? Any ideas are welcome.