Release 0.9: Steve, to Your Health!

As any modern general knows, victory is not a solution to problems; it's the start of them. When I hear all the talk about Yahoo!, Microsoft, Google, AOL and NewsCorp, I think of generals discussing strategy: We'll invade -- I mean, buy -- such and such a territory. We'll annex this part, split that one off, create a special zone for such and such a minority business line, merge the two online divisions. We'll do a pincer movement with our allies, cut the enemy off at the pass...

But companies and countries aren't so much real estate to be divided with measuring sticks and calculators. Having a new owner doesn't magically create a healthy business any more than a new government or even elections can create a civil society. Even Google, which to many eyes can do no wrong, is discovering some of these realities as it attempts to annex DoubleClick. Customers don't like to be traded around anymore than citizens do.

Countries and companies need to be grown, not constructed or assembled. So how does this apply to you and Microsoft, Steve?

First of all, why take on Yahoo!? Unlike the old Iraq, it's not even evil, and its weapons of mass profitability, called Panama, seem to have been mostly a figment of certain engineers' and analysts' imaginations. By buying Yahoo!, you will only have bought new problems for yourselves.

Meanwhile, there is fresh territory out there, territory that doesn't need to be bought or conquered. It needs to be cultivated. The territory I'm thinking of is health care. [Disclosure: Yes, I have vested interests here: I am or was an investor in a variety of health care start-ups, including Medstory, which you bought last year. The rest below.*]

This market is a monster, potentially much bigger than Iraq -- I mean, than Yahoo! And if you invest here, you'll be growing all along, mostly organically, rather than trying to squeeze profits out of a revenue stream by cutting costs.

In the long run, it is bigger than your current business: Doesn't it make sense that people will spend more on their own health than on their PCs (whether directly or through taxes)?

There are two big opportunities in health care, both well suited to you (and the second one less to Google, before you even ask).

On the consumer side, hosting health records and providing a platform for consumer health applications, MS has the advantage of consumer trust/visibility. Some in the industry (especially Yahoo! and Google) may despise your company, but to consumers it is mostly a familiar and reputable name. They trusted it with their Hotmail; they will trust Health Vault with their medical info. And they need applications to manage and explore that information, not just for health care, but around prevention and healthy living.

Institutions as well

On the enterprise side, you already have a small business selling to health-care institutions; invest to grow it into a big one. MS is good at selling to enterprises and governments, which still perform a huge amount of health care processes, especially overseas.

In the long run, health care is a global business, with most of it in the emerging markets that comprise most of the world's population - and in which MS is mostly welcomed. Like it or not, health care in these markets is still mostly a government responsibility - and they desperately need software tools to become more effective. Yes, I would love to see every Indian villager and Tibetan monk and African school child with his or her own health record...but meanwhile I'd settle for clinics that could upload disease statistics to a government health database and track the progress of each patient's treatment or the dates of each child's vaccinations.

The reductions in costs and the gains in productive lives would actually be enough to pay Microsoft's bills with just a few years' lag (just like any good investment). If I were an investor, I would cheer the company's focus on a market big enough to make a difference to MS, and serious enough to absorb and reward long-term investment. Truly, MS is so large that what's good for the world is good for Microsoft.

In the end, to be a healthy business, you don't need to solve the problems of Yahoo! or its stockholders. You need to solve the problems of your customers.

Disclosure: You can tell I'm sincere about this: My medical investments/affiliations include 23andMe (consumer genomes), Keas (stealth), Ovusoft (consumer fertility), PatientsLikeMe, ReliefinSite (pending, consumer pain diary), Resilient and You-Take-Control (both permissions and data-access infrastructure), and Voxiva (data collection and management).

Comments

[joebaggadonuts]

Microsoft never, ever built anything in new territory before someone else had already gone there and succeeded in making a business out of it. I dare you to find an exception. While Steve Jobs has famously said, they just have no taste, their history shows also that they have no ability to move into unexplored territory. And, as you can see by the other comments here, nobody trusts them.

True, and a good point, that the MEDICAL field has been explored for years, by the computer and software industries but they have not really done anything but over promise and deliver incremental improvement, unless you are looking at the diagnostic device field. (And, PLEASE don't use the words Health Care, I see a doctor for medical care and advice not for health care. This bullsh1t corporate healthcare which ushered in big insurance as a henchman industry has practically destroyed medical practice and impovershed average patient health in this country). Unless you have damned good insurance or are terminally wealthy, don't get a serious illness.

[Querent]

Dear Esther,

Your "release 0.9" schtick is shallow and tiresome.
Who is Steve?
How is Microsoft, the company whose "updates" routinely crash the company's own applications, "trustworthy"?
What planet are you from?

[marlovian]

Let us all join Esther on the heavenly stairway to this new vista (aka the blue screen of death).

[aceholiday]

wikigovernment '08

[Lemoenus]

I would rather die than give my health records to Microsoft.

[WilliePilgrim]

Thanks for sharing that interesting perspective. Those are very good points. Health care is due for a revolution as health care, in the sense of its being information, is ideally suited to being made ubiquitous. How? Volume. And while I see you've invited a bit of criticism for characterising Microsoft as reliable and trustworthy, I think you correct on that also if we mean trust, not in the sense of being altruistic, but rather in the sense of being "there" for the long term, and not likely to be bought up by General Electric or tomorrow's big idea.
As far as the security of the information,our medical records being so private because their misuse can lead to such misery for the individual, I really wish that our laws were re-designed so that abuse was subject to an inordinate amount or retribution favoring the individual instead of, as it seems, where the individual simply can't be expected to marshall the legal means to go after those corporate concerns that have abused or even jsimply eopardized the privacy of the individual, and that should be for all areas of privacy and public trust. Forget fairness; as if the corporate entity needed protection from individuals who would hoodwink them when clearly the threat is in the opposite direction as we see our rights to privacy and protection eroded both forces within both governement and business world. Prove that trustworthiness begins with the santity of the individuals right to privacy above all else.

[BillOfRights]

Everyone's health records should be in a large database run by Microsoft? I'm sure that's a great idea for your portfolio, Esther, but is it really a good idea? Doesn't anyone care about their privacy any longer?

I also question the idea that people's detailed health records need to be kept *anywhere*.

How would it help a doctor treating a woman in an emergency to know that she had an abortion 20 years ago? Would doctors have time to dig through all these health records before starting treatment? Would they even bother?

I believe this health records database stuff is another perfect storm of the public being duped into giving away their privacy and tax money, corporations looking for more revenue at the expense of the people, and control freaks in the government finding another avenue keep us fearful and in line.

[philistine]

Microsoft is reliable and trusted? You're kidding, right?