Herman Melville’s take on healthcare’s business strategy

Someone once summed up one of Fred Astaire’s screen tests with the following; “Can’t sing. Can’t act. Balding. Can dance a little.” Probably the same guy who evaluated my Mensa application. I’ve been accused of having a similar outlook. I once accosted a guy who was walking on water, accusing him of not being able to swim—but that was a looonnngggg time ago.

The internet is full of opinions, but hopefully not full enough. One of the reasons I chose math over English as my major was the affection I held for getting the right answer, or barring that being able to know precisely where my errant efforts led me away from the answer.

In my narrow-minded view of the universe the downside of English, literature—the soft studies—was the notion held by those who taught that there was more to be divined by the story than just the story. Those who can do; those who can’t teach. They displayed a Stepford mentality in their obdurate ability to outthink both the author and their students, to bring forth nascent ideas of the author’s hidden meaning.

Herman Melville wrote Moby Dick. I am willing to bet he wrote it just the way he intended to. Nobody has uncovered a frayed notebook of Melville having penned his thoughts about the real meaning of life from a cannibal’s perspective, or suggesting Queequeg was a misunderstood cross-dressing sycophant who was never close to his mother. We don’t come away from our reading of Moby Dick with a more in-depth ability to understand anything except for perhaps what it felt like to live aboard a whaling ship.

These interpretations are poppycock. Art critics do the same thing as they bloviate about the hidden meaning behind what the artist really intended to convey, meaning only they can see. Ever notice how none of these popinjays, these opiners present their opinions as fact? Pretentious fops.

I write and paint. Those who’ve read my missives know there is no buried meaning. If I had wanted to convey something else I would have written something else. If I use dark colors and bold brush strokes when I paint it is because I feel they add to what I want to show; it is not a reflection of having missed two days of Zoloft.

Nobody will ever know what Shakespeare intended to convey with his addition of the three witches in Macbeth, or whether Joyce Kilmer had ever seen a tree. That said, I do have a few strong opinions about where this whole business model of healthcare is headed. I think these types of opinions; along with the opposite opinions differ from the type offered up as truths in an English Lit class. They differ in that at some point they will be proven right or wrong—time will tell.

As I have written, I think the large provider model—the business model—is seriously flawed. Moreover, I think it may prove fatal. Providers will run out of costs to cut, will run out of processes to re-engineer, and will have no more Italian marble with which to line the foyer. The good news is that they will still have the machine that goes “Ping” just in case somebody needs it.

I do wonder how Melville would have expressed his ideas about healthcare.

Paul M. Roemer
Chief Imaginist, Healthcare IT Strategy