Originally, manhole covers had four sides. Some were squares, and some were not, although I doubt many were parallelograms. Four-sided manhole covers were not very good. They were not very good because many of them, when removed, fell through the manhole. And so engineers designed a series of grates beneath the manhole covers to prevent the covers from falling to the bottom of the manhole.

In the initial days of our space program our scientists tried to invent a pen that could write in zero gravity.

The next time you see a manhole cover look at its shape. It is round. Why? Because it is impossible to drop a round manhole cover down a round manhole. While the NASA was trying to design a zero gravity pen, the Soviets used a pencil.

Easy problems have easy solutions. Those are the types of problems with which most organizations grapple. Create a committee. Build a plan, acquire funding and solve the issue.

Increase revenues by ten percent. Increase your HCHAPS scores by twenty percent. Executives mistakenly label those initiatives moonshots.

The thing missing from almost every healthcare business moonshot I have studied is the moonshot—and the rocket.

President Obama stated in this year’s state of the union message that Joe Biden’s new charter is to cure cancer.   Now that is a moonshot. That it is difficult is what makes it worthy of being called a moonshot.

JFK didn’t announce to the world in the early 1960’s, “Our goal is to get a man to Iowa and bring him home safely by the end of the decade.” His target was the moon, hence the term moonshot.

In business there are no fair fights. And sooner or later a healthcare organization is going to do something that makes its competitors state, “We never saw that coming.” Blockbuster never saw it coming. Neither did Sears. And you can bet your last dime that some of the executives in those organizations thought about developing a plan to try to mimic what Netflix and Amazon did; but they were too late.

So if you are going to have a moonshot you are going to need a rocket. The moonshot is the goal. The rocket is the means to achieving the goal. For those who remember the space program, many of the first rockets never left the launch pad. And several others exploded. The failures didn’t change the need for a rocket; they merely showed that other changes were needed.

Unfortunately, most firms that change an industry do not come from within that industry. MGM did not morph to become Netflix. Macy’s did not wake up one day and decide to become Amazon.

The organizations that changed the entire delivery model of healthcare started with nothing. They did not have a hospital. They did not offer insurance. And they did not make pills. They did not even have a patient.

Walmart and CVS and Walgreens and Rite Aid. But they figured it out, and strangely they each came to market at roughly the same time with roughly the same business model. And they still don’t make the pills and they still don’t provide insurance. In spite of those shortcomings they see and treat more patients each year than the largest health system.

Imagine the first conversation in the boardroom when Sally stood up and announced, “I have an idea.” Sally put up her first slide and said, “My idea is that by the end of the decade we can be treating patients in every state in the U.S. without every having to build or buy a hospital.”

“And just how will we do that?”

“People will just come. And they will tell their friends. And they will come many times each year. And while they are here we will also give them their medicine. And doctors will send their patients here to get their medicines. And those people will see that they don’t always have to go to the doctor. They can simply come here. And they can come without having to make an appointment, and we will change healthcare.”

That was a moonshot.

But it does not have to be healthcare’s only moonshot.   But it will be until somebody creates another one and starts building a rocket.

I think cognitive, cloud-based healthcare consumerism is the next moonshot, but few firms are even discussing it in a manner that makes it worthy of the term.

For those who need an idea to get started, here are two moonshot consumerism ideas.

• Within five years people will manage their health daily using natural language through a smart device.
• Within five years, on a daily basis providers and payers and retail pharmacies will be managing the health of people across the country whether or not they are our patients.

Now go build your rocket.