Brilliant pieces of work don't come around every day. Mike Masnick's piece modestly ;-) called The Grant Unified Theory On the Economics of Free is one of these pieces.

If you have ever wondered how to make money when so much is given away for free these days, this piece is for you. It's a bit abstract — the comments section clearly shows that it is hard to comprehend for many — but exactly on the money, IMHO.

The hard part is that it requires people to re-think what business they are in. To be workable, it must be a business that has both a free component to it, and a scarce component. For example, software (free) and support (scarce); or recorded music (free) and concerts (scarce). But not razors and blades (both scarce).

According to market research firm IDC, the world generated 161 billion gigabytes -- 161 exabytes -- of digital information last year. (via New York Times). Wow.

That's like 12 stacks of books that each reach from the Earth to the sun. Or you might think of it as 3 million times the information in all the books ever written, according to IDC.

I'm not sure even how many zeros that number has, I hope my title is correct.

We all know that the US healthcare system — just like the healthcare systems of many other countries — has become unsustainable. We also know from experience that changes in the healthcare industry come slowly; probably quite a bit more slowly than the double-digit growth rate of health expenses that is reaching 20% of GDP.

So Quo Vadis Health?

Fortunately, increasingly many people both inside and outside of the healthcare industry are seeing this not just as a problem, but as an opportunity. To give this community a "virtual water cooler" to hang out, we recently put up a wiki and a couple of mailing lists at:

health20.org

If you are interested in the unconventional, the disruptive, the new new thing in healthcare, why don't you join us? There will be a second HealthCamp some time in February, building on the success of the first HealthCamp in San Francisco. Sign up the announce mailing list to find out where and when.

Now, that's unexpected. A group of rather respectable people have created an Open Healthcare Manifesto, which has been modeled after the famous Clue Train Manifesto.

The call it the Health Train. It lists the following principles:

• Openness
• Empowerment
• Conversation
• Empathy
• Trust
• Critical Thinking
• Guidance
• Control
• Credentials
• Transparency
• Privacy
• Anonymity
• Scientific Validity
• Conflicts of Interest
• Sponsorship
• Promotion
• Controversy
• Civility and Respect

Here is a summary (quoting):

This Manifesto proposes principles under which open media could become a force of positive change in public health and the healthcare system. It steers clear of issues that may favor any stakeholder group over another, aside from promoting greater empowerment of individual healthcare consumers and professionals. The goal of this effort is not to offer specific prescriptions for a healthcare reform, as different people and groups have very different ideas. The objective is to propose general principles under which open expression and discussion can force system change for the better. This is work in progress that will benefit from constructive criticism.

It makes rather interesting reading. Here are some of my notes/quotes from the introductory chapter. Download the report from here.

• the current paths of many healthcare systems around the world will become unsustainable by 2015
• problems: costs are rising rapidly, quality is poor or inconsistent, access/choice often inadequate. Also: globalization, consumerism, demographic shifts, increased burden of disease, expensive new technologies/treatments
• healthcare systems that fail to address this new environment will "hit the wall"
• today value in healthcare is difficult to see: data regarding the healthcare prices is tightly held and difficult/impossible to access or comprehend; quality data is scarcer still and most anecdotal or incomprehensible
• consumers' ability to predict healthcare quality is equivalent to a roll of the dice
• in the win-win scenario, consumers will assume much greater financial oversignt and responsibility for their healthcare
• by 2015, consumers will comparison shop for healthcare in the same manner they shop for other goods and services.
• health infomediaries will become fixtures in the healthcare landscape
• care delivery must shift from focus on episodic acute care to include and embrace prevention and chronic condition management
• new settings: retail stores, workplaces, homes. Lower prices, enhanced convenience, more effective delivery channels than traditional healthcare venues.
• chronic patients will be empowered to take control of their diseases through IT-enabled disease management programs
• their treatment will center on their location, thanks to connected home monitoring devices
• patients and their families, assisted by health infomediaries, will replace doctors as the leaders in chronic care management
• transformation of today's massive, general purpose hospitals into "centers of excellence" devoted to specific conditions and combination triage centers