Drunkenness is not disinhibition. Drunkenness is myopia--Malcolm Gladwell writing for the New Yorker, Drinking Games: How much people drink may matter less than how they drink it.  A 2010 Malcolm Gladwell quote harkened me back to the waning days of the aughts. Fast forward slightly shy of a decade and look how nicely innovationness fits into the quote. Many will argue for their self-assembled definition or interpretation of innovation but when all is said and done--all the machination looks myopic. My favorite quote lately is from Amanda F. Palmer (if you are a fan you absolutely know to what the middle initial refers)--"We can only connect the dots we collect." This brings me back to myopia. We have collectively decided that R&D is a measure of innovation or somehow elevates the status of a company. Those of us analyzing data realize that R&D is not the only measure needed for hypothesis generation around innovation. For example, I completed a project where I evaluated SEC filings for several pharmaceutical companies. Even in my data saturated world I was gobsmacked to hear how many of the accounting measures used in filings are Non-GAAP. The Generally Accepted Accounting Principles (GAAP) earnings and adjusted results often trail pro-forma adjusted figures. Because pro forma models are based on anticipated results, GAAP models are often less bullish. And look a little drab on earnings reports. I am a big fan of the Oslo Manual. I don't do anything without it. The last thing we need is more subjectivity around important measures of "value" or "innovation". Although not updated regularly it is surprisingly prescient and timely. After all, it is our responsibility to continually collect measures of innovation and potential value. A small book with big ideas, The Laws of Medicine describes it as the ability to "manipulate knowledge under uncertainty"--Siddhartha Mukherjee. A quick summary of his laws can be found here. Innovation comprises a number of activities that are not included in R&D, such as later phases of development for preproduction, production and distribution, development activities with a lesser degree of novelty, support activities such as training and market preparation, and development and implementation activities for innovations such as new marketing methods or new organisational methods which are not product and process innovations. Innovation activities may also include acquisition of external knowledge or capital goods that is not part of R&D.--Oslo Manual You should also go old school if your goal is a less varnished definition of innovation. I happened upon The Theory of Economic Development by Schumpeter published in 1934. He came pretty close to a modern framework for what we measure or should consider measuring when thinking about innovation.
I suggest expanding the list based on recent readings in Rethinking Economics. The main premise of the latest book by Kate Raworth, Doughnut Economics, 7 ways to think like a 21st century economist discussed in earlier blogs, Change isn't necessary--survival isn't mandatory and Measuring the quality of your intent reminds us of our capability of over-reaching our finite resources or under-shooting societal responsibilities. Global reach into R&D that includes areas of unmet need should top the list. Thinking about myopia, why don't we hear more about economic theory during the cacophony of news around drug prices? Newsfeeds go no deeper than "prices are rising". Where is the explanation of why? How did we end up with commodity fallacy of healthcare in the US? Why is healthcare actually NOT a free market? When is the last time we discussed public calling or public interest in the media? As described back in the 1920s... For public utility regulation to be considered appropriate or for that industry to be “affected with public interest,” early courts and legislatures agreed that two conditions should be met: (1) that the industry meets “an important human need” (i.e. necessity); and (2) some feature of the market presents a “risk of oppression” (i.e. power).--Charles Wolff Packing Co. v. Court of Indus. Relations, 262 U.S. 522, 538 (1923); Block v. Hirsh Agreed there is a lot to unpack when talking about healthcare. My point (and lets face it, the point of this blog) is to encourage the expansion of what we think of when we think about healthcare. It is impossible to extricate healthcare from history, political will, economic theory, data, numeracy, medicine, finance, law, and government. I listened to a rebroadcast of a Freakonomics podcast Everything You Always Wanted to Know About Money (But Were Afraid to Ask). A persistent theme is typically a variation of, "If financial literacy is so important; and so many people are bad at it--what are we doing wrong?" A legal scholar, Lauren Willis opines the following: It’s like saying, “We should start teaching everybody to be their own doctor, teaching everyone to be their own mechanic.” Terribly inefficient to do that. Not only is it inefficient, but it has this culture of blaming the consumer. “You’re the one who didn’t figure this all out. You didn’t go to the classes or didn’t pay attention,” or whatever. And that’s not going to help in the long run. Aren't we indeed saying this about healthcare? We pretend healthcare is a free market--although it is not. The patient is being labeled as the new block buster in healthcare. Think of the buzz worthy, "shared-decision making". Although patients have asymmetrical knowledge they are now being asked to determine the level of intervention and healthcare they deem of "value".
If the disease is chronic or life-threatening, the patient is coerced into the system on at least two levels. First, nobody enters the "disease" market voluntarily and second, once you are here, you pay the price that is demanded--even though you likely have no idea what that is going to be. Here is how I am defining innovation at this moment--a reach that exceeds its grasp. Comments are closed.
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