Writing predictions is always/never fun, because you take a moon shot in advance and can always turn out to be wrong. That being said, I try never to predict things I don’t already know something about, and then I try to spread word about what’s coming to people who aren’t expert in what I’m predicting. For that reason, some of my predictions can appear out of the mainstream. What a surprise.
1) The success of Louis CK‘s unusual distribution strategy will once and for all change the publishing and entertainment industries. Right now, the publishers are wildly trying to control the distribution of content with legislation pending in Congress. Let’s assume it will fail, as there are petitions all over the internet to fight SOPA (otherwise known as the Stop Online Piracy Act HR3261) and its sister in the Senate. By the time you read this, the chips will probably have fallen one way or another on this particular attempt to screw up the internet by people who don’t understand it, but the legislation won’t matter, because of Louis CK.
Louis CK is a comic who had a hilarious show on HBO that later went to FX. He decided to produce a single ”
concert,” or whatever you call it when a comic stands up there and is funny in front of you, and distribute it himself over the internet. He offered it free, suggested a $5.00 donation, and made $750,000 profit after covering his $250,000 costs. He keeps all that profit. He shares it with no “label,” publishing company, network, or whatever. HE and WE are the network.
This will continue to happen. Once content goes from atoms to bits, “piracy” can’t be stopped, and neither can the worker (Louis CK) owning the means of production. Louis CK is now a publisher. There’s a train moving in a certain direction here, and many lawyers and even creators think that standing in front of it and waving their arms in fear about the coming trains wreck will stop it. No way.
2) Just as Mark Zuckerberg and Eric Schmidt changed our views about social privacy, the number of data breaches this year will make people think twice about the privacy of health records. This year more than any other has been the year of electronic health records, and most of the small physician offices that installed them with ARRA (Stimulus) money are just figuring out how to use them. These providers have consultants, and some of these consultants are already privy to patient information, and bound by HIPPAA rules. But laptops get lost and stolen, physician staff turns over, and our records are not secure, no matter what anyone says. In fact, the only person who has real trouble getting access to medical records is the patient, who has to sign forms to receive his/her own data.
We are going to learn to live with our health information being “out there,” both intentionally and unintentionally.
If you are a patient with a serious or chronic condition, you may already have chosen to put it out there by joining a support group or a site like Diabetes Connect or Patients Like Me. You may also be monitoring your weight or blood pressure with a Withings scale and an iPhone app, wearing a Fitbit or a Jawbone. Slowly, we are learning to reap the benefits of sharing our health information and crowd sourcing our treatment plans.
3) The global startup movement will continue to accelerate, even though the funding for companies that need follow-on rounds will dry up. My friend Mark Suster from GRP Partners predicted that 2012 would be a “shitstorm” for startup companies seeking more money for expansion. There are several reasons for this. First, angels and VCs have funded too many of the same thing. Some of the clones will have to disappear. Second, VCs are having trouble raising funds because their institutional investors (pension funds, university endowments) are still reeling from losses in 2008 and have lost the taste for alternative investments. Nevertheless, there are now enough incubator/ accelerator programs in most cities to provide a richer ecosystem than we had five years ago, or even three. And since capital will come where there is a good deal, even states and countries without indigenous VC communities will get noticed.
4) Rapid fire technological change in health care will taken place in advance of “Obamacare.” Obama’s health plan may not be ideal, but it has done something I have been waiting for. It has shaken up the industry and forced it to consider new business models and ways to deliver service. Both insurers and providers are facing about 32,000,000 formerly uninsured patients, coupled with the need to spend 80% of premiums collected on actual care. Look for (finally) the rise of technology in remote patient monitoring and wellness incentives. Look also for an increase in primary care docs, retail facilities that treat non-urgent illnesses, and fewer conversations with the actual doctor, who will become the medical director of her own practice. And employers are already beginning to penalize us for some health conditions like high blood pressure or smoking, shifting a larger percentage of our health insurance premiums to us. There’s an amazing amount of activity around using technology to produce behavior change. Let’s call this human engineering.
