I’m currently reading Thomas Friedman’s engaging book, The World is Flat. It is indeed amazing how creative people have been with respect to minimizing financial costs by using technology – especially through outsourcing and/or homesourcing. Friedman cites multiple examples among which is one that I personally found very interesting. It is about a McDonald franchise situated in Missouri that processes its drive-through orders through by rerouting the customer’s call to not one of its own flesh-and-blood employees but rather to a call-center in Colorado! The man behind this idea, Steve Bigari, has now left the Mickey D family and is focusing full-time on developing America’s Family – a non-profit dedicated to help low-wage workers in America.
Anyway, Steve’s model and the overall idea of outsourcing got me thinking. Currently, social entrepreneurship is thriving due to the enthusiastic, young, ingenious entrepreneurs thinking of creative ways to alleviate social problems. Could one of them potentially tap into the successful model of outsourcing and adapt it to fit their targeted area? Since my interest is in bettering the delivery and cost of healthcare and pharmaceutics, I can imagine a creative fellow setting up shop in a buzzing metropolis of a developing country to serve citizens of a developed country where the healthcare costs are steep (we all know who I mean here). This entrepreneur can hire employees specializing in science, pharmaceutics, and healthcare (M.D.s, PhDs, etc). He can then create a hotline that his “patients” abroad can dial into. Calls would be charged at a cost a mere fraction of the cost of an in-person consultation in the country of the patient. These calls would then be rerouted according to the nature of the problem. Cold and cough? Transfer to the Internal Medicine department. Acne issue? Transfer to Dermatology. The entrepreneur can then extend this idea further by offering medical outsourcing services in addition. If this company is trying to reach out to the poor and low-wage workers, it can have different charges based on the customer type and the salary bucket that they fall into. The profits made by “treating” customers earning more than $x can then subsidize the cost for the people earning less than $x.
Perhaps my idea sounds a bit amateurish. Perhaps a model like this is already in place? I’d love to know as I continue to build my knowledge about this space.
Very interesting idea. Web MD with cheap PhDs for more complicated queries.
The 2 biggest issues would be trust and liability.
Original comment posted by User Kevin Parcell on Acumen Community Forum where this blog is also posted:
Outsourcing exploits the weakest and most vulnerable workers and resources, and then moves on when they are exhausted, either because rising wages price the work-force out of the competition or because a natural resource becomes too rare to profitably extract. The people who write the histories of these adventures are mostly made-wealthy as exploiters and thus they mostly tout it, although the occasional Michael Moore rises from the tempest-tossed and embarrasses the fat-cats by pointing out that the exploited were exploited irresponsibly.
The exploiters generallly duck the cameras, but they would be right to defend their actions as compulsory because the export model that is our global marketplace is a competition to exploit as irrepsonsibly as possible, in which the few who try to buck the sytem usually go broke competing with the McWall.
And certainly, poor people anywhere might be happy for the work, but almost every export business functions by exploiting one place to enrich another, and the result is the decimated planet we have, with all its hunger and poverty. I think this is the challenge called social enterprise development – to exploit responsibly – and I admire how well Acumen Fund is doing. In a sense this is the difference between a business and a charity: business exploits, which is to say it takes, while charity gives; and just as a good charity gives responsibly, so a good business – a social enterprise – takes responsibly.
That being said, outsourcing access to health services is a very good idea that can work very well when we remove it from the competitive market. Here in the US, the people who profit from competitive health markets – the insurers – defame ending competition as “socialized medicine”, while the rest of the world knows it as economy-of-scale accomplished through taxation. Unfortunately, some of the nations providing universal health care employ outsourcing to lower their costs – they use labor in distant nations where their employees have no health coverage. I don’t believe anything illustrates the fatal flaw in the export/outsourcing model better.
The lowest standards of living in the world are not in places that are currently being exploited for labor but those places that are unworthy of exploitation. Those places with few resources or undeveloped infrastructure that would be more trouble than they are worth to exploit.
As for the outsourcing medicine, if the doctor isnt licensed to practice medicine in the US, then he wouldn’t be able to prescribe medication to treat any illness discovered. And many people would not trust diagnoses made over skype or phone, so the market would necessarily need to be niche. The current system of importing general practitioners from abroad seems to be working. Also by forming a new tier in medicine that allows nurses to prescribe certain medication should also keep costs down. Another important idea to keep costs down would be to empower more people with chronic illness to self medicate instead of having them come in for shots, etc.