Category Archives: Healthcare

No more free-lunch bailouts

With governments spending on a massive scale to mitigate the economic fallout from Covid-19, they should be positioning their economies for a more sustainable future.
By Mariana Mazzucato and Andreo Andreoni – The Covid-19 crisis and recession provides a unique opportunity to rethink the role of the state, particularly its relationship with business. The long-held assumption that government is a burden on the market economy has been debunked. Rediscovering the state’s traditional role as an ‘investor of first resort’—rather than just as a lender of last resort—has become a precondition for effective policy-making in the post-Covid era.

Fortunately, public investment has picked up. While the United States has adopted a $3 trillion stimulus and rescue package, the European Union has introduced a €750 billion ($850 billion) recovery plan [albeit still under deliberation], and Japan has marshaled an additional $1 trillion in assistance for households and businesses.

However, in order for investment to lead to a healthier, more resilient and productive economy, money is not enough. Governments also must restore the capacity to design, implement and enforce conditionality on recipients, so that the private sector operates in a manner that is more conducive to inclusive, sustainable growth.

Government support for corporations takes many forms, including direct cash grants, tax breaks and loans issued on favorable terms or government guarantees—not to mention the expansive role played by central banks, which have purchased corporate bonds on a massive scale. This assistance should come with strings attached, such as requiring firms to adopt emissions-reduction targets and to treat their employees with dignity (in terms of both pay and workplace conditions). Thankfully, with even the business community rediscovering the merits of conditional assistance—through the pages of the Financial Times, for example —this form of state intervention is no longer taboo.

And there are some good examples. Both Denmark and France are denying state aid to any company domiciled in an EU-designated tax haven and barring large recipients from paying dividends or buying back their own shares until 2021. Similarly, in the US, the Massachusetts senator Elizabeth Warren has called for strict bailout conditions, including higher minimum wages, worker representation on corporate boards and enduring restrictions on dividends, stock buybacks and executive bonuses. And in the United Kingdom, the Bank of England has pressed for a temporary moratorium on dividends and buybacks. more>

‘Shareholder value’ versus the public good: the case of Germany

Support for companies amid the pandemic must come with social and ecological strings attached.
By Emre Gömec and Mustafa Erdem Sakinç – With uncertainty around the world about how and when the coronavirus outbreak will decelerate, whole business sectors have been affected by lockdowns and are facing ruin. In Germany, more than 750,000 companies have put over 12 million employees on reduced working hours (Kurzarbeit), dwarfing the 3 million hit by the 2008 crisis.

Society’s loss goes beyond the toll on employment. As the crisis lengthens, innovative capabilities accumulated over years and even decades may atrophy and disappear, making it far more difficult to emerge from the pandemic with a healthy economy.

This ‘innovation drain’ can be avoided if, and only if, corporations devote every available resource to retaining, and reinvesting, in productive capacity. Implementation of the rescue packages adopted in Germany in March and June must thus fundamentally address future practices of corporate resource allocation.

Making government support conditional on replacing value-extractive practices, such as excessive dividend payments and executive compensation, is the most effective way to block damaging business decisions which undermine investment in productive capabilities and secure employment.

Germany’s case was, it’s true, not as dramatic as that of the US, where S&P 500 companies, having fallen victim to the American disease of corporate financialization, distributed 92 per cent of their net income between 2009 and 2018 in stock buybacks and dividends. Still, in the decade from 2010 to 2019, 65 German companies in the DAX 30 and MDAX 60 indices paid out a total of €338.8 billion, or 46 per cent of their combined profits, in dividends, in addition to €35.3 billion, or 5 per cent of profits, in stock buybacks. more>

Updates from McKinsey

An operating model for the next normal: Lessons from agile organizations in the crisis
Companies with agile practices embedded in their operating models have managed the impact of the COVID-19 crisis better than their peers. Here’s what helped them cope.
By Christopher Handscomb, Deepak Mahadevan, Lars Schor, Marcus Sieberer and Suraj Srinivasan – For many companies, the first, most visible effects of the COVID-19 pandemic quickly created a challenge to their operating and business models. Everything came into question, from how and where employees worked to how they engaged with customers to which products were most competitive and which could be quickly adapted. To cope, many turned to practices commonly associated with agile teams in the hope of adapting more quickly to changing business priorities.

Agile organizations are designed to be fast, resilient, and adaptable. In theory, organizations using agile practices should be perfectly suited to respond to shocks such as the COVID-19 pandemic. Understanding the experiences of agile—or partially agile—companies during the crisis provides insights around which elements of their operating models proved most useful in practice. Through our research, one characteristic stood out for companies that outperformed their peers: companies that ranked higher on managing the impact of the COVID-19 crisis were also those with agile practices more deeply embedded in their enterprise operating models. That is, they were mature agile organizations that had implemented the most extensive changes to enterprise-wide processes before the pandemic.

That suggests implications for less agile companies as economies reopen. Should they set aside the agile practices they adopted during the pandemic and return to their traditional operating models? Or should they double down on agile practices to embrace the more fundamental team- and enterprise-level processes that helped successful agile companies navigate the downturn?

We analyzed 25 companies across seven sectors that have undergone or are currently undergoing an agile transformation. According to their self-assessments, almost all of their agile business units responded better than their nonagile units to the shocks associated with the COVID-19 pandemic by measures of customer satisfaction, employee engagement, or operational performance.

Executives emphasized that the agile teams have continued their work almost seamlessly after the shock, without substantial setbacks in productivity. In contrast, many nonagile teams struggled to transition, reprioritize their work, and be productive in the new remote setup. The alignment between agile teams’ backlogs and their business priorities allowed them to shift focus quickly. more>

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Updates from Georgia Tech

Why Restarting the Global Economy Won’t be Easy
By Jerry Grillo – As the world contemplates ending a massive lockdown implemented in response to COVID-19, Vinod Singhal is considering what will happen when we hit the play button and the engines that drive industry and trade squeal back to life again.

Singhal, who studies operations strategy and supply chain management at the Georgia Institute of Technology, has a few ideas on how to ease the transition to the new reality. But this pandemic makes it hard to predict what that reality will be.

“There is really nothing to compare this pandemic to,” he said. “And predicting or estimating stock prices is simply impossible, unlike supply chain disruptions caused by a company’s own fault, or a natural disaster, like the earthquake in Japan.”

But COVID-19 represents a new kind of mystery when it comes to something as complex and critical to the world’s economy as the global supply chain, for a number of reasons that Singhal highlighted:

  • The global spread of the virus and duration of the pandemic. “We have no idea when it will be under control and whether it will resurface,” Singhal said. “With a natural disaster you can kind of predict that if we put in some effort, within a few months we can get back to normal. But here there is a lot of uncertainty.”
  • Both the demand and supply side of the global supply chain are disrupted. “We’re not only seeing a lot of factories shutting down, which affects the supply side, but there are restrictions on demand, too, because you can’t just go out and shop like you used to, at least for the time being,” he said. “And all this is taking place in an environment where supply chains are fairly complex – intricate, interconnected, interdependent, and global.”
  • Longer lead times. “We get close to a trillion dollars of products annually from Asian countries, about $500 billion from China,” Singhal said. “Most are shipped by sea which requires a four-to-six-week lead time. The fact that logistics and distribution has been disrupted and needs to ramp up again will increase lead time. So, it will take time to fill up the pipeline, and that is going to be an issue.”
  • Supply chains have little slack, and little spare inventory. While manufacturing giants such as Apple, Boeing, and General Motors have more financial slack to carry them through a massive economic belt tightening, their suppliers, spread out across the globe, come in different sizes, different tiers, “and these smaller companies don’t have much financial slack,” said Singhal, pointing to a report of small and medium sized companies in China, “which have less than three months of cash. They’ve already been shut down for two months, and cash tends to go away quickly.

“Many of these companies may go bankrupt,” he added. “So we need to figure out how to reduce the number of bankruptcies. Government is going to play an important role in this, and the stimulus package the U.S. has approved will be helpful.” more>

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Yes, someone is to blame

A pandemic may be represented as a ‘natural disaster’. A global depression is however the product of ideology and powerful political actors.
By James K Galbraith and Albena Azmanova – An unprecedented economic crisis is descending on Europe. It is, the president of the European Central Bank, Christine Lagarde, declared recently to the European Parliament, the worst in peacetime.

In the United States, the Federal Reserve Bank reports the worst decline in output and employment in 90 years. The World Bank warns that the world is on the precipice of the deepest slump since 1945—with up to 60 million people pauperized, many in countries already poor.

Lagarde hurried to clarify that this vast human tragedy was, in her view, ‘of no one’s fault or making’—as if a medical crisis could metamorphose into a social crisis all by itself. The catastrophe is however the work of ideas, of politics and of policies.

In the US, testing was botched, delayed and is still not available on demand. In France, vast stocks of personal protective equipment, accumulated for the H1N1 epidemic, had been sold off, stored badly and ruined. In the United Kingdom and Sweden, the authorities thought first to let the virus run free, seeking ‘herd immunity’ at the implicit price of many thousands dead.

These were not mere mistakes or simple accidents: they were political decisions. They were consequences of an ideology built over decades. There were sins of commission and sins of omission—to invoke a pair of concepts developed by Hannah Arendt—their result a fragile economic structure, marked by precarity and primed for collapse.

The sins of commission came first. From the late 1970s, political leaders throughout the west embarked on the formidable project which came to be known as neoliberal capitalism. Deregulation, decentralization, privatization, balanced budgets and tight money were key elements of the ‘Washington consensus’ advanced by national elites and the international financial institutions, especially the International Monetary Fund. Public services and welfare programs were slashed, including critical expenditures on public health.

The initial goals were to break trade unions and curtail inflation, albeit at the expense of core manufacturing capability. more>

Updates from McKinsey

Ready, set, go: Reinventing the organization for speed in the post-COVID-19 era
The need for speed has never been greater. Here are nine ways companies can get faster.
By Aaron De Smet, Daniel Pacthod, Charlotte Relyea, and Bob Sternfels – hen the coronavirus pandemic erupted, companies had to change. Many business-as-usual approaches to serving customers, working with suppliers, and collaborating with colleagues—or just getting anything done—would have failed. They had to increase the speed of decision making, while improving productivity, using technology and data in new ways, and accelerating the scope and scale of innovation. And it worked. Organizations in a wide range of sectors and geographies have accomplished difficult tasks and achieved positive results in record time:

Redeploying talent. A global telco redeployed 1,000 store employees to inside sales and retrained them in three weeks.

Launching new business models. A US-based retailer launched curbside delivery in two days versus the previously-planned 18 months.

Improving productivity. An industrial factory ran at 90-percent-plus capacity with 40 percent of the workforce.

Developing new products. An engineering company designed and manufactured ventilators within a week.

Shifting operations. Coordinating with local officials, a major shipbuilder switched from three shifts to two, with thousands of employees.

At the heart of each of these examples is speed—getting things done fast, and well. Organizations have removed boundaries and have broken down silos in ways no one thought was possible. They have streamlined decisions and processes, empowered frontline leaders, and suspended slow-moving hierarchies and bureaucracies. The results, CEOs from a wide range of industries have told us, have often been stunning:

“Decision making accelerated when we cut the nonsense. We make decisions in one meeting, limit groups to no more than nine people, and have banned PowerPoint.”

“I asked on Monday, and by Friday we had a working prototype.”

“We have increased time in direct connection with teams—resetting the role and energizing our managers.”

“We adopted new technology overnight—not the usual years—as we have a higher tolerance for mistakes that don’t threaten the business.”

“We’re putting teams of our best people on the hardest problems. If they can’t solve it, no one can.”

Because of the pandemic, leadership teams have embraced technology and data, reinventing core processes and adopting new collaboration tools. Technology and people interacting in new ways is at the heart of the new operating model for business—and of creating an effective postpandemic organization. more>

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Updates from McKinsey

Return: A new muscle, not just a plan
Return is not a phase; it’s a way of operating. A nerve center can help build the capabilities that businesses need in the “next normal.”
By Mihir Mysore, Bob Sternfels, and Matt Wilson – In less than four months, COVID-19 has upended almost all expectations for 2020. Beyond the loss of life and the fear caused by the pandemic, businesses around the world have faced disruptions at a speed and scale unprecedented in the modern era.

Companies everywhere are now wrestling with the question of how to reach the next normal safely. Many talk about a return to the workplace as a plan that needs to be implemented: a series of systematic steps to reach some kind of stable operating model, in a world where vaccines are adequately available or herd immunity has been reached. In many cases, these plans suggest a return to some relatable version of the past.

Yet the intrinsic uncertainties that might scupper such plans continue to mount. Executives readily admit, for instance, that it is tough to write a deterministic return plan because of the likelihood of a resurgence, discoveries about how the virus is transmitted and whom it affects, the nature and duration of immunity, and continued changes in the quality and availability of testing and contact tracing. The best possible plan today is merely a strawman that will need near-continuous recalibration and change.

Another critical uncertainty is the future of remote work. Some feel that recent events have driven a real productivity gain they do not want to lose. However, they recognize that a wholesale shift to remote work has had many false dawns. Silicon Valley has experimented with it most extensively, but after many attempts to implement telecommuting, our research found that at 15 top firms, only 8 percent of the employees work remotely. These companies do not want to try this again only to roll it back in a few years.

Customer behavior is a third unknown. Companies see the clear shift to digital among consumers and its inevitable impact: online shopping has expanded by up to 60 percent in some categories, and up to 20 percent of online consumers in the United States have switched at least some brands recently. But it’s unclear whether once the pandemic recedes, these customers will return to their old ways or if the pandemic will create new types of consumers.

Given these and other uncertainties and the need for experimentation and fast learning to navigate through them effectively, we believe that the next step in the response of businesses cannot be thought of as a phase at all. It will be open ended rather than fixed in time. A better mental model is to think about developing a new “muscle”: an enterprise-wide ability to absorb uncertainty and incorporate lessons into the operating model quickly. The muscle has to be a “fast-twitch” one, characterized by a willingness to change plans and base decisions on hypotheses about the future—supported by continually refreshed microdata about what’s happening, for example, in each retail location. And the muscle also needs some “slow-twitch” fibers to set long-term plans and manage through structural shifts. more>

Updates from Chicago Booth

US small businesses have little cushion against prolonged disruptions
By Michael Maiello – Even in a growing economy, most small businesses in the United States lack sufficient reserve capital to endure a prolonged business interruption, so a natural disaster, pandemic, or any condition that interrupts normal operations can quickly lead to job cuts and business failures. If the government wants to keep small businesses afloat, its support must be enacted quickly and generously and be easy to access, according to a survey of 5,800 small businesses conducted early during the COVID-19 outbreak in the US.

University of Illinois’s Alexander W. Bartik, Chicago Booth’s Marianne Bertrand, and Harvard’s Zoë Cullen, Edward Glaeser, Michael Luca, and Christopher Stanton have been studying small-business behaviors, decision-making, and attitudes. Their research provides a detailed look at the financial health of small businesses heading into COVID-19 and underscores the need for fast and easy-to-access government interventions when businesses are interrupted.

The researchers conducted their survey as the Coronavirus Aid, Relief, and Economic Security (CARES) Act was signed into law in late March and implemented in April. By then, small-business owners, who employ 48 percent of American workers, had already cut their workforces massively, a sign of their precarious finances even ahead of the outbreak. Three quarters of survey respondents, who are all members of Alignable, a small-business network, reported they had cash on hand to cover expenses for no more than two months.

Survey respondents who believed the pandemic would last longer were more pessimistic about their companies’ chances of surviving. The researchers estimated that business closures could lead to almost 33 million job losses if the pandemic were to last four months, 35 million if it were to extend six months. more>

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Social commons: the social protection we want

Universal basic income would offer a deadweight subsidy to low-paying employers. The route to security for all lies in the concept of ‘social commons’.
By Francine Mestrum – The coronavirus crisis has put ‘basic income’ once more on the agenda. It is understandable, since the crisis has hit all vulnerable people in our societies particularly hard. Many in precarious working conditions have lost their job and joined the ranks of the poor. These people deserve help. Ergo, give them some money, without conditions.

Sure, but let us be clear what we are talking about.

Once again—even more than in the recent past when the debate previously erupted—there is an enormous semantic confusion. Sometimes authors speak of the universal basic income as proposed by Phillippe Van Parijs or Guy Standing. But, in most cases, what is meant is some kind of minimum income, only paid to those who need it. This is the case, for instance, with the ‘basic income’ now introduced in Spain.

The first option, the ‘real UBI’, has to be rejected, as earlier explained. First, if one wants to solve poverty, there is no need to give money to the rich, who most often do not even pay taxes. Secondly, if one wants to improve mental wellbeing—as mentioned in the Finnish report on the brief experience with ‘basic income’ there—there are many ways to achieve this. Income security can indeed be a very important factor for wellbeing but the former is not synonymous with a universal basic income.

Thirdly, it seems rather contradictory to seek a fair tax system with contributions from big corporations, if at the same time the state allows companies to lower wages and offers to complement these wages with a basic-income subsidy—a kind of negative income tax. That would, at best, be a zero-sum game, for the state as well as for the corporations.

A UBI can only be acceptable if it can guarantee a decent standard of living, complementary to social protection. But then it becomes a very serious financial problem—far too expensive, as Van Parijs and Rutger Bregman admit. more>

America’s new civil war (II)

By Basil A. Coronakis – A chaos theory that claims a butterfly in Manhattan may generate a tornado in China.

That’s the theory, but in practice the tiny virus that was either purposely or accidentally dripped from China’s Wuhan Institute of Virology has created world-wide chaos, and we are just at the beginning. Our society has just entered into a large-scale evolution, seemingly far from a final settlement. How far that end is, nobody can seriously predict. Nor can they imagine exactly how it will end as the process is taking on the shape a major social confrontation. Everybody is taking positions against everybody else, and everyone will end to be on its own.

At present, very few people understand what kind of situation the world is getting to. The general panic caused by the virus was just the excuse to trigger a large-scale evolution, which for the time being remains under the radar, due to the fact that it is only the very beginning. The reasons can be summarized by the unbridgeable social gaps generated by periods of prolonged austerity, extended overregulation, the ever-increasing politically uncontrolled powers of administration and a scarcity of true political leaders.

When coupled with an unreasonable and prolonged lockdown, which added unemployment and misery to an already toxic mix, you have the perfect recipe for a social uprising.

Presently, three players affect the socio-political making of our times – the United States, China, and Russia. The European Union, although an integral part of the West, is leaderless and acts more like an unhappy player with no real role in a play where the first act is being staged across the Atlantic.

The United States is in civil war and one intelligent exercise would be to figure out what title future historians will give to this hopefully short, chapter in their history. more>