The long term implications of Japan’s massive earthquake and tsunami have recently begun to materialize. Over the course of the last twenty years, management principles have centered on efficiency; do more with less.  Six Sigma, Lean Manufacturing, outsourcing, and off-shoring have boomed. Perhaps our fascination with reducing costs and optimizing return on assets has manifested in an overly minimalistic view of the world.

The recent supply chain disruptions have illustrated the vulnerability of our thinking as just in time translated into late product shipments, unsatisfied customers, and sluggish earnings, spanning from Toyota to Tiffany’s. The vulnerability may be far greater for smaller companies with less sophisticated logistics and reliance on a smaller web of suppliers.

Thus the central question is shifting away from what is the minimum possible cycle time to what are the supply chain risks and how can they be mitigated? Manufacturers have had to adapt, in some cases reengineering their products to use components or materials that have been suddenly unavailable.  Some product development teams have had to adapt, at times looking like a scene from Apollo 13 (when astronauts famously had to construct a part based on the materials they had on hand).

Customers have the right to ask more questions about how their vendors manage supply and what types of contingencies they have in place.  As has been evident in recent years, vendors and customers alike must think broadly about what eventualities could disrupt the global marketplace and collaborate on solutions. The horrific events in Japan reflect only the latest in a series of events that are reshaping how products come to market.

A federal judge’s recent ruling that elements of the health care bill are unconstitutional has heightened the health care debate.  Republicans, feeling their oats and perceiving a mandate are threatening to repeal the Patient Protection and Affordable Care Act.

It was only after my friend and colleague Dr. Bala Chandrasekhar explained most of the information in this post to me that I first came to understand the fundamental problem.  Our medical community suffers from perverse incentives. The system does not reward results; it rewards the extension of care.

In the world’s best hospitals, such as the Mayo Clinic, physicians collaborate, in a finite space, where information is shared and decisions are made. In the overwhelming majority of cases, patients are shuttled around, from general practitioners, to specialist, and from one laboratory to the next.  Information about the patient’s medical history is rarely shared, an approach that does not support the best medical outcome for patients.

The advent of electronic medical records and new rules governing payments is the impetus to consolidation in a business so unsophisticated, that many medical files and prescriptions are managed with a piece of paper, pen and fax machine.  The institution of medicine needs to undergo radical change, and the prospects of larger organizations managing our care means that the stakes are getting higher.

Unlike professionally managed businesses, there are massive variations in best practices in medical groups.  Physicians hate oversight, and we pay the price in an estimated 100,000 people a year dying in U.S. hospitals from pure negligence (errors).

It is intuitive to all of us that raising medical care costs are unsustainable, yet the numbers are daunting.  The convergence of an aging populace and exponential health care inflation will double Medicare costs within a decade.  By 2020, Medicare and Medicaid are projected to increase from 21% to over 30% of federal spending (non-interest payments), and that doesn’t include massive spending by state and local governments. Proponents argue that we have the best medical care in the world; but at what cost? A knee replacement that costs upward of $40,000 in the U.S., costs $5,000 in Germany. We all want the best health care, but at some point common sense must prevail.

According to the bipartisan congressional report -Restoring America’s Future, “slowing the growth of health spending is realistic. Other advanced countries have substantially lower health spending as a share of GDP, while still achieving measures of access and quality that often exceed those in the United States. Although a uniquely American approach is required, these comparisons show what is achievable.” Health care reform focuses on capping costs for doctors and reforming various forms of insurance coverage (including universal coverage). It does little to reform the underlying behavioral issues that are driving up health care costs.  The fee for service model is dated and irrelevant.

If these costs are not constrained, our fiscal mess will get much worse, and our businesses and personal wealth will be drained by massive tax increases.  Small business owners, who bear the brunt of a bloated health care bureaucracy in the form of inflated health insurance premiums must advocate for more meaningful reforms.  Our economic future depends on it.

When the Internet was first thrust upon us, we didn’t know what to make of it. Nor did we know which of the entrants of the budding new market would win the beauty contest.  Our intuition was that someone (such as AOL, Netscape, Microsoft, Google, and Yahoo) would, and that the technology would be a game changer.

There are times when a technology is bigger than the first-to-market entrant who introduces it to us.  A current case in point is Toyota, a company who has been vilified in light of their massive quality and public relations problems. Yet Toyota has my attention, as they are braced to create disruption.

I recently bought a Lexus hybrid. I didn’t really buy it for environmental reasons, although reducing my carbon footprint was certainly a bonus. I bought it because I wanted all the toys, Lexus service and quality and was intrigued by the concept of 35 miles to the gallon (in a volatile world where the price of oil is at risk).

At its core, strategy is about managing trade-offs, and this technology provides the potential for consumers to gain the most, and give up the least.  I believe hybrid technology will emerge as a breakthrough, cross-over technology adopted by the majority of drivers in the U.S. in the next 5-7 years.  Electric cars are novel, yet inconvenient.  Americans are not going to adapt to sitting at charging stations for 2 hours, nor will they settle for a lack of power.  U.S. oil producers will not support any material shift to hydrogen, or corn, or recycled Twinkies, or whatever.  While the Prius was perceived as small and sluggish, the Lexus (a Toyota brand) is neither, and proves that the underlying technology can appeal to the masses. Toyota is way ahead of the pack in hybrid technology and I believe the day will come when it will provide a significant competitive advantage.

Of course this post is not about hybrids at all, it is about identifying breakthrough technologies that can disrupt an industry. Often, fortunes are made by the purveyor of a technology, as well as others who create alliances or business that can feed off it.

There are entire cottage industries being built to support such technologies, including the myriad of developers creating apps for The App Exchange (SalesForce) and Apple App Store.

Will Apple beat Microsoft in business computing (the answer is already clear in consumer products)?  Will cloud computing completely alter the technology landscape in ways we can’t even comprehend? Which mobile technologies will change the way we work and live?

What changes in health care technologies will revolutionize the way we care for the sick?  What emerging technologies could reshape your industry? What new delivery systems will improve the way your customers do business (or consume products)?  The answer will come based on who can create the best balance of trade-offs and win the beauty contest.