Thought Experiment: What if Facebook, Skype and PayPal Merged?

by John Julius Sviokla on March 10, 2010

Many people don’t know that Bostonian William Crapo (Billy) Durant founded General Motors, and if you ever go to the old General Motors Building in Detroit, you will see his initials emblazoned on the coat of arms in the eaves of the building.  Durant was the visionary who crashed together the Buick, Oldsmobile, Chevrolet, and Cadillac companies, just to name a few.  Due to his financial aggressiveness he controlled but then lost GM twice and it was finally taken over by Alfred Sloan, who built it into the world’s most successful enterprise of its day.

Imagine if we had a Billy Durant of bits who could bring together Facebook, Skype and PayPal.  Such an entity would become –  the world’s first self-organized conglomerate.  With 350,000,000 million users in Facebook it would become one of the world’s biggest phone companies overnight, while bringing significant, growing and profitable revenues to Facebook.  (Skype’s 3rd quarter revnue for 2009 was $185 million, just before it was purchased for $2.75 billion by a group of private equity folks lead by Silverlake Partners.)  We all know that friends, even today, want to talk sometimes.  Moreover, Skype is an especially cheap alternative when a person is in a remote country using a cell phone.  When I was recently in Romania, I used Skype to call because it cost $.03/minute when my cell phone was $4.99/minute.  This means that adding Skype would continue to grow Facebook in developing countries very quickly.  Also, as cell phones are more capable – and the Apple iPad becomes a reality, more and more calls will flow over Skype.

PayPal could bring a fantastic engine to provide both real dollars, and the burgeoning market for virtual currencies and gifts.  The digital gift market in Facebook is reported to be $40-50 million dollars and growing rapidly.  PayPal could create both “real” and “virtual” credits, which could be traded among the members of the community.  In addition, if PayPal were willing, they could provide a reasonable reputation management system.  In order to deal with financial fraud, the company has a pretty strong system to determine if someone on the network is legitimate, or not.  This type of risk assessment could become a feature of this new ecosystem in which you could see the reputation value of a person — if they wanted to expose it — as vetted by PayPal.

I believe such a triumvirate could launch a global community and commercial market which would change the way that commerce is done.  Facebook already is becoming the “single sign on” system for new sites because they make it easy for you to “sign on using your Facebook ID”.  Imagine if Skype adds telephone & video conferencing, and PayPal payments and reputation — the sky would be the limit.

I think all businesses have to look carefully at the power of self-organization, because self-organized systems usually work faster because they act more like a market and companies  are more bureacratic than market like in terms of their speed and coordination.  Firms need to be getting experience working with, marketing to, and transacting among these new markets because somewhere out there is today’s W.C. Durant — just waiting to assemble the new, self-scaling organization which will change everything!

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How Behavioral Economics Can Help Cure the Health Care Crisis

by John Julius Sviokla on March 1, 2010

This post was co-authored with Bret Schroeder and Tom Weakland and is also posted at HBR at http://tinyurl.com/yel2j3y

Noncompliance with medical advice is one reason the U.S. health care is so costly. Yet it has received only cursory attention in the national health care debate — undoubtedly because politicians don’t want to risk offending their constituents.

How bad is this problem? According to a study by the National Community Pharmacists Association, three of every four Americans don’t take their drugs as directed. Forty-nine percent forget to take them; 31% don’t fill their prescriptions and 29% stop taking their pills before the drugs run out! According to the New England Healthcare Institute, this costs the U.S. $290 billion per year (over 11% of our $2.5 trillion health care bill).

More waste comes from missed appointments. According to a cross-study analysis, no-show rates for doctor’s visits run as high as 20% to 30%. Although there is no system-wide estimate of the effect, one study pegs the overall cost of each missed appointment to be over $700 to the health care system. Given the fact that in 2006 there were about 900 million appointments, the annual cost to the system is over $150 billion.

We think there is a tremendous opportunity to use behavioral economics (which recognizes that people aren’t always rational) and relatively simple technology to create new tools that aid health organizations in managing consumers’ behavior and that help patients improve their own actions. Even very small changes in patient population behaviors would have a dramatic impact on costs.

For example, our firm worked on a project to help the state of Gauteng, South Africa, create an information infrastructure to help manage diabetes care. Our approach used a combination of education, clinics, web services, and cell-phone reminders to get patients to heed their doctors’ advice. Gauteng was able to reduce missed appointments from about 70% to 30% almost immediately.

We are now in the midst of designing a new system that employs a number of behavioral economics concepts (reminders, pre-commitment, social pressure, default options, etc.) to reduce waste even further.

Sure, it would be nice if we all rationally acted in our own best interest and followed the doctor’s orders — but we don’t. By recognizing that and using insights from behavioral economics to design innovative approaches, we can improve health and drive down costs.

For example, after a stroke doctors usually prescribe a blood thinner to help reduce the chance of recurrence from 24% to 4%. Despite the fact that taking this drug significantly reduces the chance of an additional brain damage, many patients don’t take their medicine.

Researchers Kevin Volpp, George Loewenstein et al, conducted a small-scale experiment to see if they could combine three incentive ideas drawn from behavioral economics to change this sad state of affairs. They used (1) small, frequent rewards, (2) a small chance at a big reward, and (3) the regret of missing a payoff.

In one test group, 20 patients were entered into two daily lotteries. All participants had a one in five chance of winning a $10 prize, and a one in 100 chance of winning a $100 prize. (For those of you who remember your probability class, this means they had an expected value each day of $3.) Patients had an electronic pillbox in their homes that recorded whether or not they took their medicine. If they had not taken their pills correctly, they were disqualified from the lotteries. Winners who had not taken their medication were informed that because they had not complied with the drug regimen, they would receive nothing.

Noncompliance dropped from 22% to under 2% for the entire three months of the study. A well-designed $3 payoff was a more powerful motivation than a 20% decrease in the likelihood of an additional stroke!

Clearly, investments in such creative solutions that reflect how people really think could rapidly generate a huge, measurable human and financial return. It is time to make such investments a priority.

Our questions for our readers are:

  • How well do you manage your own health? Why or why not?
  • If you work for a participant in the healthcare system, how focused is your firm on helping change behaviors — not just manage bad outcomes?

Tom Weakland leads the health care and public sector practices of Diamond Management & Technology Consultants. Bret Schroeder is a principal in Diamond’s health care practice.

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Policing Google and Other Fun Topics: Ben Edelman

February 17, 2010

I met a very bright young man today by the name of Ben Edelman, an Assistant Professor at Harvard Business School, who is involved in a number of interesting things from his current post on Typosquatting — how companies reserve popular misspellings of popular website addresses, to the very interesting topic of taking on Google [...]

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I Need a Miracle Every Day: Fishy Sensors…

February 16, 2010

My grandmother Catherine McCaig lived to be 105 years old, and worked until she was 99. She cried when she saw the beginning of James Cameron’s Titanic because she lost her best friend Bridget on the voyage. I remember talking with her about her first ride in a car and she said, “We thought we’d [...]

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Can the USA Regain its Love of Speed?

February 11, 2010

We used to love being the nation of the leading edge: the fastest and tallest of everything: fastest computers, tallest buildings, fastest cars, and so on. Below is a picture from Wikipedia of the Stanley Steamer in 1903 setting the world wide speed record for the mile at the Daytona Beach Road Course. I have [...]

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Ten Propositions for the Virtual Age…

February 8, 2010

Back in 1993, Jeffrey Rayport and I were trying to understand the implications of the exploding information world. It was about a year before the first browser, Mosaic, was created. Below are our “ten propositions for the virtual age”. I’d love your reaction to our thoughts of that time…

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Brand Management and the 10:45 Per Day Generation

February 2, 2010

The Kaiser Foundation recently released a study documenting the astounding fact that 8-18 year olds in the United States have increased their media use from 8hrs 33 mins per day in 2004 to 10hrs 45 mins in 2009, which means that except for when they sleeping or in school they are almost always consuming media. [...]

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Is This Innovation Too Disruptive for My Firm?

January 15, 2010

One of the trickiest decisions in business is to assess: is this innovation too innovative for my firm? You need to decide, will the core business embrace the new product or service, or reject it?  Xerox, which invented the laser printer, ethernet, and the personal computer — rejected the new computer and network but adopted [...]

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Five Keys to Creating an Information Advantage

December 18, 2009

The value of having superior information has been true throughout human history, and the fact that my friend Tom Davenport’s book on Competing on Analytics has enjoyed tremendous success is a signal that this topic is hot and becoming hotter!. I believe that in addition to great analytics which Tom so beautifully documents, an information [...]

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Customer Service 2.0: Transparency, Tribes, and Talent

December 7, 2009

I confess that I have a warm spot in my heart for customer service operations. It is probably because I met my wife of 29.5 years Eileen Marie when she and I were on the customer service phones at the Polaroid Corporation. As an old phone jockey, it is apparent to me that the world [...]

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