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Live from the CHIME Fall Forum: What Fareed Zakaria Knows That We in U.S. Healthcare Need to Keep In Mind

October 16, 2015
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Fareed Zakaria’s keynote address Friday at the CHIME Fall Forum put into a bracing global and historical context the intense efforts to transform U.S. healthcare with information technology
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It was fascinating to hear Fareed Zakaria’s keynote address Friday morning at the CHIME Fall Forum in Orlando (sponsored by the Ann Arbor, Mich.-based College of Healthcare Information Management Executives). Speaking in the Mediterranean Ballroom of the JW Marriott Grande Lakes Resort, Zakaria—a noted journalist, commentator, author, and TV program host—mesmerized his audience with his brilliant overview of the economic and technological changes transforming the world these days.

But it was how Zakaria framed the challenges of U.S. healthcare that was particularly insightful. But let me navigate my way towards that.

To begin with, Zakaria talked about how much the world has changed since he was a boy growing up in India in the 1960s and 1970s (he was born in Bombay, now Mumbai, in January 1964). At the time he was born, the author noted, India was still relatively isolated from the global economy and from global society in key ways. Now, however, it is, like nearly every country (with a very few exceptions, like North Korea, which he didn’t mention), India has been drawn into the intense vortex of global developments, both economically, in terms of commercial interdependency with other nations, and technologically, as more and more of Indian society becomes connected to the web-driven world of 21st-century communications and global culture.

Fareed Zakaria explains global trends to the CHIME15 audience

Zakaria noted that we’ve experienced three huge global economic transformations in the last few hundred years. He stated that “We’ve had this globalization evolution that has brought countries from all over the world into basically the same capital market system, and it has allowed for this great wave of globalization, which has included outsourcing” of goods, the processes of production, and labor. “In the 16th and 17th centuries, with the advent of tall ships, you began to move goods around the world,” he said. And then, “In the 18th and 19th centuries, you began to be able to move capital around the world; and now, you can send capital and jobs around the world through outsourcing. There are still 3 billion people still not participating in the global economy, but they will,” he advised. “There are still a billion people in India, and a billion in Africa, who don’t have access to the Internet.” But all that is changing, he noted: “You’re already seeing people outsourcing, in China, to lower-labor-cost countries like India; and companies in India now outsourcing labor and production to Bangladesh.” Meanwhile, the inclusion over time of more and more national economies into the global economic system has led to business prosperity throughout the world. “In 1979, the number of countries growing at 3 percent or more a year was about 32,” he noted. “In 2007, before the financial crisis, that number was 124. And it’s still 85 today.”

Meanwhile, the advance of information and other technologies is transforming not only business, but also societies, Zakaria noted. More and more individuals throughout the world are becoming plugged into communications and information technologies, and as such technologies move towards near-universalization, it is disempowering governments and other traditional power centers, and empowering individuals and average people. He provided an interesting example with regard to the execution of a coup d'état, noting that “In the 1940s, whenever there was a coup in any country, the coup plotters would go to the presidential palace and radio station and take those over. In the 1950s, it was the presidential palace and the TV station. Today, you would still take over the presidential palace. But what would be the point of taking over a radio station or TV station, since very handheld device has the power to transmit information? That’s the reality of today’s disaggregated information system.”

Meanwhile, computational power is going to continue to transform how people live and work, Zakaria noted, though of course, there have been downsides to it, too, as the ability to outsource industrial labor and production from a wealthier country to a less-wealthy one has meant, in the United States, the loss of many millions of manufacturing and other jobs, jobs that will never return. And he did not sugarcoat that reality for his audience. Speaking of industrial magnates, he said, “You play a kind of global arbitrage game, where you find the labor in one place, the capital in one place, the market in another place. But as an American worker, you’re trapped. And globalization and technological change are like a pincer movement, depressing your wages. Thus, “this extraordinary downward movement” in the real wages of average Americans, a trend that has continued for decades. “At an aggregate level, it’s been great for the U.S. economy. But for the average American worker, it’s been the opposite. I think Apple employs about 15,000 people in the U.S.”