In his 1983 book “Adventures in the Screen Trade,” novelist William Goldman, after years writing scripts for Hollywood movies, famously penned the line “Nobody knows anything.” To be honest, I’ve never read the book. But everything I’ve read about the book tells me Goldman was referring to the fact that no one in Hollywood, despite all the screen tests and market research, could ever reliably predict how a picture would be received by the public. Thirty years later, that’s still so, despite the digital revolution that has made it possible for companies and marketers to gather huge volumes of consumer data and fine tune their products and pitches. After all, I imagine it would seem logical to Disney executives that a $250 million “Lone Ranger” remake featuring Johnny Depp as Tonto and mega producer Jerry Bruckheimer would be a hit. It’s the team that brought you “Pirates of the Caribbean!” the ads reminded us. And then there’s that Glendale animation studio that decided it would be a good idea to make a movie about a supercharged snail racing in the Indy 500. Is anyone really surprised – outside of Hollywood – that that turkey bombed too? Then again, sometimes there are smart, unexpected movies that surprise us. For anyone who now and then visits the multiplex or rents at home, the titles quickly come to mind, from “Winter’s Bone” to “Silver Linings Playbook.” But let me not beat a dead horse – er, make that a dead Silver – about a topic most would agree: Hollywood makes (mostly) bad and a (few) good movies, and in 2013 its still really all a crap shoot. Now, let me ask, doesn’t it feel like the health care industry is just as inscrutable, if for far different reasons? Rather than trying to figure out if an audience will prefer racing snails or naughty smurfs, they are trying to understand a monumentally huge industry involving individual health care decisions, miles of government red tape and millions of doctors and businesses. I can’t even tell you how many recent articles I have read in which industry executives or so-called experts either say they have no idea or disagree on the implications of some new development in the industry. Of course, the current focus of all the debate is on the Affordable Health Care Act, better known as ObamaCare. And with good reason, since few really believe the act will make health care more affordable even if it does as expected lower the number of the uninsured. But I don’t want to spend too much space debating an act that is an astounding 1,990 pages long. I’m not sure even God know how this will all turn out given the complexity of the act and the U.S. health care industry. The last figure I saw put the industry at $2.7 trillion. Yes, trillion, not billion. Now there’s a budget figure Jerry Bruckheimer would like! And with an industry that big there’s always all sorts of waste and fraud, of course. The fraud du jour, by the way, if you haven’t caught the news, is the apparent billing of Medi-Cal by drug treatment centers in Southern California for services never rendered. Last I read, the scam totaled less than $100 million, so it doesn’t quite rank up there with the Lone Ranger turkey, which will cost Disney perhaps $190 million. But then, there are entrepreneurs who are finding new and different legal ways to make a buck despite the partisan brawl going on in Washington, D.C. over efforts to repeal the reform act. Let’s call them health care’s surprise silver linings. One such person is Dr. Cherlin Johnson, who we feature on this issue’s cover. She opened an upscale urgent care clinic in Beverly Hills seven years ago and after much experimentation and long hours found out how to make it work. Now, she’s expanded her Executive ER business with a new clinic in Calabasas that features what I imagine everyone would want in health care: quality services provided in pleasant surroundings at reasonable and transparent prices. So why does it seem there are so few Executive ER’s in health care, and instead packed waiting rooms with sweating patients and harried doctors? Maybe because just like the film business, nobody knows anything. Laurence Darmiento is editor of the Business Journal. He can be reached at [email protected].
