David W. Johnson

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Transforming the Built Environment: Unlocking Value Across the Health Care Continuum


Health care providers suffer from a unique form of institutional irony: delivering institutionalized care in centralized, high-cost facilities impedes their ability to meet their communities’ expansive health and wellness needs. …

Mission-Critical Repurposing: Converting Aging Senior Living Properties to Affordable Housing


In 1908, the Jewish Home for the Aged of the Northwest opened in St. Paul, Minnesota, serving eight residents. As the facility deteriorated, the local Jewish community raised funds and …

A Second Coming: Medical Education’s Desperate Need for Another Flexner Revolution


On June 26th, 2019, American Academic Health Systems announced its intention to cease all medical activities at Hahnemann University Hospital by September 6th, 2019. With roughly 17,000 annual admissions, Hahnemann …

How Consumer Demand Is Transforming Autism Care


Autism Spectrum Disorder (ASD) is the fastest growing, lifelong developmental disorder in the country. ASD affects 1 in 59 children, and boys are five times more likely than girls to …

Don’t Let Special Interests Block Pending Rules for Sharing Patient Healthcare Data


On September 23rd, the seven healthcare lobbyists listed below sent a letter to the leaders of the Senate Health, Education, Labor and Pensions Committee (HELP) and the House Committee on …

Platforming Health Care to Transform Care Delivery


NEJM Catalyst Article for September 19, 2019 David W. Johnson, MPP Amy Compton-Phillips, MD Hospitals used to be at the center of the health care universe. Today, new business models …

An American Inquiry: Why I Wrote The Customer Revolution in Healthcare


What convinced a former Peace Corps volunteer and healthcare investment banker like me that the U.S. healthcare system (the System) requires revolutionary overhaul? It really came down to just one …

The Truth About Genetics, Epigenetics and Chronic Disease


Chronic disease consumes 86% of the national health expenditure and kills 7 of 10 people. President Clinton and Obama both created initiatives to cure cancer through genetic research and therapies. …

Should Doctors Make Less Money?


In an August 1st commentary published in the Washington Post, columnist Catherine Rampell asks an intriguing question of the Democratic presidential candidates promoting a Medicare-for-All health insurance program: “Will your …

How Commoditizing Colonoscopies Will Drive New Business


Colonoscopies are the American College of Gastroenterology’s preferred strategy to detect colon cancer. Ten million Americans annually undergo colonoscopies at a cost approximating $10 billion. Although colonoscopy prices vary, the …

Win-Win Partnerships: Strategics and Sponsors Increasingly Team Up


As US healthcare consolidation continues, innovative corporate buyers (strategics) and private equity investors (sponsors) are partnering to accomplish increasingly complex transactions. Such deals can create win-win arrangements that serve market …

4 Success Strategies of Interfacing Healthcare Companies


In post-reform healthcare, incumbent health systems must adapt or die from the force of  innovative new companies. Incumbents are vulnerable to value-based attacks. They are asset-heavy, revenue-centric and have ineffective …

5-Steps to Ensure Wise End-of-Life Decision-Making


Why is it taboo to talk about death? Too often, American families avoid confrontation with death and suffer from catastrophic emotional, medical and financial consequences. Medicare spends 26% of its …

The Future of Liberated Data in Medicine


Digitization and globalization of medical knowledge will double every 73 days by 2020.[1] When a patient enters an exam room, they will likely encounter a “Dr. Know-it-All” or come prepared …

Repositioning Temporary Staffing Services: Meeting Healthcare’s Strategic (and More Permanent) Need for Labor Flexibility


American workers increasingly wear scrubs, not overalls or store uniforms.(1) In late 2017, healthcare surpassed manufacturing and retail to become the largest employer in the U.S. economy. 19 million people …

Should Hospitals Pay Taxes?


Many health systems and hospitals operate as Not-for-Profit (NFP), mission-oriented organizations that do not pay sales, excise, property or other taxes. In exchange, NFPs must publicly report the level of …

3 Successful Telemedicine Companies Disrupting Healthcare


In August 2017, Hurricanes Harvey and Irma devastated the South and Southeast regions. Florida evacuated over 7 million people, 7.4 million people lost power and almost 60 hospitals throughout the …

MARKET CORNER CONVERSATIONS: Jeff Dunn, CEO of Redivus Health


Jeff Dunn DO / MBA and David Johnson discuss the realities of cardiac arrest inside the hospital, for patients and clinicians, in Episode 18 of Market Corner Conversations. Survival rates are …

VIDEO of Fireside Chat: Tom DeRosa, Welltower & David Johnson: Delivering Better Care, Outcomes & Health for Seniors


David Johnson interviewed Tom DeRosa, CEO of Welltower, for a packed audience at MATTER on June 19th. Tom considers Welltower a “platform for innovation on scale” in the realm of …

3 Essential Values Home Care Needs to Capture Greater Market Share


The home healthcare sector is dominated by “mom and pops” in a highly-fragmented and under-performing market. Fraud is rampant and customer care is inconsistent. The Department of Health and Human …

Regulatory Chess: Positioning for Competitive Advantage


To entrepreneurs, regulation is the enemy of innovation. That’s especially true in healthcare. Experts agree that healthcare is one of the most, if not the most regulated industry in the …

A GPS for Cardiac Arrest: In Life-or-Death Moments Clinical Apps Save Lives


Resuscitating Your Patients and Building Your Clinical Reputation The plane is in a nosedive. The sweating pilot is fighting to control the aircraft. A nervous co-pilot is furiously flipping through …

Getting Urgent about Urgent Care: Health Systems Go Big on Retail


Historically, health systems have delivered acute care services in hospitals and ambulatory facilities. Their business models centralize care delivery in expensive settings to optimize their operations and revenue. In avoiding …

An Unbearable Burden (Part 2): Wide Variations in State Health Insurance Costs


The Healthcare Affordability Index (Index) is a simple and powerful metric for assessing the impact of rising healthcare cost on American living standards. The Index measures the relationship between the total …

Market Corner Conversations: Merrill Goozner, Modern Healthcare Editor Emeritus & Author


Merrill Goozner passionately points out the stark contrast between well-functioning industries and the US pharma industry, especially its relationship with the government and pharma pricing. Dave Johnson certainly relates to …

Let’s Get Real: Medicare for All Can’t Work, but Affordable Health Insurance for All Can


As it has in the last three presidential elections, healthcare is emerging as a decisive political issue in the 2020 election. Unlike in those previous elections, however, universal health insurance …

How to Improve Patient Satisfaction with Transparent Payment Systems


American healthcare patients are demanding more price transparency, affordable services and quality care. Why are they not receiving it? How can healthcare organizations listen to consumers and set themselves up …

Consolidating Retail Medicine: Positioning Single-Specialty Practices for Acquisition


Single-specialty medical practices are the front door of American medicine. Dentists, Dermatologists, Ophthalmologists, GI doctors, ENT doctors, Internists, Gynecologists, Obstetricians, Urologists and their “retail medicine” counterparts provide high volumes of …

Interoperability Battle Lines: Data Freedom Fighters vs. Entrenched Data Blockers


On a cold Minnesota morning in January 2018, Fairview Health Services CEO James Hereford addressed Twin Cities business executives regarding healthcare IT and innovation. (1) With an advanced degree in …

How Crony Capitalism in Healthcare Hurts Communities and Markets


Does “pro-business” equate to “pro-market”? Or is crony capitalism blurring the line in the healthcare industry? How can consumers tell if they are being treated fairly? There are two types …

MARKET CORNER CONVERSATIONS: Dr. Jonathan M. Zenilman, Johns Hopkins University


Hear how Dr. Zenilman’s residency at Kings College Hospital in the early 1980s, at the epicenter of the AIDS epidemic, started his career in infectious disease, through the CDC, to …

4 Data Principles Healthcare Companies Need to Advance Care Delivery


What if the healthcare industry could use data as efficiently as Amazon? What if physicians could know the habits of patients like Amazon knows consumers’ buying history? What is physicians …

The Big (Tech-Enabled) Shift: Turning Healthcare Consumers into Customers


Consumerism was the hot topic at this year’s HIMSS conference in Orlando and at the JP Morgan conference. Attendees debated whether 2019 will mark the year healthcare finally tips toward …

How to Provide Value-Based Care to Drive Customer Engagement


“Dr. Knows Best” is no longer the only sell healthcare companies can make to consumers. In post-reform healthcare, successful companies need to provide quality value-based care, innovative technological solutions and …

When Pillars Crumble: A Warning for Healthcare?


Raghuram Rajan’s new book The Third Pillar provides an insightful framework on the relationship between the three pillars of modern society: federal governments, the marketplace and local communities. I’ll share …

MARKET CORNER CONVERSATIONS: TOMER SHOVAL, CEO & FOUNDER, SIMPLEE


Tomer Shoval, CEO & Founder of Simplee, discusses how his relentless focus on the customer created a payment platform for health systems that actually increases customer satisfaction and improves financial …

Forced Resignations at NCH Healthcare System Expose Medicine’s Dark Side


An ongoing feud between independent physicians and hospital administrators in Naples, Florida, exploded last month, damaging the trust between the community, providers and the health system. (1) The furor centered …

An Unbearable Burden: Paying for Commercial Health Insurance


The Healthcare Affordability Index (the Index) is a simple and powerful metric for assessing the impact of rising healthcare cost on American living standards. The Index measures the relationship between …

After the Breakups: Big Payers Find Vertical Love in New Faces


In rapid succession at the end of 2018, CVS closed its $70 billion acquisition of Aetna and Cigna closed its $67 billion acquisition of Express Scripts. The consolidated companies are …

When the Price Is Right: Aligning Payment with Health System Transformation


In 1952 at the tender age of 25, Elizabeth became the Queen of England upon the death of her father King George V. The popular Netflix series “The Crown” depicts the …

Getting Precise about Precision Medicine: Balancing Hope, Potential and Cost


Definitions of precision medicine are anything but precise. For seriously ill patients and their families, precision medicine therapies provide a hope when all else has failed. They’re willing to risk …

#1 Strategy All Successful Healthcare Organizations Should Know


American healthcare companies have a blind spot that will disrupt the growth of their organizations. The old way of American healthcare business has always been a payment battle between large …

Eisenhower’s Prophesy: The Healthcare Industrial Complex (TM)


On January 17, 1961, three days before leaving office, Dwight D. Eisenhower spoke to the nation one last time as its president. Eisenhower’s observations about war, peace and democracy are …

MARKET CORNER CONVERSATIONS: Deborah Grisko, President & Executive Director, Almost Home Kids


“At Almost Home Kids, our mission is to provide transitional care in a home-like setting to children with complicated health needs, training for their families and respite care.” – Deborah …

Frontline Decisions in Real Time: What Health Systems Can Learn from the U.S. Military’s Defeat of Al Qaeda in Iraq


“The teams were operating independently—like workers in an efficient factory—while trying to keep pace with an interdependent environment. We all knew intuitively that intelligence gathered on AQI’s [Al Qaeda in …

How to Create Pro-Market Healthcare Reform in an Opioid Crisis


Over 200,000 Americans have died since 2000 due to opioid overdoses.[1] That’s equivalent to all of Salt Lake City[2] disappearing from our country. The epidemic is destroying communities throughout America, …

MARKET CORNER CONVERSATIONS: JIM HARDING, FOUNDER & CEO, MULTISCALE HEALTH NETWORKS


Jim Harding, Founder & CEO of MultiScale Health Networks, joins David Johnson for Episode 13 of Market Corner Conversations. Jim discusses how he applied his experience as a serial tech entrepreneur …

Brand-Heavy and Asset-Light: Moving Beyond the Acute-Care Mindset


For health systems, the day of reckoning is near. A recent Morgan Stanley report states that over 1,000 of the nation’s 5,000+ hospitals are currently weak or at risk of closing. …

Amplifying Transformation: Addressing Medicare Advantage’s Disadvantages


The U.S. healthcare system will not change the way it delivers care until it changes the way it pays for care. Perverse incentives riddle fee-for-service payment (FFS) and lead to …

MARKET CORNER CONVERSATIONS: MUDIT GARG, FOUNDER & CEO, QVENTUS


Mudit Garg, Founder & CEO of Qventus, joins David Johnson for Episode 12 of Market Corner Conversations. Mudit shares how he views the challenges clinicians push through to provide care data …

No Time to Waste: Revolutionizing Healthcare Data Collection, Curation and Application


Healthcare data wants to be free, but it is oppressed. Entrenched oligarchs trap information within closed, centralized systems that prioritize revenue collection, misuse resources and tolerate medical error. Data gasps …

A CONCRETE DESCRIPTION OF THE CLOUD


In the simplest terms, cloud computing means storing data and software applications on the Internet, in secure files, then accessing that data and programs over the Internet rather than from physical …

Autism Therapy Shines Bright: Early Intervention, Improved Access and Individualized Care Change Lives


Autism Spectrum Disorder (ASD) is the nation’s fastest-growing developmental disorder, one that touches each child and family in unique and complicated ways. A  lifelong condition, ASD requires individualized treatments that …

MARKET CORNER CONVERSATIONS: Luigi Zingales, University of Chicago


Luigi Zingales, University of Chicago economist, joins David Johnson to discuss the key components of capitalism that encourage innovation rather than creating paralysis in markets. Listen to his thoughts on …

Geeking-Up Healthcare: Consumer Giant Best Buy Makes a Big Move


Healthcare has experienced a parade of surprising megamergers and acquisitions during the last year. At first glance, Best Buy’s August acquisition of GreatCall may be the most startling. At a …

As GM Goes, So Goes Healthcare: Dynamics of Demand-Driven Reform


“For years I [have] thought what was good for our country was good for General Motors, and vice versa.” Charles E. Wilson Last month, General Motors signed a 5-year agreement …

Against the Wind: Hospitals Challenge CMS’s Pro-Market Payment Reforms


Over the past month, the Centers for Medicare and Medicaid Services (CMS) announced several pro-market policies that will enhance pricing transparency, stimulate competition (and fair prices) for routine procedures and eliminate burdensome reporting requirements. …

Black-white Tornado

Belts and Suspenders: Major Healthcare Transactions Position Companies for Whatever Comes Next


During President Richard Nixon’s historic 1972 trip to China, the press asked China’s premier Zhou Enlai to comment on the French Revolution’s impact on world affairs. Zhou famously replied, “Too early to …

CMS Misdirection: Two Troubling Decisions Damage Market Competitiveness


In well-functioning healthcare markets, governmental regulatory policies ensure access, safety, quality and privacy. The government’s most important role is creating level-field competition through balanced regulation, targeted enforcement actions and price/outcomes …

MARKET CORNER CONVERSATIONS: Amitabh Chandra, Harvard Business School


Amitabh Chandra, economist and the McCance Family Professor of Business Administration at Harvard Business School, joins David Johnson for Episode 10 of Market Corner Conversations. Chandra shares his path form labor economist …

Gawande’s Gift: Re-Imagining Corporate Wellness and Healthcare


Amid much fanfare, the Amazon, Berkshire Hathaway, JP Morgan health venture (ABJ) announced on June 20th that its new CEO will be acclaimed author and surgeon Atul Gawande. Gawande starts his new job …

How Soccer Explains Healthcare: Collective Performance Defines Success (1)


The 21st FIFA World Cup kicked off on June 14th when host Russia trounced a weak Saudi Arabian team 5-0 at 81,000-seat Luzhniki Stadium in Moscow. It equaled the most lopsided opening …

Soccer ball & stethoscope

Destination Medicare Advantage: Lonnie & Cathy’s Quest for Great Health Insurance


In 1993, the health insurance industry funded the legendary “Harry and Louise” campaign to mobilize public opinion against the Clinton healthcare reform proposal. The strategy worked. Despite enormous investment of political capital, …

Lonnie & Cathy Quinn, Happy Medicare Advantage Members

MARKET CORNER CONVERSATIONS: Dr. Mike Roizen, Cleveland Clinic Foundation


Dr. Mike Roizen, Chief Wellness Officer and Chair of the Wellness Institute at Cleveland Clinic, joins David Johnson for Episode 9 of Market Corner Conversations. Dr. Roizen is the creator …

Pro-Market and Pro-Business: Not Always the Same, Particularly in Healthcare


Shortly after publishing Market vs. Medicine: America’s Epic Fight for Better, Affordable Healthcare in June 2016, I met with my former investment banking colleague, Jullia Quazi. Jullia arrived with a very funny story …

MARKET CORNER CONVERSATIONS: JAKE CRAMPTON, MEDSPEED


Jake Crampton, CEO of MedSpeed, joins David Johnson in Episode 8 of Market Corner Conversations. Crampton shares how MedSpeed facilitates “intra-company logistics.” MedSpeed’s customers transform their transportation networks from cost …

Market Corner Conversations: Jake Crampton, CEO, Medspeed


Jake Crampton, CEO of MedSpeed, joins David Johnson in Episode 8 of Market Corner Conversations. Crampton shares how MedSpeed facilitates “intra-company logistics.” MedSpeed’s customers transform their transportation networks from cost …

Superhero Healthcare (Part 2): Already Here; Growing Fast; Payment-Driven


Part I of Superhero Healthcare identified several bright spots within American healthcare where liberated caregivers deliver appropriate, efficient care to engaged patients; where the interests of health companies and their customers align; and where compassion, …

Superhero Healthcare (Part 1): Liberating America’s Caregivers and Patients!


Most weekends in America, long lines form outside cineplexes as ardent fans of DC and Marvel Comics catch the latest iterations on the big screen. Since the dawn of motion …

Dr Superhero

Market Corner Conversations: Dr. Toby Cosgrove, Cleveland Clinic


Toby Cosgrove, M.D., former CEO of the Cleveland Clinic Foundation, joins David Johnson in Episode 7 of Market Corner Conversations. Dr. Cosgrove shares how he built a culture of empathy …

Mission First: Mission Health’s Surprising Sale to HCA


On March 22nd, Mission Health in Asheville, North Carolina announced its intention to sell its seven-hospital not-for-profit (NFP) health system to HCA Healthcare, the nation’s largest for-profit healthcare system. The …

Market Corner Conversations: Dr. Rushika Fernandopulle, Co-Founder & CEO, Iora Health


Rushika Fernandopulle, M.D., Co-Founder & CEO of Iora Health, joins David Johnson in Episode 6 of Market Corner Conversations. Rushika shares how he decided that the incremental change model wasn’t working …

Goodbye “Dr. Know-It-All”: Medicine’s Liberating Knowledge Explosion


The digitization and globalization of medical information is overwhelming traditional medical practices. Physicians confront a continuous avalanche of medical discoveries on disease origins, symptoms and treatments. By 2020, medical knowledge …

Dr Know It All Icons

Scaling Relationship-Based Care: “Different Spokes (Care Models) for Different Folks”


In 1970, Marcus Welby, MD became ABC Television’s first show to top network television ratings. Dr. Welby was a cheerful family practice physician with a soothing bedside manner who was …

Market Corner Conversations: Dr. Amy Compton-Phillips


Amy Compton-Phillips, M.D., joins David Johnson in Episode 5 of Market Corner Conversations. Amy is the executive vice president and chief clinical officer for Providence St. Joseph Health. She oversees …

Market Corner Conversations: Mike Pykosz, Oak Street Health


In Episode 4 of Market Corner Conversations, Mike Pykosz, CEO of Oak Street Health, shares the bottom-up approach Oak Street takes toward its Medicare Part B members. Oak Street creates …

Upsizing Dentistry: Putting More Bite into Primary Care


Quad/Graphics, the American printing company, was founded near Milwaukee, Wisconsin in 1971 by a husband and wife team. Harry and Betty Quadracci saw advantages in a family approach to doing …

Teeth model stethoscope

Platforming Healthcare (TM): Owning Hospitals Is So 2015


The news that Amazon, Berkshire Hathaway and JP Morgan Chase joined forces to create their own healthcare company rocked the industry. The ten largest health insurers and pharmacy businesses lost …

Fortress Healthcare Meanders Toward Value


There are more “suits” in downtown San Francisco each January for JP Morgan’s annual healthcare conference than the rest of the year combined. Heavy rain drenched San Francisco on January …

Is Tax-Exemption Necessary? Enlightened Health Systems Should Consider the Unthinkable


 In the mid-1800s, English philosopher and political economist John Stuart Mill developed “Utilitarianism,” a framework for making moral decisions. In Mill’s formulation, an action achieves optimal social utility when it …

5 Days that Shook the Healthcare World


In 1919, journalist John Reed published Ten Days that Shook the World, a first-hand account of the October 1917 Russian Revolution. During that dramatic 10-day period, Vladimir Lenin’s Bolsheviks took …

Lexington, Concord and Medicaid Drug Formularies: Massachusetts Fires Another “Shot Heard Round the World”


Market Corner Commentary for December 13, 2017 On the 19th of April in 1775, a ragtag Massachusetts militia confronted the mighty British army in search of Colonial munitions and rebellion …

Honey vs. Vinegar: Value-Based Pricing Wins Customers and Market-Share


Common wisdom holds that “it’s easier to catch flies with honey than vinegar.” That aphorism also applies to payers seeking lower prices for routine healthcare procedures. It “tastes” better when …

Taxing Consequences: House Republicans Target Tax-Exempt Hospital Bonds


Market Corner Commentary for November 21, 2017 Having failed to “repeal and replace” the Affordable Care Act, House and Senate Republicans have set their sights on reforming the U.S. tax …

Telemedicine Marches Forward


After Hurricane Harvey and Irma hit the Gulf Coast in August 2017, America’s leading telemedicine companies volunteered their services to people and institutions in medical need. As reported in Med City …

Uber 911


Traditionally, most people dial 911 in a medical emergency and ask for an ambulance. Increasingly today, some hail a ride from Uber or Lyft to get to the closest Emergency …

Good Intentions Aren’t Enough: Choosing Wisely Misses the Target


Market Corner Commentary Special Report for November 8, 2017 Earlier this year, the Choosing Wisely campaign celebrated its 5th anniversary. Choosing Wisely is a well-funded, practice-focused organization created to reduce …

Capitalizing on Comprehensive Care: Cultivating a Medicare Advantage Mindset


This paper is Part 3 in our series on payment reform. After highlighting various efforts to reign in healthcare costs over the past 50 years in Part 1, Part 2 …

Crony Capitalism Has Consequences: Opioid Distribution, Destruction and Death


Market Corner Commentary for October 25, 2017 – Special Edition Talk about bombshells. On October 15th, the Washington Post and 60 Minutes released a detailed and damning investigative report titled …

Introducing the Healthcare Affordability Index: High-Cost Private Health Insurance Reduces Family Incomes


Today, Dr. Ezekiel Emanuel and I along with Aaron Glickman published Measuring the Burden of Health Care Costs on U.S. Families in the Journal of the American Medical Association (JAMA). …

Market Corner Conversations: Rick Kimball, NFL & Medical Marijuana


In Episode 3 of Market Corner Conversations, Dave Johnson speaks with Rick Kimball about their commentary Mile High Potential: NFL Veterans Tackle America’s Opioid Crisis. The podcast digs into the social catastrophe …

Moving at the Speed of Medicine Part II: Taking “Systemness” to the Next Level


Football is a “system” sport. Offense, defense and special teams function as distinct units with their own coaches, schemes and measures of success. The better teams bring all these components …

Merle Power! Living Long and Prospering


By Kurt Waltenbaugh and David W. Johnson Merle Phillips is a petite 110-year old 4’9” fireball who keeps doing big things. She’s writing her twelfth book and recently created a …

Market Corner Conversations: Kurt Waltenbaugh, Carrott Health


In Episode 2 of Market Corner Conversations, Dave Johnson speaks with Kurt Waltenbaugh, the founder and CEO of Carrot Health, an exciting data analytics startup based in the Twin Cities. …

In the Eye of the Storm: When Outcomes Matter, Telemedicine Delivers


During the last week in August, Noah’s Ark found a new home in Houston. Unfortunately, it didn’t deliver medical supplies. Between August 25th and 29th, Hurricane Harvey dropped an almost …

Battling Cancer: Partnering to Make Headway Against Medicine’s Toughest Foe


Cancer has been humanity’s most persistent nemesis. Bone fragments and written records indicate that cancer afflicted people in ancient Rome, Greece and Egypt. Today, cancer is America’s second leading killer, …

Amazoning Pharmacy: Attacking “Indumbent” Business Practices


Sky-rocketing drug prices have captured the nation’s attention. President Trump echoes Senator Bernie Sanders when he asserts that drug companies are “getting away with murder.”[1] Republican and Democratic legislators alike assert …

Advantage Medicare Advantage: Delivering Healthcare’s Triple Aim to America’s Seniors


Hitting the Sweet Spot for Patients and Providers The United States is experiencing a demographic tidal wave. Baby Boomers are turning 65 in record numbers and that trend will accelerate …

Senate Republicans Confront Their Healthcare Waterloo: Now What?


Last weekend Senators Jerry Moran of Kansas and Mike Lee of Utah announced they could not support Speaker Mitch McConnell’s Better Care Reconciliation Act of 2017 (BCRA). Their defections put …

A Chicago Story: Gun Violence; Budget Cuts and Social Contagion


It was an eventful July 4th weekend in the Land of Lincoln. The Illinois Senate over-rode Governor Bruce Rauner’s veto to pass its first state budget in over two years. …

Market Corner Conversations: Paul Walczak, NuVista


4sight Health’s inaugural episode with Paul Walczak, the CEO from NuVista, a remarkably innovative post-acute care company coordinating value-based delivery in southern Florida that achieves superior outcomes at very low costs. …

Forming a More Perfect Health System: Senate Republicans Confront Their Policy Demons


Senator Mitch McConnell is the most effective Senate Majority Leader since Lyndon Johnson. A tactical maestro, McConnell faces the seeming impossible task of uniting the Republican party’s divergent conservative and …

A Seismic Home Care Shift is Redefining Post-Acute Care


Earthquakes occur when pent-up pressures release along geological fault lines. These seismic events reconfigure adjacent landscapes as energy waves distribute from the quake’s epicenter. U.S. healthcare is rife with fault …

The Iceberg Cometh: Welcome to Sickville, USA


In the western suburbs outside Minneapolis, two men lead average lives. Surveying them as part of the general population, no health system, insurer or policy maker would notice anything that …

Symbiotic Disruption: Skilled-Nursing-REIT Ecosystem Adapts to Market Dynamics


Nature thrives on symbiosis. Its many ecosystems would not exist without important relationships between sometimes strange bedfellows. The oceans’ most colorful coral reefs, for example, are often found in clear …

clinical academic medicine 

40 Years in the Payment Reform Wilderness: DRGs to Nirvana


Introduction In an ideal state, a well-functioning healthcare delivery system should provide the right care at the right time and the right place, while being accountable for clinical and financial …

health insurance plans 

“Indumbent” Healthcare Thinking: Prices Don’t Matter


In a March 29th New York Times article, author Elizabeth Rosenthal chronicles America’s dystopian system for coding and billing medical treatments. Rosenthal concludes that the medical-billing system itself is a …

best health policy

Darwinian Outsourcing: Big Pharma Adapts to Market Realities


by Kristin Carey and David W. Johnson Competitive markets drive innovations in business efficiency and strategy. Twenty-five years ago, Big Pharma companies did little outsourcing. Fortified by robust cash flows …

academic medicine partners 

Trumpian Healthcare Reform: A “Silver Linings” Legislative Playbook


Special Edition: Market Corner Commentary for March 29, 2017 Last Friday was supposed to be the shootout at the healthcare corral where Republican gunslingers were going to take the first …

venture capital fund 

AHA! Healthcare is Both a Right and a Commodity


In late January, I participated in an Oxford-style debate regarding whether healthcare is a commodity. The debate was the featured event at Tata Memorial Centre’s Platinum Jubilee Conference in Mumbai, …

market vs medicine

Scaling Healthcare’s Mt. Everest: Peak Performers Engage Technology and Consumers


Climbing the highest mountains requires organization, preparation and strategy. Scaling Mt. Everest is a full-scale expedition. Large teams rely on a sophisticated infrastructure of supplies, equipment and support staff. A …

ZDogg Speaks: Rebooting Primary Care (The Unedited Version)


For the better part of a decade, I practiced inpatient hospital medicine at a large academic center (the name isn’t important, but it rhymes with Afghanistan…ford). I used to play …

Moving at the Speed of Medicine: Turbo-Charging Performance with Strategic Partnerships


Insourcing is a time-honored practice employed by market-dominant companies. Rather than contract with external experts, companies dedicate internal resources for specialized functions. While generally less efficient, insourcing enables companies to …

Letting Go: Steward Sells Its Hospitals and Embraces Patient-Centric Care


Last September, Massachusetts-based Steward Health Care System announced that it would sell its 9 hospitals to Alabama-based Medical Properties Trust (MPT) for $1.2 billion in a 15-year sale-leaseback transaction with …

Mile High Potential: NFL Veterans Tackle America’s Opioid Crisis


Professional football has long since surpassed baseball as America’s most popular sport. The NFL’s Super Bowl is a national party. Super Bowls represent 19 of America’s 20 most-watched TV broadcasts. …

The Rise and Fall of Academic Medicine: AMC Competitiveness in Post-Reform Healthcare


Rome wasn’t built in a day and didn’t collapse overnight. After centuries of growth, prosperity and domination, the Roman Empire began a long slow decline at the peak of its …

Channel Shifting: Ominous Black Friday Trends for Health Systems


The results are in. The National Retail Federation (NRF) just released their survey results for post-Thanksgiving shopping. The numbers were strong. 154 million consumers shopped this holiday weekend, up 2% …

Behavioral Health Goes Local: The Emergence of Integrated, Community-Based Services


by Todd Rudsenske and David W. Johnson From addiction to depression to psychosis, mental illness exacts a growing toll on individuals, families, communities and health systems. We can measure its …

Healthcare’s Gettysburg Moment


Seven score and thirteen years ago this month (November 19, 1863), Abraham Lincoln delivered his renowned Gettysburg Address at the dedication for the Soldiers National Cemetery. With the ravages of …

Overturning Obamacare: A 5-Point Plan for President-Elect Donald Trump


Two weeks ago, I distributed a 5-Point healthcare plan for presumed President-elect Hillary Clinton. That was then. In a remarkable and unprecedented election surprise, Donald Trump defeated Hillary Clinton and …

HealthCare.Gov’s Death-Defying 2013 Launch: Implications for Government-Led Payment Reform


Enrollment for purchasing health insurance on public health exchanges began November 1st. Headlines for this fourth enrollment period include: 22% average price increases; major health insurers dropping coverage; and single …

Overhauling Obamacare: A 5-Point Plan for President-Elect Hillary Clinton


Absent a cataclysmic surprise next Tuesday, Hillary Clinton will become the 45th President of the United States. She will govern a divided electorate with highly-polarized elected officials. It’s no longer …

Winning “The Cub Way”: It Takes an Organization (Postscript)


On Saturday evening, the Chicago Cubs won the National League pennant and the City of Chicago went crazy. The Wrigleyville celebration rocked until dawn Sunday morning. After a 71-year absence, …

Value Quest: Capital Formation Challenges for Non-Profit Health Systems


by David W. Johnson, James Moloney and Carsten Beith   There’s a battle outside and it’s ragin’ It’ll soon shake your windows and rattle your walls For the times they …

health care system

Overcoming Medical Errors of Omission: The Cure Requires Organizational Empathy


Organizations fail or decline more frequently because of what they did not do than because of what they did.                                                             Russell L. Ackoff Professor of Management Science Wharton School, University …

Medtech in the Fast Lane: Embracing Services, Solutions and Consumerism


by Rafe Hanahan and David W. Johnson Manufacturing built America. The iconic automotive industry epitomizes this organic relationship between industrial strength and economic growth. Since the early days of Ford …

medicine and health

Winning “The Cub Way”: It Takes an Organization


The Cubs just finished the 2016 regular season with 103 wins and baseball’s best record by a mile. They have spectacular pitching, powerhouse hitting and solid defense. Las Vegas odds-makers …

health forum education

What Would Einstein Do? Embedded Dilemmas in Disrupting Markets


Earlier this month, Ford CEO Mark Fields made two head-scratching announcements to advance transportation services in San Francisco. Ford acquired Chariot, a popular crowd-sourced shuttle-van service that uses algorithms to …

transforming american healthcare

Market Evolution: Addressing Structural Flaws on Public Health Exchanges


After two-plus years of operations, clear structural flaws have emerged in the design and function of public health exchanges. Health insurance cooperatives have largely failed. Many traditional insurers have suffered …

health care services

Epi(c) Pharmaceutical Market Failure


It was hard not to feel sorry for Mylan CEO Heather Bresch as she sat for an extended CNBC interview on the morning of August 25th. Clearly on the hot …

Healthcare Advisory Services

Rankings and Reactions: CMS Launches Star Ratings for Hospitals


“The fault, dear Brutus, is not in our stars But in ourselves.” [1]                William Shakespeare On July 27th, the Centers for Medicare and Medicaid Services (CMS) released its first-ever quality …

Providence Health & Services

Summer Book Report: 4sight Health’s Busy August


With Labor Day weekend approaching, state fairs in full swing, and the barbeque calling, most of us have just half a mind on work. At 4sight Health we’re enjoying the …

health insurance plans 

The Big Lift: Improving Public Health Exchanges


Bring out the Xanax. Anxiety among Obamacare supporters is skyrocketing. The bad news just keeps coming. Aetna has joined UnitedHealthcare and Humana in announcing plans to exit almost all public …

Being American: How Exceptionalism Is Transforming U.S. Healthcare


Midway through the Rio Olympics, the prowess of the diverse, raucous and remarkably talented U.S. team is on full display. We marvel at the athletes’ dedication. Their enthusiasm is infectious. …

Imagine Better Healthcare

Where’s the Beef? Employers Question the Value of Hospital Mergers


In an iconic 1984 commercial for Wendy’s hamburgers, the diminutive octogenarian Clara Peller and two friends are eating hamburgers at the fictional “Home of the Big Bun.” Disappointed by their …

Back with Vengeance: Vertical Integration’s Demons Wreak Havoc


With pride and promise just two short years ago, Catholic Health Initiatives (CHI) introduced Prominence Health, a wholly-owned subsidiary, that would “significantly advance CHI’s ability to excel in a pay-for-value …

advancing organizational change 

Obama Speaks: A Presidential Assessment of Obamacare


Market Corner Commentary for July 27, 2016 Earlier this month, President Obama took the unprecedented step of authoring an academic research article in The Journal of the American Medical Association …

4sight Health

Made in America: Venture-Backed Healthcare Solutions


Market Corner Commentary for July 20, 2016 Last month, Reed Abelson of the New York Times chronicled the challenges of Oscar Health, the venture-funded health insurance company. Despite massive investment, …

care transformation

It Takes Two to Tango: Cracking the Patient/Customer Engagement Code


The tango is a beautiful, complex, fast-paced dance that gets the heart racing for participants and spectators alike. The intimacy of two partners moving in coordinated lockstep leaves no doubt: …

4sight Health

Great Consumer Expectations: Data-Enabled Healthcare Outcomes and Service


Health companies experience excessive variation in clinical outcomes, quality metrics, procedure pricing and customer satisfaction. This frustrates providers, payors, employers and patients alike. All Americans want the healthcare system to …

health forum education 

The Post-Acute Gold Rush: Winning the Race to the Claims Office


Gold’s glitter and the lure of quick riches led 90,000 unruly prospectors to California in 1849. The gold rush was on and it had rules. Prospectors had to actively work …

american health system

Healthcare’s Dysfunctional Pricing: Be Afraid. Be Very Afraid.


The Health Care Cost Institute (HCCI) released its annual report of healthcare prices last month. To no-one’s surprise, HCCI found huge variation in commercial prices for 240 common medical services …

medicine and health

Rethinking Cyber-Security: A New Paradigm for Democratizing Data Exchange


Liberated data connects people, informs decision-making, stimulates innovation, streamlines production, creates wealth and advances humanity.  The upward trajectory of human accomplishment arises from ever-more sophisticated data exchange supporting ever-more complex …

capital formation design

Asset-Light and Ready: Physician Groups Embrace Accountable Care


Hockey superstar Wayne Gretzky gave the business world its most over-used strategic metaphor, “I skate to where the puck is going to be, not where it has been.”  In healthcare, …

Imagine Better Healthcare

Necessity Turbo-Charges Productivity at Cleveland Clinic Florida


Coming into 2015, Ozzie Delgado confronted a thorny problem. Cleveland Clinic Florida was experiencing expansive demand for surgical services. Occupancy was already at 92% and there would be no capacity …

transforming american healthcare

Lactose Intolerance: Aaron Rodgers and the Cheese-Heavy American Diet


Wisconsin may never be the same. Green Bay Packers star quarterback announced this month that he has stopped eating dairy products to “get healthier.” As Bart Simpson might observe, the …

Rebate Madness: Branded Drug Pricing Goes Rogue


Like hospitals that optimize revenues through complex assignment of charges, discounts and subsidies, aligned pharmacy benefit managers (PBMs) and pharmaceutical companies manipulate retail and net pricing on “branded” drugs to …

medicine

Let’s Talk: Constructive End-of-Life Decision-Making


At Jeff Shield’s memorial service, Genie Shields proclaimed that her husband’s death has been a “gift,” one that enriches all who receive it. When it became clear that lymphoma would …

FTC Chasing the Wrong Healthcare Villain in Chicago


Last December the Federal Trade Commission sued to block the proposed merger between Advocate Health Care and NorthShore University Health System. The combined company’s annual revenues would exceed $7 billion. …

New Rules: Accountable Care Changes Everything


People go to Las Vegas to let loose, take in the shows and have fun but mostly to gamble. At HIMSS 2016, payors, providers, investors and other industry insiders are …

Rethinking Healthcare.Gov: As Covered California Goes, So Goes Nation?


Rethinking Healthcare.Gov: As Covered California Goes, So Goes Nation? The 17 state-run healthcare exchanges are real-life “laboratories” for the federally-run exchanges that operate in 34 states. No state exchange has …

Market vs. Medicine Book Launch: You Are Invited


After more than a year of research, writing, editing, re-writing, and re-editing, Market vs. Medicine: America’s Fight for Better, Affordable Healthcare is being printed and will be available on May …

market vs medicine

Now You See It…. The Unreliability of Government Student Loan Forgiveness


Each October, the Association of American Medical Colleges (AAMC) publishes its “Debt, Costs and Loan Repayment Fact Card”. It surveys recent medical school graduates and details the amount and composition …

Two Runners, Two Countries, Two Emergencies: You Decide


For over a decade I’ve plodded up and down the Chicago lakefront with the same group of idiotic runners. Through wind, sun, snow and rain we babble about anything that …

Misdirected Fury: The Boston Globe “Spotlights” Concurrent Surgeries


Market Corner Commentary for March 2, 2016: Misdirected Fury: The Boston Globe “Spotlights” Concurrent Surgeries At Sunday night’s 88th Academy Awards, Spotlight won the Oscar for best picture. The movie chronicles …

Healthcare’s Productivity Paradox: Ferocious Exploitation of Reimbursed Payment


Market Corner Commentary for February 17, 2016-Healthcare’s Productivity Paradox: Ferocious Exploitation of Reimbursed Payment Las Vegas is a strange place to attend a medical conference. In June 2014, the Healthcare …

Big Data’s Ups and Downs: The Good, The Scary and The Creepy


Market Corner Commentary for February 10, 2016-Big Data’s Ups and Downs: The Good, The Scary and The Creepy Big data analytics are essential for understanding consumer preferences. Collecting, measuring and …

Pursuing What Works: Genetics, Epigenetics and Chronic Disease


Market Corner Commentary for February 3, 2016-Pursuing What Works: Genetics, Epigenetics and Chronic Disease Genetics-based therapies represent the pinnacle of medical science. Billions of dollars have poured into research to …

chronic disease management

U.S. Healthcare in 2016: Enjoy the Sideshow; Watch the Main Event


Market Corner Commentary for January 27, 2016- U.S. Healthcare in 2016: Enjoy the Sideshow; Watch the Main Event For the sixty-second time, the U.S. House of Representatives passed legislation repealing Obamacare …

Exchange Matters: UnitedHealth Takes a Stand or Does It?


Market Corner Commentary for January 20, 2016 During an investor call in November, the nation’s largest health insurance company (UnitedHealth Group) delivered a body blow to the Affordable Care Act’s …

Manipulating Demand: Paying Patients for Lower-Cost Care


Market Corner Commentary for January 13, 2016-Manipulating Demand: Paying Patients for Lower-Cost Care In October, Planet Money aired a podcast with the intriguing title “Pay Patients, Save Money.” Their report …

Providence Health & Services

Dynamic Tension: Rethinking Health System Governance


Market Corner Commentary- Health System Governance- for January 6, 2015 John Koster MD and David Johnson The winds of post-reform transformation are blowing through healthcare. Long-established health systems confront existential …

market-based health care system

Rational Lending: Demystifying Medical Student Loan Debt


Market Corner Commentary—Demystifying Medical Student Loan Debt, for December 16, 2015 Winston Churchill famously observed that “Russia was a riddle wrapped in mystery inside an enigma.” Churchill’s language provides an …

Medical Student Loan Debt

Fujifilm’s “Moment”: Disruption, Adaptation and Health System Transformation


Almost every healthcare “transformation” discussion includes Kodak’s cautionary tale – how the once iconic company fails to embrace digital imaging, capsizes and drowns. The story’s moral is to embrace disruption, …

transformation

November Indigestion: The Idiocy and Promise of Benefit Selection


Market Corner Commentary for December 2, 2016- November Indigestion: The Idiocy and Promise of Benefit Selection David Johnson and Nathan Bays Dave’s wife Terri Brady is a Senior Leadership Coach at …

benefit

The Why, The How and The What: Consumerism, Trust and Brand Love


Market Corner Commentary for November 12, 2015-The Why, The How and The What: Consumerism, Trust and Brand Love Health systems are awakening to the market reality that consumerism is redefining healthcare …

brand

Getting Right with Consumers: Right Businesses. Right Places. Right Prices.


Market Corner Commentary for November 11, 2015-Getting Right with Consumers: Right Businesses. Right Places. Right Prices. Consumerism has the force and precision of heat-seeking missiles. Customers flocked to Walmart because it …

consumerism

Righteous Analytics: Right Data. Right Time. Right Way


Market Corner Commentary for November 4, 2015- Righteous Analytics: Right Data. Right Time. Right Way Technology is on the cusp of channeling diagnosis and treatment toward best outcomes at lowest costs. …

data

“Amazoning” Healthcare’s High Prices


“Amazoning” Healthcare’s High Prices A recent Kaiser Health News article reports that prices for basic women’s health services vary dramatically within and across markets. The cost for mammograms in Dallas …

prices

Value Rules: Playbook for Post-Reform Healthcare


Market Corner Commentary for October 21, 2015-Value Rules: Playbook for Post-Reform Healthcare Warren Buffett famously noted that “price is what you pay and value is what you get.”  In fee-for-service …

value

“The Cubs Way”: Lessons in Leadership, Cultural Change and Performance Improvement


Market Corner Commentary for October 14, 2015-“The Cubs Way”: Lessons in Leadership, Cultural Change and Performance Improvement Any team can have a bad century!  The Chicago Cubs define ineptitude.  They …

Calm Before the Storm? Rating Agencies Lift Negative Industry Outlooks


Market Corner Commentary for October 7, 2015- Calm Before the Storm?  Rating Agencies Lift Negative Industry Outlooks Summer was good to health companies.  Many have never been stronger.  On August 26th,  Moody’s revised …

Doc-Fix Legislation: Medicare Makes Physicians an “Offer They Can’t Refuse”


David Johnson and Nathan Bays-Doc-Fix Legislation: Medicare Makes Physicians an “Offer They Can’t Refuse” After years of temporary fixes and short-term extensions, the U.S. Congress repealed Medicare’s Sustainable Growth Rate …

The Tyranny of Average Costing: Profit and COST in Value-Based Delivery


Market Corner Commentary for September 23rd-The Tyranny of Average Costing: Profit and COST in Value-Based Delivery Michael Porter, the eminent Harvard Business School professor, defines “value” in healthcare as “achieving the best …

Mind and Medicine: Amplified Healing Through Behavioral Science


Market Corner Commentary for September 16, 2015-Mind and Medicine: Amplified Healing Through Behavioral Science In announcing his Precision Medicine Initiative, President Obama articulated a medical future where genetic discovery shapes tailored …

Of Metrics and Meaning: Making Sense of Healthcare Quality Ratings


Market Corner Commentary for September 9, 2015-Of Metrics and Meaning: Making Sense of Healthcare Quality Ratings As healthcare becomes more consumer-focused, hospital and physician rating systems are proliferating.  Yelp is …

Rebels with a Cause: Venture Companies Attack Healthcare


Market Corner Commentary for September 2, 2015-Rebels with a Cause: Venture Companies Attack Healthcare There is a meaningful shift occurring in healthcare private equity and venture investing.  The “smart money” …

Kinky Boots, Swedish Dialysis and Demanding Customers


Market Corner Commentary for August 26, 2015-Kinky Boots, Swedish Dialysis and Demanding Customers The oldest and best advice in business is “give customers what they want.”  From Broadway to Sweden, …

Individual Mandate: Are You Up for N=1 Healthcare?


Market Corner Commentary for August 19, 2015 (disruption)-Individual Mandate: Are You Up for N=1 Healthcare? Yogi Berra famously observed, “The future just ain’t like it used to be.”   In N=1: How …

King for a Day: Winning Strategies in Post-Reform Healthcare


Market Corner Commentary for August 12, 2015 -King for a Day: Winning Strategies in Post-Reform Healthcare-(#Quality Outcomes) Great leaders ask great questions. Banner Health’s CEO recently wrote and asked me, …

Medicare at Fifty: More Yesterdays than Tomorrows?


Market Corner Commentary: August 5, 2015-Medicare at Fifty: More Yesterdays than Tomorrows? A version of this commentary appeared in Huron Healthcare’s “Perspectives” on July 30th With Harry Truman watching, Lyndon …

Reimbursement Roulette: Health Companies “Double Down” on Revenue


Market Corner Commentary: July 28, 2015-Reimbursement Roulette: Health Companies “Double Down” on Revenue A version of this commentary appeared in “Academy 360” on July 23, 2015 Let the good times …

David Jones’ Locker: Humana and the Perils of Vertical Integration


Market Corner Commentary: July 22, 2015-David Jones’ Locker: Humana and the Perils of Vertical Integration American healthcare is losing the iconic Humana brand.  Aetna has announced it will acquire Humana …

Crossing the Technology Chasm: Tele-ICUs Save Lives and Money


Crossing the Technology Chasm: Tele-ICUs Save Lives and Money The Leapfrog Group’s[1] fact sheet on ICU Physician Staffing estimates that preventable ICU deaths exceed 54,000 each year. This figure excludes …

healthcare in usa 

Uber Up! Customer Interfacing Discovers Healthcare


Market Corner Commentary: July 15, 2015-Uber Up!  Customer Interfacing Discovers Healthcare A version of this commentary first appeared in “Academy 360” on July 9, 2015 More “suits” flock to downtown …

Polling for Meaning: Healthcare, Hospitals and Consumer Sentiment


Market Corner Commentary: July 8, 2015-Polling for Meaning: Healthcare, Hospitals and Consumer Sentiment A version of this commentary first appeared in “Academy 360” on June 25th Consumers dislike healthcare but …

No One is an Island: Meaningful Second Opinions


Market Corner Commentary: July 1, 2015-No One is an Island: Meaningful Second Opinions A good friend (let’s call him John Donne) in his mid-fifties recently wrote describing his treatment for …

Welcome Back, Kotter! Leading Health System Change


#Leading Change-Market Corner Commentary: June 24, 2015-Welcome Back, Kotter!  Leading Health System Change A version of this commentary first appeared in “Academy 360” on June 11th In the popular 1970s …

Chasing Colonoscopies: It’s the Customer, Stupid!


Market Corner Commentary: June 17, 2015-Chasing Colonoscopies: It’s the Customer, Stupid! Who knew a routine colonoscopy could illuminate the wild world of healthcare consumerism? Before getting to my story, let’s …

Deep Web Rising: Healthcare’s Looming Cyber Threat


A version of this commentary first appeared April 30th in “Academy 360”-Deep Web Rising: Healthcare’s Looming Cyber Threat Healthcare is a “target-rich” environment for cyber criminals. Cyber attacks on health …

Supreme Court vs. Obamacare II: Decision Time


This article first appeared in Huron Perspectives on June 2, 2015-Supreme Court vs. Obamacare II: Decision Time The “Thrilla in Manila” in 1975 was Mohammad Ali and Joe Frazier’s second …

Holy Sheets! Fast-Tracking Delivery Innovation



Holy Sheets! Fast-Tracking Delivery Innovation Hospitals have used cotton linens since the early 1900s.  Crisp, white sheets touch all patients and epitomize healing.  “Hospital corners” describe the proper way to …

Exploiting Perverse Incentives: Kentucky Basketball and Prime Healthcare


  Hoping to become college basketball’s first undefeated champion in almost forty years, the Kentucky Wildcats captured the nation’s attention as they qualified for this year’s “Final Four” tournament in …

payer and regulatory policy 

When Healthcare is a “Lemon”: Asymmetric Information and Market Failure


When Healthcare is a “Lemon”: Asymmetric Information and Market Failure In 1970 George Akerlof published “The Market for “Lemons”: Quality Uncertainty and the Market Mechanism in The Quarterly Journal of …

Supreme Court vs. Obamacare II: High Drama; Not the “Main Event”


The “Thrilla in Manila” in 1975 was Mohammad Ali and Joe Frazier’s second championship fight. In 1967, Ali refused conscription as a conscientious objector. He was convicted of draft evasion, …