Editor's Note: Better Times

There were stacks and stacks of "canned" vegetables, which in the South means homegrown green beans, tomatoes, and other homegrown produce in glass jars. It was in the basement of one of my elderly relatives' homes, and I can still picture how neat the hundreds of stacks were. They were not so much placed as actually displayed. I couldn't reconcile that with a quart of beans worth 75 cents.

But I didn't grow up in the Depression. To a baby boomer like me it seemed quaintly ridiculous that they would store such a bounty. These were not survivalists or Y2Kers, just country folk who knew what it was like to go hungry for days.

I have thought about my grandparents and the other now-fallen branches of my family tree more in the past few months, mostly because the headlines keep screaming that the country is in the worst financial crisis since the Depression. As I wrote in this month's cover story, hospitals are seeing historic downturns that are unlike anything they have seen. Shrinking elective revenue, higher bad debt, layoffs, and declining portfolio returns combine to force hospitals to do more than just solve one pain. It may be time to shrink and survive for most. They are selling and saving—stacking the canned goods, so to speak.

If there is a productive aspect to a deep recession, it may be an opportune time to reimagine some of the bloated processes in healthcare that perhaps did not previously have natural momentum to chisel when times were flush. At least the hope is that forced efficiency may create leaner, more nimble healthcare organizations on the light side of the tunnel.

It is worth remembering we have not re-created the economic conditions of the Depression with deflation, income reductions of 40%, and population displacement. But we are experiencing the mood in all its layers. I may have found some of the practical heirlooms of that fear in a relative's basement, but what I also know is that optimistic generation got married, had kids, built houses, and saved the world from totalitarianism a few years later.

Most hospitals will probably "lay off and sell off" just enough to get by, and emerge fundamentally unchanged. A few will take a lesson from history and find miracles in hard times.

Jim Molpus
Editor
jmolpus@healthleadersmedia.com