HJNO Jan/Feb 2026

HEALTHCARE JOURNAL OF NEW ORLEANS I  JAN / FEB 2026 17 price. To achieve these enhanced value proposi- tions, companies strive for greater operational effectiveness, operational efficiency, or both simultaneously. And they are constantly mea- suring the variables, objectives, and key results that track most closely with their ability to reli- ably deliver that value proposition. Companies that successfully establish an effective cus- tomer value proposition typically attract the largest number of customers and, as long as they maintain efficient operations, achieve the greatest profitability. In short, the customer value proposition is the promise of better outcomes per dollar spent from the customer’s point of view. Of course, this is the aspirational version of capitalism. In the real world, many industries have drifted to- ward planned obsolescence, forced upgrades, and products that are intentionally difficult to repair or reuse — sometimes designing the “customer value proposition” around making sure you have to buy again. That is problematic enough when we are talking about phones or appliances; in healthcare, where patients are vulnerable, information is opaque, and opting out is often impossible, a profit-first design that is not anchored in genuine improvements in health becomes especially dangerous. Customer Value Proposition: Getting it Wrong How is our medical economy working right now? I think most would agree that we are far away from the aspirational version of capitalism outlined above. I do think most — but not all — providers, hospitals, health systems, and pay- ers are trying hard to provide a good service experience. They recognize that the best way to earn patient or member loyalty is to strive to provide the best possible service experience. However, are these providers, hospitals, health systems, insurers, and other stakehold- ers truly operating in a free market that primarily rewards them for enhancing patient and mem- ber health outcomes? Are they all competing on a level playing field across a large variety of customer segments to deliver the highest qual- ity possible at the lowest possible price? Are they attempting to gain a deep understanding of a large variety of customer segments so they can identify the specific segments for which their offerings will be most attractive? Isn’t that how value-based competition based on results — we need to confront the economic architec- ture that quietly shapes everything clinicians and patients experience. In other words, it’s the economics, stupid. Customer Value Proposition: Getting it Right In this case, it’s medical economics. But be- fore we get to that, let me state categorically that I am a big fan of free market–based capi- talism as an economic system. And let me also state that the people working so valiantly in healthcare are not at all stupid. Healthcare has long attracted the best and brightest minds in the pursuit of serving a cause greater than ourselves. But I think we can have a thoughtful discussion about whether the power of markets that work so well for many aspects of the U.S. economy are working well in healthcare. To do that, let us first look at what works well within a market-driven economy. When companies compete on who can pro- vide the best service, product, or experience by providing the highest quality at the lowest price, we all benefit. In general, over time, the quality, durability, and reliability of most prod- ucts that we purchase improve as companies compete with the results they achieve and the value they provide. Innovation represents the cutting-edge of how companies continuously refine and improve their products and service offerings in an attempt to grow market share and attract new customers and segments of customers. In the pursuit of new customers and customer segments, companies are constantly refining and improving their customer value proposi- tion. A customer value proposition (CVP) is a clear statement that explains why a customer should choose your product or service over al- ternatives by articulating the specific problem you solve or they need you to address, the unique benefits or outcomes customers can expect, and the differentiation that sets you apart from competing options. A strong CVP focuses on the customer’s perspective, not the company’s features, and communicates how your offering creates superior value — whether through better results, higher quality, lower cost, reduced risk, improved experience, or some combination of these. Sometimes, these improvements in CVP are targeted at addi- tional features, and sometimes by attempting to provide the same or better quality at a lower In the 1992 presidential race, Bill Clinton’s campaign faced what seemed like impossible odds. President George H. W. Bush was widely popular after the Gulf War. In March 1991, days after the ground war ended in Kuwait, 90% of polled Americans approved of President Bush’s job performance, and most analysts believed he would win a second term easily. But inside Clinton’s campaign headquarters in Little Rock, Arkansas, the Louisiana native and political strategist James Carville understood some- thing essential: While Washington insiders were still focused on foreign policy triumphs, ordinary Americans were feeling the effects of an economic recession. To keep the campaign laser-focused on the issues that mattered most to voters, Carville hung a sign in their campaign offices with three simple messages — all directed internally to staff, not as a public slogan: 1. Change vs. more of the same; 2. The economy, stupid; and 3. Don’t forget healthcare. 1 Carville’s sign was meant as a constant re- minder against distraction: the word “stupid” was directed at campaign staff, emphasizing discipline, message focus, and fidelity to what voters were actually experiencing. By the time voters went to the polls, the focus paid off. The recession — not the Gulf War — became the defining issue of the election. And the second item on Carville’s list became one of the most enduring political refrains of the modern era: a reminder that systems fail when they ignore the real forces shaping people’s lives. Carville’s mantra worked because it forced a campaign to stay relentlessly focused on those forces. Healthcare desperately needs an equiv- alent moment of clarity. For all the complexity we layer onto it — modern technologies, more quality metrics, additional regulatory levers, new payment models — the truth is that most of the dysfunction in U.S. healthcare is not mys- terious at all. It is economic. We have built a system where incentives reward volume over value, transactions over relationships, proce- dures over prevention, documentation over de- liberation, and compliance over compassion. The result is a landscape where good people are trapped in bad systems, where the “rules of the game” consistently undermine the actual goals of medicine. To understand what’s wrong with healthcare, we do not need a new slogan