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              82                 THE PRACTICE OF INNOVATION

                 During the early or mid-sixties, the structure of American health
              care began to change very fast. Three young people, the oldest not
              quite thirty, then working as junior managers in a large Midwestern
              hospital, decided that this offered them an opportunity to start their
              own  innovative  business.  They  concluded  that  hospitals  would
              increasingly need expertise in running such housekeeping services as
              kitchen,  laundry,  maintenance,  and  so  on.  They  systematized  the
              work to be done. Then they offered contracts to hospitals under which
              their new firm would put in its own trained people to run these serv-
              ices,  with  the  fee  a  portion  of  the  resultant  savings. Twenty  years
              later, this company billed almost a billion dollars of services.
                 The final case is that of the discounters like MCI and Sprint in the
              American long-distance telephone market. They were total outsiders;
              Sprint, for instance, was started by a railroad, the Southern Pacific.
              These outsiders began to look for the chink in Bell System’s armor.
              They found it in the pricing structure of long-distance services. Until
              World War II, long-distance calls had been a luxury confined to gov-
              ernment and large businesses, or to emergencies such as a death in the
              family. After World War II, they became commonplace. Indeed, they
              became the growth sector of telecommunications. But under pressure
              from the regulatory authorities for the various states which control
              telephone rates, the Bell System continued to price long-distance as a
              luxury, way above costs, with the profits being used to subsidize local
              service. To sweeten the pill, however, the Bell System gave substan-
              tial discounts to large buyers of long-distance service.
                 By 1970, revenues from long-distance service had come to equal
              those  from  local  service  and  were  fast  outgrowing  them.  Still,  the
              original price structure was maintained. And this is what the new-
              comers exploited. They signed up for volume service at the discount
              and then retailed it to smaller users, splitting the discount with them.
              This gave them a substantial profit while also giving their subscribers
              long-distance service at substantially lower cost. Ten years later, in
              the early eighties, the long-distance discounters handled a larger vol-
              ume of calls than the entire Bell System had handled when the dis-
              counters first started.
                 These cases would just be anecdotes except for one fact: each of
              the  innovators  concerned  knew  that  there  was  a  major  innovative
              opportunity in the industry. Each was reasonably sure that an innova-
              tion would succeed, and succeed with minimal risk. How could they
              be so sure?
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