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Supply Chains In The Crosswinds · Taking The Supply Chain Pulse

• 0:02
  SPEAKER_00: Welcome to a special edition of Taking the Supply Chain Pulse.
• 0:06
  SPEAKER_00: Today we're diving deep into the headlines and the trends that are shaping supply chains right now.
• 0:10
  SPEAKER_00: We've got two incredible guests to help us unpack it all.
• 0:13
  SPEAKER_00: Joining Fred are Brian Jensen, the chairperson and executive vice president at Saynange, and Tom Redding, the Executive Vice President of Healthcare.
• 0:21
  SPEAKER_00: We'll talk about what's making news in the industry, what's happening in our current projects outside of healthcare, and how supply chain planning is evolving in today's unpredictable environment.
• 0:30
  SPEAKER_00: This is going to be a candid, insightful conversation you won't want to miss.
• 0:34
  SPEAKER_00: So let's jump right in.
• 0:37
  SPEAKER_03: What we want to do is sort of let our fingers stick it up in the air and talk about what's in the wind and uh supply chain in the country.
• 0:45
  SPEAKER_03: Um in my lifetime, we usually have always had to deal with maybe one disruption at a time.
• 0:53
  SPEAKER_03: Uh and um we usually resolve that, pat ourselves on the back, tell us uh tell other people how great we are and go on to doing what we were doing before anything happened.
• 1:02
  SPEAKER_03: But right now, um we've got a lot of stuff out there going on, and I wanted to bring in our senior leaders and have them talk about A, what they're seeing, what kind of projects uh uh our clients are asking us to work on in the various uh areas, and B, talk about uh what the possible disruptions may be caused by some of the headlines in today's news, and C what we might be able what we might look forward to seeing in the future.
• 1:31
  SPEAKER_03: So Brian, why don't we kick off with you?
• 1:34
  SPEAKER_03: Uh what kind of projects uh are we focusing on in the areas outside of healthcare right now?
• 1:40
  SPEAKER_01: Well, a lot of the project focus has been on supply chain planning, sales and operations planning, sales inventory operations.
• 1:48
  SPEAKER_01: Um, even before we had some of the chaos or questions or uncertainty that we have from tariffs through to big beautiful bills and beyond.
• 1:58
  SPEAKER_01: So there was already a focus on how do I streamline my supply chain, how do I make it more effective, as opposed to two years ago when we were in the thick of helping design buildings like there was no tomorrow in the whiplash from COVID.
• 2:11
  SPEAKER_01: Remember, COVID seems like a lifetime ago now.
• 2:14
  SPEAKER_01: In you know, 2020, we had the pandemic.
• 2:17
  SPEAKER_01: 2021, there was an apt realization that the direct-to-consumer demand for product to be moved to my front doorstep instead of me going out to pick it up was here to stay.
• 2:27
  SPEAKER_01: It was not going to recede, didn't keep growing at the same rate.
• 2:31
  SPEAKER_01: So fulfillment centers were a must.
• 2:33
  SPEAKER_01: Commercial real estate was high, vacancy rates were as low as possible.
• 2:36
  SPEAKER_01: Well, all that pent-up demand that got pushed into 2021, 2022, and even part of 2023, that's been satisfied.
• 2:43
  SPEAKER_01: And it may have sucked forward demand that we would have been addressing right now, that we don't have to.
• 2:50
  SPEAKER_01: But now that they turn to the supply chain, how do we get product in more effectively, more cost effectively?
• 2:56
  SPEAKER_01: How do we stay in stock?
• 2:57
  SPEAKER_01: How do we beat the competition?
• 2:58
  SPEAKER_01: And that's dovetailed into or picked up the tailwinds of hey, everything from overseas is now going to cost another 54%.
• 3:04
  SPEAKER_01: No, 154%, no, 20 more percent.
• 3:07
  SPEAKER_01: No, we're gonna make a great deal, gonna be a great deal, it's gonna be huge.
• 3:10
  SPEAKER_01: The uncertainty is the worst case because you end up just doing gyrating on what if this, what if that, what if it's 54%, what if it's 154%, what if it's 200%, what if it's 10%, and you get a different answer in each scenario, and you get a different strategy from each scenario.
• 3:29
  SPEAKER_01: So we've been doing an enormous amount of that kind of strategy work now, relatively relative to what we used to do.
• 3:36
  SPEAKER_03: Yeah, that's that that's that's very interesting.
• 3:39
  SPEAKER_03: You know, the one thing, I'm sorry to interrupt, but the one thing uh um that I sort of I learned when I was getting my MBA, like like you, I'm a liberal arts dude.
• 3:48
  SPEAKER_03: So when I got a when I got an MBA in business, I had to learn all the stuff from scratch.
• 3:53
  SPEAKER_03: But um, you know that you look at inventory and you look about inventory is a couple things.
• 3:57
  SPEAKER_03: It's the supplies you need to get the stuff done, but then it's also an alternative use of cash.
• 4:03
  SPEAKER_03: Uh so it scraps organizations.
• 4:05
  SPEAKER_03: If you have if you have too much on hand, you're crippling your cash flow.
• 4:09
  SPEAKER_03: Uh and um a lot of the uh things that I've been reading lately uh about AI um is the ability to actively predict demand.
• 4:18
  SPEAKER_03: Uh, and that's just what you're talking about.
• 4:20
  SPEAKER_03: Tom, what are you seeing in what kind of projects are we doing right now in healthcare uh that uh folks seem to be uh asking of us?
• 4:30
  SPEAKER_02: Yeah, I think I mean it certainly would echo all the things that Brian said.
• 4:33
  SPEAKER_02: I think I think we're seeing uh, you know, many folks may or may not know, but there's a lot of aging infrastructure, you know, across the nation in terms of facilities, you know, the hospitals are getting older, investments required at those individual hospitals.
• 4:47
  SPEAKER_02: Um, regulations are forcing hospitals to think differently about how they serve those patients.
• 4:52
  SPEAKER_02: There's a lot more decentralization of care, so a lot more ambulatory care centers, a lot more physician offices, a lot of different points for uh patients to kind of enter the health system.
• 5:02
  SPEAKER_02: So for us, as we're seeing these more and more, you know, kind of decentralized health systems and with all the mergers and acquisitions, it's leading to more questions around what should we do to centralize?
• 5:14
  SPEAKER_02: How do we potentially, you know, leverage scale for pharmacy or sterile processing or supply chain or any of those different kind of support departments?
• 5:22
  SPEAKER_02: And it's it's it's asking the question, there folks are asking the question of like what's next?
• 5:26
  SPEAKER_02: You know, where am I going with with this?
• 5:28
  SPEAKER_02: And eventually it might be delivering to the home.
• 5:31
  SPEAKER_02: So, how do I deliver durable medical equipment or how do I deliver pharmaceuticals or supplies or whatever it is?
• 5:36
  SPEAKER_02: So I think for us, there's a lot of activity around you know, how do you leverage scale for these organizations, not just building new hospitals or expansions, but how do you leverage all the resources?
• 5:45
  SPEAKER_02: You mentioned inventory, it's transportation, it's it's the people, the systems, all those things that kind of have to be knitted together.
• 5:52
  SPEAKER_02: So it's it's getting getting more complicated by the day.
• 5:55
  SPEAKER_03: Yeah, and and let's get back to what Brian was talking about, the idea of of predicting uh predicting demand.
• 6:02
  SPEAKER_03: I guess you could also say the uh idea of predicting possible disruptions.
• 6:08
  SPEAKER_03: Um how would you say, Brian, that the non-healthcare industry is prepared for disruption?
• 6:16
  SPEAKER_03: Now, before you answer that, my my impression is uh we in healthcare have always uh reacted when you really would like to be able to respond.
• 6:28
  SPEAKER_03: And we in healthcare have this um feeling that we are the redheaded stepchildren as far as uh having a mature uh supply chain operation compared to everyone else.
• 6:42
  SPEAKER_03: So given the challenges out there, how well prepared do you think uh the the uh non-healthcare supply chains are for uh handling potential disruptions?
• 6:53
  SPEAKER_01: Well, I think it depends dramatically on the vertical that you're talking about.
• 6:59
  SPEAKER_01: Um how reactionary or how expeditious they are currently.
• 7:03
  SPEAKER_01: The food supply chain, for example, much higher turns because of spoilage, because of the pragmatics of maintaining a deep food inventory.
• 7:12
  SPEAKER_01: So they're very good at having a constantly full pipeline and making sure that it's it's it's primed and moving towards its customer base.
• 7:20
  SPEAKER_01: Others I'll give you an example from way back in my early history toys.
• 7:26
  SPEAKER_01: Toy manufacturers manufacture on a flat line.
• 7:28
  SPEAKER_01: Toys mostly get sold in the last quarter of the year.
• 7:31
  SPEAKER_01: So there's a constant build-up and build-up and build up all year long just to have enough so Santa Claus doesn't have an empty sack at the end of the year.
• 7:40
  SPEAKER_01: If that gets disrupted, there's no recovery because you can't accelerate the manufacturer.
• 7:45
  SPEAKER_01: So it very much depends upon the vertical or the business type you're talking about, the product type you're talking about, um, and what they normally do and how well they can deal with disruption.
• 7:57
  SPEAKER_01: Not many supply chains are stealing themselves right now to guard against disruption.
• 8:03
  SPEAKER_01: Customers are through different inventory positioning, through different sourcing choices and things like that.
• 8:11
  SPEAKER_01: But overall supply chains are really the result of what the customers and the suppliers do within those supply chains.
• 8:17
  SPEAKER_01: That that gives you the ability of the supply chain to support a disruption or a change or a shortfall or a shutdown or anything like that.
• 8:26
  SPEAKER_01: It's kind of the way you gave a definition.
• 8:28
  SPEAKER_01: My definition of inventory is a little bit different.
• 8:30
  SPEAKER_01: You don't manage inventory.
• 8:32
  SPEAKER_01: Inventory is the thing that happens to you because of everything else you've managed.
• 8:36
  SPEAKER_01: How well you've predicted sales, how well you've purchased, how frequently you've set up your inbounds to meet your sales demands, and how well you've guessed on what's going to be hot and what's not from my old retail days.
• 8:47
  SPEAKER_01: Inventory is the result, and it does have that cash impact you mentioned, and it does can sometimes be your advantage.
• 8:54
  SPEAKER_01: If you have it all when everybody else runs out, suddenly supply and demand becomes your friend.
• 8:59
  SPEAKER_01: So it does depend on the supply chain you're talking about.
• 9:02
  SPEAKER_01: You've seen real modern examples right now of tariffs on auto parts suddenly driving up the prices of cars that are already on the lot, or supply chain saying, we're going to guarantee the price of this car on the lot because we know it didn't cost us much more because it came in before the tariffs and use that as a competitive advantage.
• 9:20
  SPEAKER_01: So it's all how you react to those little nuances in your supply chain.
• 9:24
  SPEAKER_01: Unfortunately, I don't see many people doing anything to change that situation other than what they've done normally to support their particular vertical.
• 9:32
  SPEAKER_03: Well, the toy folks should have a big advantage because they already know that this year uh they're only going to be selling two dollars per girl instead of 30.
• 9:44
  SPEAKER_03: So that should that should have helped them with forecasting their demand.
• 9:48
  SPEAKER_03: Is that fair?
• 9:49
  SPEAKER_01: Yeah, yeah.
• 9:50
  SPEAKER_01: If if if that would come true, um as much as anything else.
• 9:57
  SPEAKER_03: So well, Tom, what are you seeing about uh the healthcare side as far as uh being able to uh do a better job of planning for disruption?
• 10:06
  SPEAKER_03: And we've been we've been disrupted, and we're we're gonna talk in a minute about some of these headlines, but we've been disrupted in several directions, sometimes completely out of the blue.
• 10:16
  SPEAKER_03: Are we getting any better?
• 10:18
  SPEAKER_02: Yeah, yeah, it's uh it's obviously up for debate, but I I think what I think health systems are focused on is you know, they is really building you know more um reliable relationships with their suppliers.
• 10:31
  SPEAKER_02: So trying to get away from that transactional nature of, hey, just I'm gonna try to beat you up to get the best price possible.
• 10:37
  SPEAKER_02: I think I think some of those conversations are starting to change about you know what's the what's the best value they can provide.
• 10:43
  SPEAKER_02: And and I think at the end of the day, it's about visibility.
• 10:46
  SPEAKER_02: It's about visibility of what they have from a manufacturing capacity or if it's or if it's inventory or whatever it is, because it's no different during the pandemic.
• 10:54
  SPEAKER_02: I mean, you got health systems that are within the health system are calling on these manufacturers and distributors and paying different prices, they're they're competing against each other.
• 11:02
  SPEAKER_02: So at some point, you got to get some transparency with with the from a supplier standpoint to even know what they have and what and what's been allocated to these different customers.
• 11:10
  SPEAKER_02: I mean, I think that's going to be an important step.
• 11:12
  SPEAKER_02: I think long term, I think there's going to be a maybe a broader conversation about visibility.
• 11:18
  SPEAKER_02: So, can these manufacturers and distributors get visibility of the demand within the hospital versus it's purely just a customer and you're servicing those customers?
• 11:27
  SPEAKER_02: Can you start to look at the demand and the demand profiles and start anticipating whether that demand's increasing or decreasing to get control of your manufacturer and distribution operations?
• 11:37
  SPEAKER_02: So I think it's a, I think at the end of the day, it's kind of been a you versus me um environment between the suppliers and the health systems.
• 11:44
  SPEAKER_02: And I think that that has to change and will change over time as it's a necessity for them to work more collaboratively.
• 11:55
  SPEAKER_03: With all your years outside of healthcare, do you find that um the non-healthcare community um actually uh has collaborative relationships on an ongoing basis with their suppliers, or are they adversarial like um healthcare is?
• 12:14
  SPEAKER_01: It's a it's a spectrum.
• 12:16
  SPEAKER_01: Um you know, the one of the reasons that going back to my you know my previous life, one of the reasons that Walmart was such a good customer to the toy manufacturer is because Toys R Us was starting to get a stranglehold on them.
• 12:33
  SPEAKER_01: Yeah, it's it it's a more balanced relationship between suppliers and customers is always better because when one starts to take advantage, one really starts to take advantage of the other.
• 12:41
  SPEAKER_01: And it goes both ways.
• 12:42
  SPEAKER_01: Manufacturers who are sole sources for a very, very hot product or a very, very in-demand product take the same advantage over distributors and retailers that when retailers get a large chunk of the the uh manufacturer's business, they take advantage of them.
• 12:58
  SPEAKER_01: I mean, ironically, when Toys R Us, the biggest manufacturers, got paid once a year for everything we bought all year.
• 13:04
  SPEAKER_01: They got paid on December 26th.
• 13:06
  SPEAKER_01: Wow.
• 13:07
  SPEAKER_01: So there was no cash flow problem on the in the heyday of Toys R Us.
• 13:11
  SPEAKER_01: But I'll be I'll be honest with you.
• 13:13
  SPEAKER_01: I mean, in my experience has been on the healthcare side, not in healthcare dispensing and the the critical points that Tom's group deals with, but pharmaceuticals, for example.
• 13:22
  SPEAKER_01: And CIFA relationships are incredibly collaborative between pharmaceutical manufacturers and distributors, and how they how much are you going to buy, and we'll help you set the inventory so that our manufacturing can always work optimally and you can always have what you need in stock.
• 13:38
  SPEAKER_01: That's an incredible example of a healthcare supply chain that was amazingly collaborative, in part because there was so much money on the table.
• 13:48
  SPEAKER_01: You you weren't talking about cotton balls in that supply chain.
• 13:53
  SPEAKER_01: You were talking about extremely expensive biopharmaceuticals and things like that that had tremendous margin, where you know a percent or two here or there on annual sales could be$70 million, the 1%, because of the expense in the supply chain.
• 14:08
  SPEAKER_01: So collaboration is worth much more, and that's the theme I've seen.
• 14:13
  SPEAKER_01: The more the collaboration is worth to both parties, or the bigger the pile of advantage you can get, then there's enough to go round.
• 14:21
  SPEAKER_01: And you can both come out ahead, a true gain share, which isn't that common.
• 14:25
  SPEAKER_01: Grocery, if you're at the end of the spectrum where your margins are 1%, there's not much to go around.
• 14:31
  SPEAKER_01: So you're you're you're struggling in that supply chain to to capture every penny you can out of that margin.
• 14:37
  SPEAKER_03: Yeah, you know, uh we Tom and I were at a a recent uh two-day conference at the Cleveland Clinic, and they really focused on it was it was interesting to me because they had 200 uh suppliers show up.
• 14:50
  SPEAKER_03: I think uh uh out of the 200, well, 198 uh were them, and Tom and I were not the regular suppliers.
• 14:58
  SPEAKER_03: But of the uh uh 200 that showed up, I would imagine 80% of them showed up to try to figure a way to get a contract with the clinic.
• 15:06
  SPEAKER_03: And uh the end of the the immediate beginning of the two-day conference set the stage that if you don't want to work with us collaboratively so that you can help us benefit and we can help you benefit, uh you're not gonna have an opportunity to do business with us.
• 15:23
  SPEAKER_03: And uh I think that I think that's something that's um um we're we're starting to understand, I think, in healthcare.
• 15:31
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• 15:36
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• 15:51
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• 15:57
  SPEAKER_03: So let's play this little game uh going through some of the headlines.
• 16:01
  SPEAKER_03: You talked about you talked about um talked about the food industry industry.
• 16:06
  SPEAKER_03: I just saw a report this morning on YouTube where American wheat is uh is uh under some real pressure because uh countries are canceling their contracts uh with American heat, the Philippines being one of the biggest uh markets that's uh getting its wheat now, gonna get its wheat now from Canada or Australia.
• 16:27
  SPEAKER_03: Uh these things are gonna have a tremendous impact on the economy.
• 16:31
  SPEAKER_03: Uh what's that gonna do to the uh the cost of food and uh and uh getting uh product to the grocery stores?
• 16:38
  SPEAKER_03: What kind of an impact do you think that'll have?
• 16:42
  SPEAKER_01: I'm not real sure by the time you get down to the grocery store level that you're gonna see a massive impact there, other than potentially price pressure.
• 16:51
  SPEAKER_03: But it'll have it'll have a big impact in Nebraska and some of those places to the people that are in the farming industry.
• 16:57
  SPEAKER_01: I mean, absolutely disruptive for those guys.
• 17:00
  SPEAKER_01: On the suppliers, you know, I mean, farmers are already getting hurt because of tariffs and uh a lack of demand for their product that used to, you know, 80% of my crop used to go overseas.
• 17:10
  SPEAKER_01: Now that market's gone.
• 17:13
  SPEAKER_01: Um so that's gonna change it.
• 17:15
  SPEAKER_01: Um whether or not it'll have a great price pressure at the grocery store, meaning downward pressure on the prices.
• 17:22
  SPEAKER_01: I don't know.
• 17:23
  SPEAKER_01: You do you know, you're in an economy, you're in a country where they have farmers dump corn, you know, into pits to you know to keep the demand down.
• 17:31
  SPEAKER_01: And you know, when you're dealing with bulk product and commodities at that level, the price is gonna have a floor.
• 17:38
  SPEAKER_01: Um so it's subject to upward pressure, but I'm not so sure the downward I think it is gonna hurt the farmers.
• 17:43
  SPEAKER_01: It's already hurt a lot of them.
• 17:45
  SPEAKER_01: Um but at the store, I don't know that you and I would notice the difference in a local wonder.
• 17:50
  SPEAKER_03: At least not right now.
• 17:51
  SPEAKER_03: Um so I'm just looking at uh some of these things.
• 17:55
  SPEAKER_03: Last week, US bombed Iranian nuclear sites, possible war pending.
• 17:59
  SPEAKER_03: Um, you know, how are uh how is anyone looking at that?
• 18:03
  SPEAKER_03: Are we looking at it or are we just disregarding it right now?
• 18:06
  SPEAKER_02: Tom?
• 18:08
  SPEAKER_02: Yeah, I mean that's a that's a that's a big question on, but it this goes back to that I said earlier is again, if you're a health system, you don't even know, you might not even know where the products are sourced from for the products you're using.
• 18:22
  SPEAKER_02: You don't even know where it's being shipped to.
• 18:24
  SPEAKER_02: So I I I think from a health system standpoint, they're kind of blind to that stuff.
• 18:30
  SPEAKER_02: Like they just don't, they just don't know.
• 18:32
  SPEAKER_02: And I think there's been a lot of there's a lot of uh groups out there that are trying to kind of break down the the barriers to understand like where is the stuff being sourced from, where are the components being sourced from, so they can start to kind of plan that up.
• 18:45
  SPEAKER_02: They're saying, hey, this is these these um um minerals or whatever, any kind of types of things that are being used for your you know, medical devices, whatever, it's gonna impact the cost or it's gonna impact availability.
• 18:57
  SPEAKER_02: I mean, I I think right now it's like if you're a health system, you're saying, hey, listen, I got a contract, I've signed a contract that says this is what I'm gonna pay for these particular items.
• 19:05
  SPEAKER_02: And there might be some escalation incorporated in some some capacity, but in reality, it's like I can care less and I'm I'm being dramatic.
• 19:12
  SPEAKER_02: But if you're the health system, you're saying, hey, those those costs are gonna be, you know, on the manufacturers.
• 19:18
  SPEAKER_02: And honestly, I think if you look at these health systems, they're gonna say, hey, my margin is 3%, 4%, 5%, some are negative.
• 19:25
  SPEAKER_02: And you got these medical device manufacturers, you might say have 30, 40% margins, and there's gonna be some some challenges of who who takes on those costs and who's responsible for that.
• 19:35
  SPEAKER_02: I I think it's it's a concern, but I think if you don't have visibility of where stuff is originating from in the products you use, again, it almost doesn't matter because you're kind of at a disadvantage.
• 19:46
  SPEAKER_02: You're kind of like just waiting to see what happens.
• 19:49
  SPEAKER_03: So so basically what you're talking about, and uh this gets back to Brian and other industries, is the importance of uh of sourcing, and that is uh uh knowing where your stuff comes from, and also probably knowing uh alternate uh suppliers for that stuff.
• 20:07
  SPEAKER_03: Um and I know how poor poorly we did um that task in healthcare.
• 20:14
  SPEAKER_03: Um and I've always been under the impression that if you were making a Ford, okay, you start out by coming up with uh the requirements, uh output requirements for a certain part, and then after you come up with the output requirements, then you uh you try to identify potential sources for that part, and then after that you get into the uh contracting, purchasing, and acquisition.
• 20:39
  SPEAKER_03: But you're also looking for alternative uh uh providers uh for key parts.
• 20:45
  SPEAKER_03: That that's relative that's very common in other supply chains, is it not, Brian?
• 20:51
  SPEAKER_01: It is, but it's gotten more complex as of late because it's not just well, I need this part, I can get it from Canada, I can get it from China, I can get it from Mexico, I can get it from Vietnam.
• 21:04
  SPEAKER_01: But now, especially because of the way tariffs and taxes are being presented, it's about origin.
• 21:10
  SPEAKER_01: Is it made in the USA?
• 21:11
  SPEAKER_01: If it's made in the USA, it's got to have X percent.
• 21:14
  SPEAKER_01: Well, just because that part was made in the USA, if the components for that part of the raw materials are bought overseas, well, it doesn't qualify anymore.
• 21:22
  SPEAKER_01: And I'm no expert on what percentage you need from where to make it a made in the USA part or not, or a made in the USA car.
• 21:29
  SPEAKER_01: But it's not just where you got the pieces that you put together to make that car, it's where you got the materials to make the pieces to put together that car, or the subcomponents, because anybody who's been in the automotive industry knows, well, I'm having my glove box subassemblies made over here, and then they get shipped in as a whole part, but they had parts that had to be manufactured, and those parts had raw materials, which by the time you track it down, country of origin, you know, is the is the whole supply chain mantra.
• 21:57
  SPEAKER_01: Um, you could be three, four, five steps removed and suddenly realize, gee, that made in America car was only assembled in America.
• 22:03
  SPEAKER_01: All the parts were made somewhere else.
• 22:06
  SPEAKER_01: And that's what's created challenges for supply chains.
• 22:09
  SPEAKER_01: Now, magnify that or increase it exponentially because, well, we're gonna require you to do X.
• 22:16
  SPEAKER_01: Oh no, no, wait a minute.
• 22:17
  SPEAKER_01: This new regulation says Y.
• 22:19
  SPEAKER_01: Oh no, we're gonna pass this.
• 22:20
  SPEAKER_01: Oh no, this is now in-house.
• 22:21
  SPEAKER_01: Oh, it's now it's going through Votorama.
• 22:23
  SPEAKER_01: It last night was Votorama on the big beautiful bill.
• 22:26
  SPEAKER_01: Yep.
• 22:27
  SPEAKER_01: So what's in it?
• 22:28
  SPEAKER_01: Nobody's gonna know until that carousel stops.
• 22:31
  SPEAKER_01: And it's almost like the the game of chance on the boardwalk down and down the shore where the wheel goes round and you you put your money down, and oh, nope, it was pop, but it was pop blue, not pop white, you lose.
• 22:42
  SPEAKER_03: Yep, and you won't know until it stops.
• 22:45
  SPEAKER_03: And and so everybody is now becoming, by virtue of the uncertainty in the country as a whole, yep, everybody is becoming uh more re more reactionary and less responsive because they don't know what the heck's gonna happen.
• 23:02
  SPEAKER_03: Is that fair?
• 23:03
  SPEAKER_03: Oh, absolutely.
• 23:04
  SPEAKER_01: I can plan for every scenario, but not at once.
• 23:10
  SPEAKER_01: And that that's a good thing.
• 23:12
  SPEAKER_03: That's an excellent point.
• 23:13
  SPEAKER_03: Exactly.
• 23:14
  SPEAKER_03: That that is an excellent point.
• 23:15
  SPEAKER_03: And Tom, yesterday, I mean, just uh Brian to give you an example of healthcare.
• 23:20
  SPEAKER_03: Um yesterday in Becker's Becker's came out with this headline that knocked me over.
• 23:27
  SPEAKER_03: Uh last time I checked, there were 6,391 hospitals in the country.
• 23:32
  SPEAKER_03: Many of them belong to large IDNs.
• 23:35
  SPEAKER_03: But yesterday, Becker's came out with this headline that said 760 rural hospitals are in danger of closing uh in the next X amount of time.
• 23:49
  SPEAKER_03: That's that's over 10% of the number of hospitals in the country.
• 23:53
  SPEAKER_03: Um, this is what healthcare is facing.
• 23:55
  SPEAKER_03: And and the big beautiful bill that's out there uh has um been um forecasted to remove 11 million people from healthcare protection over the next few years.
• 24:07
  SPEAKER_03: And and where's that demand gonna go?
• 24:10
  SPEAKER_03: This is what Tom, how are your guys looking at that?
• 24:12
  SPEAKER_03: Or what have you heard about that?
• 24:14
  SPEAKER_03: Anything at all?
• 24:14
  SPEAKER_03: Are people afraid?
• 24:17
  SPEAKER_02: Well, again, I think you said earlier, there's a lot there's a lot of unknowns.
• 24:21
  SPEAKER_02: So until some of the dust settles and we really understand what the impact is going to be, I mean, I I do think it's it's real that again, if you're thinking about cuts to Medicaid, what that means to the a certain, again, part of the population, it's gonna it's gonna directly impact those services and whether it drives up costs because you have more chronic illnesses or issues, or folks are gonna have to drive further.
• 24:41
  SPEAKER_02: They're gonna have to drive further for care and it's gonna be more disruptive to their life and and it's gonna be more challenging.
• 24:46
  SPEAKER_02: I think you know, we we see uh again a constant challenge as health systems to find people to do the work and to find providers and find nurses.
• 24:55
  SPEAKER_02: And and you might say, well, okay, so you close those and and those folks have to move, or or you have uh, you know, other pressures in other cities where folks are now you know coming into town and that puts more pressure.
• 25:07
  SPEAKER_02: So I think there's I think it's only going to force health systems to say, I need to invest in technology, I need to invest in a way to run my operations more effectively, whether I can deliver care at a lower cost or I need to do things differently.
• 25:22
  SPEAKER_02: Because I I think if you continue with the same uh mode of how we deliver care, I don't think it's I don't think it's cost effective anymore.
• 25:29
  SPEAKER_02: I think these types of things are gonna force health systems to say, I gotta think about efficiencies, I gotta think about how do I leverage technology, how do I leverage the staff that I have.
• 25:38
  SPEAKER_02: You know, I think it's I think it's gonna put more pressure to think differently.
• 25:41
  SPEAKER_02: And it's not, again, not a bad thing, but it's it's not good for folks that potentially are disruptive for care.
• 25:46
  SPEAKER_02: I have to drive another hundred miles or I drive 50 miles for care.
• 25:49
  SPEAKER_02: It's not it's not good.
• 25:52
  SPEAKER_03: Yep, just uh an editorial comment.
• 25:54
  SPEAKER_03: I don't think uh healthcare in this country has ever been cost effective, uh, but then again, it never had to be.
• 26:00
  SPEAKER_03: So that that's uh how how we got to where we are.
• 26:04
  SPEAKER_03: Um and you know, let's see if we can brighten things up a little bit.
• 26:09
  SPEAKER_03: What good things do you guys see coming forward that's gonna try to make the make the future better than it is now, Brian?
• 26:18
  SPEAKER_01: Interesting.
• 26:19
  SPEAKER_01: Given the last few months, nobody's been looking to the bright sunrise.
• 26:23
  SPEAKER_01: We've all been looking for the break in the clouds, so to speak.
• 26:27
  SPEAKER_01: But I I think there is going to be a break in the clouds.
• 26:30
  SPEAKER_01: The the biggest one, I don't know what the end game will be, uh but stabilization, a lack of uncertainty, whatever you want to, you know, uh certainty.
• 26:40
  SPEAKER_01: I mean, I was gonna say what's the opposite of uncertainty?
• 26:42
  SPEAKER_01: Duh.
• 26:43
  SPEAKER_01: It's un you know, uncertainty.
• 26:44
  SPEAKER_01: Well, the opposite is certainty.
• 26:46
  SPEAKER_01: Whether that's good or bad will be a matter of opinion, it'll be a matter of your perspective, maybe your political orientation, maybe you know, what you had for breakfast in the morning.
• 26:54
  SPEAKER_01: Um, but it's stable.
• 26:56
  SPEAKER_01: And like I said earlier, I can plan for any eventuality in a supply chain, but not all of them simultaneously.
• 27:04
  SPEAKER_01: So once I get that certainty, I can then plan.
• 27:07
  SPEAKER_01: Whether it's my parts are too expensive to buy from here and I have to resource them, or my parts are I can get my rebate by building it all in the US.
• 27:15
  SPEAKER_01: I need to know the rules.
• 27:16
  SPEAKER_01: Give me the rules, I can play the game.
• 27:18
  SPEAKER_01: I can play the game, I can win the game.
• 27:20
  SPEAKER_01: But without the rules, with the rules still being written, you can't even start to play.
• 27:24
  SPEAKER_01: So there's no way you can win.
• 27:25
  SPEAKER_01: So that that I think hopefully is the brightest outlook we have.
• 27:29
  SPEAKER_01: But what it'll be, I'm not a good enough prognosticator to figure that out.
• 27:34
  SPEAKER_03: None of us is.
• 27:35
  SPEAKER_03: Tom, what do you what uh your your your final words, your your last uh thoughts.
• 27:42
  SPEAKER_02: Yeah, I mean, with with all these things, I mean, you said about the changing in funding and closing of hospitals, and again, I think it um again, it just creates opportunity to to think about the world differently and how do we how do we drive improvements in the work, you know, whether it's infrastructure-wise, the operations, whatever it is.
• 28:00
  SPEAKER_02: I think I think there's a there's a lot of things to be proud about of what we're doing in healthcare and what and how where the healthcare industry is.
• 28:07
  SPEAKER_02: We've made a lot of great improvements.
• 28:08
  SPEAKER_02: I just I think as time goes on, some of these these pressures seem like they're you're it's being done to us, but it's creating opportunities to do something better and and to again to turn the corner and and have brighter skies, as Brian had mentioned earlier.
• 28:20
  SPEAKER_02: So I think there's there's a lot to be be proud of and a lot of things to that we can again hang our hat on that you know we we can still do to improve the industry.
• 28:30
  SPEAKER_03: Well, I want to thank you guys for coming on today.
• 28:32
  SPEAKER_03: And uh, you know, the um the one thing that I hope that people will get from this conversation is that the time that you can just sit around and continue to get things done on a day-by-day basis is long past.
• 28:51
  SPEAKER_03: The time has come that folks need to have intimate knowledge of their organization's operations.
• 28:58
  SPEAKER_03: Uh and the time for being able to figure things out by yourself is also gone.
• 29:05
  SPEAKER_03: So folks need to have folks like us come help them uh uh address their issues.
• 29:10
  SPEAKER_03: Um I want to thank you for your insights and uh hope you guys uh have a great holiday season.
• 29:16
  SPEAKER_03: I don't know when this is gonna run.
• 29:18
  SPEAKER_03: Uh thanks, thanks a lot, guys, and thanks for joining us.
• 29:21
  SPEAKER_01: Oh, thank you, Fred.
• 29:22
  SPEAKER_03: Take care.
• 29:23
  SPEAKER_03: Thank you, Fred.
• 29:26
  SPEAKER_00: Well, that's all for today.
• 29:28
  SPEAKER_00: Thanks again for joining.
• 29:30
  SPEAKER_00: And as always, don't forget to subscribe and connect with us online where you can find all of our episodes.
• 29:35
  SPEAKER_00: If you have a topic you would like to discuss or want to be a guest on the show, you can reach out to Fred directly at F C R A N S at S T O N G E dot com.
• 29:46
  SPEAKER_00: See you next time.