The U.S. is facing a structural competitiveness problem that is leading to the weakest economy we have seen in generations.

Operational effectiveness and strategy are both essential to superior performance.

Ultimately, health care fails the most basic test. It's not organized around the needs of the patient.

Finally, strategy must have continuity. It can't be constantly reinvented.

Strategy is about making choices, trade-offs; it's about deliberately choosing to be different.

The ability to change constantly and effectively is made easier by high-level continuity.

Competitive strategy is about being different. It means deliberately choosing a different set of activities to deliver a unique mix of value.