There's a fundamental distinction between strategy and operational effectiveness.

Apple does all of its research and development in America. It has all these brilliant people sitting in Silicon Valley. But until recently, Apple made nothing in America. Zero. And the jobs that were accessible to a good, well-trained worker that knew how to do welding or assembly, none of those jobs had stayed in America. We don't have the workforce.

Strategic thinking rarely occurs spontaneously

The thing is, continuity of strategic direction and continuous improvement in how you do things are absolutely consistent with each other. In fact, they're mutually reinforcing.

The purpose of the corporation must be redefined as creating shared value, not just profit per se. This will drive the next wave of innovation and productivity growth in the global economy.

Health care historically has been a very siloed field that's organized around medical specialties - urology, cardiac surgery, and so forth - and around the supply of these specialty services. The patient is the ping-pong ball that moves from service to service.

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