What Healthcare Can Learn From Farting on Danny DeVito
The Creators of South Park on Crafting Great Stories
As the creators, writers, producers and stars of the iconic animated series South Park, Trey Parker and Matt Stone have made a habit of taking a dump on beloved celebrities. And so, Danny DeVito should consider himself lucky.
They take an iconoclastic approach to comedy, so it shouldn’t surprise that, shortly before Parker and Stone first hit the big time, their preferred pastime was to scour Hollywood’s favorite hang-outs for celebrities, pick a target and then take a picture of themselves farting on the star. Sadly for film and TV legend DeVito, he got the worst of their antics, seeing as his face is unfortunately butt-height.
Back in 1998, with South Park fresh into its second season, Parker and Stone appeared on Dennis Miller Live where they fielded a serious question from their host. “Does it scare you that you might become the people that you made fun of at the beginning?” Miller asked his guests of their newfound success.
Parker answered with a story:
“When we came to L.A., we were such losers, like, our favorite thing to do was to go to bars and try to find someone famous, and fart on them, and get a picture of it.” Among their esteemed flatulence fatalities was Jaws star Richard Dreyfuss, whom Stone crop-dusted at a party. “The best was Danny DeVito,” Parker revealed, then commenting on the distinguished actor’s diminutive stature. “Because he’s just right there at my ass level!
Fast forward about 20 years, when in 2021, Parker and Stone signed a deal with Comedy Central, reportedly for around $900M, to extend South Park through a Season 30, running until 2027. They’re also currently in the middle of negotiating with Warner Bros. Discovery and Netflix to bring their form of “strategic transformation” and status quo “disruption” to one of these platforms…..reportedly for around $2.5 billion.
Writes the Hollywood Reporter on the self-producing economic system sparked by Parker and Stone: “With South Park‘s massive library of more than 300 episodes, and more being released every year, future deals will keep the cash flowing for years to come.”
Japan Launches “New Innovation Ecosystem”
Japan, the third-largest drug market in the world by sales ($71.5 billion in 2024) last week launched a high-level council to “address structural challenges in its drug discovery ecosystem” amid growing concerns over drug lags and losses and mounting calls from the global pharmaceutical industry for greater policy stability.
Coverage from Pharma Japan:
The inaugural meeting of the government’s Public-Private Council for Improving Drug Discovery Capabilities was held on June 26 at the Prime Minister’s Office, bringing together 30 key stakeholders, including pharma trade groups, domestic and foreign venture capital firms, as well as government ministries.
The new council will discuss three main topics: 1) measures to strengthen Japan’s drug discovery capabilities, 2) ways to ensure timely patient access to the latest medicines, and 3) the creation of a sustainable social system that supports a virtuous cycle [i.e., feedback loop] of investment and innovation.
The working group will be made up of representatives selected by three major industry groups — the Japan Pharmaceutical Manufacturers Association), the Pharmaceutical Research and Manufacturers of America, and the European Federation of Pharmaceutical Industries and Associations. Senior officials from four ministries (Cabinet Office, MHLW, METI, and MEXT) will join, along with four academic experts including Mamoru Narukawa, professor at Kitasato University School of Pharmacy. A budget examiner from the Ministry of Finance will serve as an observer.
Giving a press briefing after the closed-door session, Tadayuki Mizutani, director of the Health Policy Bureau’s Policy Planning Division for Pharmaceutical Industry Promotion and Medical Information Management at the Ministry of Health, Labor and Welfare, explained that the new council differs from the ministry’s “public-private dialogue” series by focusing specifically on detailed policy measures. Whereas the public-private dialogue is a forum where the health minister and top officials seek opinions from pharma industry leaders, the new council is positioned as a platform dedicated to enhancing drug discovery capabilities, where various players from across the ecosystem convene to deliberate on specific policy initiatives, according to Mizutani.
Prime Minister Shigeru Ishiba believes in the kinetic potential of the drug market, its ‘positional value’ as a keystone to lead large-scale economic development. “The pharmaceutical industry is a core growth sector for Japan,” he said, adding, “The working group will identify policy improvements based on conditions on the ground and existing challenges, and incorporate them into specific government policies and systems.”
Which is all laudable and inarguable and speaks to the gaping hole that needs filling worldwide for big system change. But Japan’s latest Public-Private Council is far from being a novel storyline. Look no further than the “biggest reimagining” of the NHS since it was founded in 1948: lots of “hubs” to attract investment, dozens of policy experts working “exceptionally long hours” at the Department of Health’s headquarters to craft a ten-year plan for strategically-collapsing Brand NHS. The Big Reimagining aims to achieve three structural shifts in care: from hospital to community, analogue to digital and treatment to prevention.
Sort of like the United States.
Back in April, RFK Jr. hosted CEOs from big hospitals to discuss value-based care, digital transformation, patient centricity and improving care in the community. Which is not all that different from pretty much every health conference held every month in every corner of the world. An entire corpus of content floats around the ether, making happy-to-glad edits in the PowerPoints, doing and saying the done thing, the words powerless to cut through the vapidity of it all.
Those working on the NHS plan apparently lost count of the number of iterations it has been through since the first draft was completed at the end of March. “It used to be that there was a new version every four weeks, then there was a new version every four days and now there’s a new version every 48 hours,” one insider told The Times.
The senior NHS writing team was reshuffled in May after early versions of the document were rejected for being too bland. “It just wasn’t sexy enough,” one source said.
The thing that's not working is the narrative layer. Or more precisely a fragmentary worldview, now trying to break the hold of a massive feedback loop sustaining The Standard Model. You can’t invent the automobile if you’re trying to “fix” the horseless carriage.
Call it Vibe Coding
Donald Trump’s inclination to swear is coarse, un-presidential, and highly effective, writes Jemima Kelly in The power and the glory of profanity, her short burst of opinion for the Financial Times on Sunday.
“You might have missed the British prime minister’s response to the news that Israel and Iran had lunched strikes on each other in the hours that followed their ceasefire agreement on Tuesday morning. “I want the ceasefire to continue, and therefore, obviously, the sooner we get back to that, the better,” said Keir Starmer as he arrived in the Netherlands on Tuesday for the NATO summit.
You almost certainly did not miss the American president’s. “We basically have two countries that have been fighting so long and so hard that they don’t know what the fuck they’re doing. You understand that?”
By breaking free of the usual constraints of polite political language, Trump was demonstrating how significant he considered the current moment. By showing some real passion and emotion, he was bringing humanity to a subject often treated as if it were a globe-sized game of chess rather than a matter of human life and death.”
Japan’s latest ambition is small bore because it is boring, the storyline is unremarkable. The ecosystem vision is bounded too narrowly, framed around the ‘drug market’ alone and in isolation from the infinitely-expanding galaxy of other markets that add “value” to value-based healthcare.
Its strategic goals are too restricted.
Missing is the fresh take using new language, an energized narrative that makes incendiary impact, a different theory around which to build and operate an empowering network that is strategically unique, has better ‘gravitational pull’ than its peer competitors. And in the process of becoming a new industry ecosystem (“ecosystem genesis”), win new subscribers with integration schemes that deliver what citizens most desire: predictable and unhindered access to goods and services. (The late-to-the-party logic behind health insurers in the United States “pledging” last week to change their prior authorization process.)
When they started out, Stone and Parker knew how to make shows that were funny and shocking. Now they have become two of television's best storytellers. Not long ago, they surprised a screenwriting class at NYU to offer some writing advice, the blueprint that took South Park from crude to award-winning crude.
Parker explains:
Each individual scene has to work as a kind of funny sketch. You don't want 1 scene that's just like, well, what was the point of that scene? We found out this really simple rule that maybe you guys have all heard before, but it took us a long time to learn it. But we can take these beats, which are basically the beats of your outline, and if the words “and then” belong between those beats, you're f***ed, basically.
You got something pretty boring. What should happen between every beat that you've written down is either the word “therefore” or “but”, right? So what I'm saying is that you come up with an idea and it's like, OK, this happens, right? And then this happens. No, no, no, it should be this happens, and therefore this happens.
South Park keeps getting funnier and more relevant and more interesting because its creators and writers know how to construct a coherent, provocative story where all the scenes come together in a tight rhythm of intentional crudeness, much like Trump’s communications strategy. (The show is done almost entirely in-house by Parker, Stone and a small staff of about 70 people. There is enough computer animation technology in the studio to remake "Finding Nemo." But early on they hired a software consultant to make the computers "retarded," as one South Park veteran puts it, so that shows would have the same homemade look as the crude cartoons Parker and Stone made in college with construction papers and scissors.)
Applying the South Park method to change the beat of Japan’s ambition:
“We ask all stakeholders to explore continuous investments in making Japan a hub for drug discovery” to therefore position the production of cardiometabolic health as the real wealth of nations. (Part of the logic behind RFK Jr. wanting every American to wear a wearable.)
A New Narrative Layer
Nearly all healthcare content today is irrelevant. Not from the lack of output and insights, but because of it. It isn’t interesting. It doesn’t motivate. It doesn’t inspire or excite.
Regardless the industry, and the economic subsystem of vendors and advisors an industry uses to create and innovate and figure out where to go for growth, 'commercial model innovation' ultimately comes down to telling and selling a new strategy story. It is cast with unique characters in different combinations and collaborations that create space for tension and fresh dialogue.
Anu Atluru from her Substack Media and Machines:
“We are no longer designing just products or platforms or interfaces, but cognitive environments — architectures of attention that shape what people see, feel and believe. Every engineering decision is now a cultural act. Every narrative choice carries technical consequences. The stakes have risen beyond business or tech to configuring the operating system of human attention itself.”
If technology yields a flat playing field, then new power flows from a whole new taxonomy for creative leadership, a different narrative layer that animates big system strategy, therefore improving political and economic offerings (as well as the careers of this offering them).
Like the cliché-powered opus of digital transformation the writing team at NHS is struggling to craft, Japan’s Big Ambition “that all stakeholders explore continuous investments in making Japan a hub for drug discovery” doesn’t energize because it doesn’t unearth a unique throughline, different words to cut through the vapidity of it all.
It could use a few farts and F-bombs.
/ jgs
John G. Singer is Executive Director of Blue Spoon, the global leader in positioning strategy at a system level. Blue Spoon specializes in constructing new industry ecosystems.