The first line of A Tale of Two Cities by Charles Dickens, is the most often quoted line in speeches: "It was the Spring of hope and the Winter of our discontent." The thoughts expressed in this one line are so transcendent as to have described the French Revolution as well as the more contemporary "Arab Spring" and its aftermath. 

 

As a young college student intern, I was assigned to study infant mortality in Nassau County, NY. Despite having one of the highest per capita incomes in the US, Nassau County, NY, had a persistently high infant mortality rate. The county's infant mortality rate was in fact equivalent to that of a third world country in 1969. 

 

My studies revealed the causes of this deplorable situation. The rich or relatively wealthy, established their domains on Long Island (LI).  Places like the Gold Coast area of LI gained renown because of The Great Gatsby and other tales of the legendary wealth of its inhabitants; the Vanderbilts, the Whitneys, the Roosevelts, J.P. Morgan and enumerable captains of American industry and finance. Alongside these wealthy enclaves were ghettos; adjoining villages where black and immigrant nannies, butlers, gardeners and other servants lived. 

 

Downton Abbey drew attention to the "downstairs" lives of those who were dedicated to service and servitude to a landed aristocracy. Communication between the aristocracy and its servants was arranged through a system of bells and a scripted system of decorum which controlled social mobility as restrictively as the Indian caste system. Decorum and place was maintained by a complex system of fashion, manners, dress and position, manifested through manners as a reflection of morality. Napoleon's comment on decorum and protocol would have been descriptive of this age; "It was worse than a crime, it was a faux-pas."

 

On Long Island, the enclaves of the poor grew alongside those of the rich. As Long Island developed, a rash of East-West arteries grew, just as fewer North-South roads were developed. The public transportation systems which were affordable to the poor, developed in parallel to the East-West arteries. The North-South public transportation systems, where they were developed at all, were not designed to accommodate the medical needs of the un-wealthy. As a result, those "underserved" financially became underserved from a healthcare or medical point of view as well. The automobile-accessible and public transport-accessible system was not designed with public medical care clinics, hospitals and the un-wealthy in mind. 

 

 

Today's innovations in e-commerce, Fintech, education, medical care, retail commerce and distribution are layered upon the fabric of constrained accessibility. Innovation in a variety of sectors has made increasingly evident the importance of logistics as a measure of efficacy in customer satisfaction and accessibility. 

 

 

In the US, accessibility is a function of wealth. The US spends more money on education and medical care than any other nation. The effectiveness of both these critical services to a country where the per capita income is $20,000 a year, is mitigated by accessibility. Affordability determines economic accessibility. It is a fact that in the US dumb, rich kids are more likely to succeed than are smart, poor kids, a reflection on the efficacy of the US educational system. Economic status affects the relationship between the attainment of wealth and health by the US public. 

 

 

Reverse innovation, as conceived by Vijay Govindarajin  of Tufts, an advisor to GE, and Chris Trimble, suffers from a lack of vision. It is conceived as a means of providing affordable and accessible healthcare and other services to the "underserved" in wealthy countries by multinationals adopting the less costly innovations of poorer, emerging economies. In the process, the multinational "reinvents" itself. 

 

 

The lack of vision in this conception of reverse innovation, is in the restricting of its application to multinationals. In order to fully understand my thesis, one must first understand the connection between immigration, new business starts, job creation and economic development. Latinas created 24% of the small, new businesses in the US, in 2014. Small business is responsible for most of the new jobs and for the resultant economic development of affected communities. To restrict reverse innovation to multinationals is short-sighted in the  extreme, as it ignores the rise of and role of micro-multinationals in global trade. It also ignores the propitious effect of bilateral trade among micro-multinationals. The dependency of global trade on multinational-driven innovation is part of the Conventional Wisdom.

The Conventional Wisdom is all too common and none too wise.