Shhhh! If you speak about it you’ll jinx it, but it’s all good right now because something might get done in health care.

On Wednesday, two main trade associations representing America’s health insurers indicated they were ready to cut a deal with the Big O: we’ll cover everyone regardless of pre-existing conditions if you require that everybody gets coverage.

That’s the biggest trade since A-Rod to the Yankees for Soriano and a player to be named.

In 93-94 when Hil tried to get this done, the mere suggestion that such hurdles could be overcome would have drawn guffaws.

And there are other reasons to be optimistic.

Tom Daschle knows his way around the yard.

The private sector wants out from employee health care costs which oh by the way, foreign competitors never had to pay.

Big Pharma has even nodded assent. A little. We think. Maybe. 

Yep! That was Montel Williams on TV this week saying, “Early diagnosis and preventative treatment can save lives and lower health-care costs…that’s why everyone should have affordable health insurance.”

Way to go Montel!

So who’s left, doctors? They could kvetch about reimbursement, working conditions and whatever but if they play their cards right they get tort reform out of this and besides, doctors have been emasculated for so long, this one isn’t even going to hurt.

It’s hard to imagine physicians, who are fed up like no other with their career choice, wouldn’t go for the ride just on the chance things could get better.

A lot of people in South Korea had November 13 circled on their calendars. That was College Entrance Exam Day, an annual event that affects and perhaps reflects modern South Korean society as much as any on the calendar.

In South Korea, 80% of high school seniors attend college, and the results of last week’s 9-hour mostly multiple choice test will strongly impact the college they attend. Years hence, it will impact their success in securing desirable entry positions in large companies and the public sector.

So it was a big deal for the 600,000 students that took the Exam this year, and practically the whole country rose up, as it does every year, to help them do their best.

Offices and the stock market opened an hour late to assure the roads were open just when students needed a stress-free trip to the Exam sites. Non test-taking school children were given the day off to minimize noise. The nations’ national utility had 4,000 people on standby in case the power went out. Airplane take-offs and landings were halted during listening comprehension.

By 6pm though, it was over. Newspapers had published every question and the correct answer. Poorly performing students could hope for a better showing next year. The test prep industry began a new cycle and media outlets shelved their tip lines which had helped students improve concentration, study habits and dietary intake in the days before the test.

Many colleges and government officials feel it’s not right to have so much riding on a single test. They want to add essays, recommendations and related subjective material to college acceptance criteria.

But others like things as they are. They like a system that gives every student the same chance to succeed and the objectivity with which grades are assigned. 

No matter, everybody’s holding the date in 2009.

Big Pharma always had a special place in its heart for America. Why wouldn’t it? Americans spent a ton on health. Americans valued innovation and minimized regulation. Americans even let Big Pharma price its products.

And America generated half of Big Pharma’s worldwide profit.

But things change. Now, Big Pharma thinks its future lies in the developing world. Pfizer just reorganized itself to reflect that as a matter of fact. That move came after Pfizer began cultivating a presence in 130 Chinese cities. Heck, Pfizer just established a JV with a bank to develop rural markets for basic drugs in Bangladesh of all places.

Jean-Michel Halfon was describing Pfizer’s strategy when he told the Economist, ‘serving customers in developing countries is now “a business not a charity,’” but he might have spoken for all Big Pharma.

Why the change? Follow the money. Annual drug sales are expected to grow by 34% per year in emerging markets compared with 9% in the US and Japan, and 14% in Europe.  In less than a decade, drug sales in emerging markets should top $300 million, which is equal to total current sales in America and the 5 top European countries combined.

And frankly, Big Pharma doesn’t know what it’s got in the Big O. What if he were to permit the import of cheap Canadian drugs? What about his threats to have Medicare negotiate tougher price discounts? That could cut American sales by 3-10% right there, according to the Boston Consulting Group.

Meanwhile just because it’s a good idea for Big Pharma to focus on developing countries doesn’t mean it can execute. New marketing and sales strategies will be needed, not just recycled riffs designed for the American, Japanese and European markets. It can expect some tough sledding with distribution partners and regulatory complexity as well.

And what will it do about pricing?