Healthcare is a bitch. I don’t have to tell you that, but I will from the perspective of a brand strategist.

My health insurance provider is Blue Cross/Blue Shield of North Carolina, and I pay a hefty fee for coverage for my family and myself each month. The brand promise of any healthcare provider that your family will be provided with a level of comfort and service. Comfort in that your family knows that, in case of catastrophic illness, your spouse and children will be taken care of and you’ll have the comfort in “knowing” that a visit to your family physician will cost us only our co-pay.

Well, that brand promise is now gone. Consider this:

A few months back, I received a call from my primary physician informing me of his change in practice from that of a general practitioner to that of an “Executive Physician.”  The idea is that to continue to use my family doctor, not only do I have to pay the co-pay from my insurance, but an additional $1,500 a year each for my wife and myself – and an additional $750 for each of my two children.

This fee entitles me to hour long visits, even though I really want shorter visits – not longer ones. I also get his personal cell number and pager number in case of emergences. I never knew he unavailable when I needed him before. Apparently, he was.

My now-former doctor simply could not make a living on the co-pay of patients and the remittance given him by the medical insurance companies. He believed that he would have to take on too many patients and deliver less than adequate care to simply make a living and have enough cash on hand to pay his malpractice insurance.  So he changed his model and I was forced to changed doctors.

Sad, I liked him. I don’t like my insurance company. And now the brand promises of comfort and service has been threatened.

Well, more bad news for the banking industry. The market leader has made a move. Now watch everybody follow.

The news that Bank of America will limit overdraft fees for debit cards is mildly bad but predictable news for the rest of the industry. Not because BofA will be the only one to do this. Nope, because only Bank of America will be known for it while the rest of the industry sits stroking its chin over what to do next.

And they’ll execute only one strategy: Copy the market leader.

It astounds me that so many banks have been so unimaginative in the wake of their troubles. BofA’s news is by no means a game-changer. It’s a tiny thing really, but you can bet the competition will follow suit in order to keep up even if they have discussed doing this themselves months ago.

The question: Why didn’t someone else, someone hungrier and not the market leader do this first? Instead of that, the other banks will now be forced to do what they have no doubt considered and so they will follow the market leader until it thinks of something else. Again.

We have been doing a lot of work with financial companies recently, and it continues to amaze us how many of them are unwilling to make changes, no matter how small. They wait until the market leader does it. They have been enacting this “strategy” for years.

But that strategy does not help them one iota.

That’s because copying the market leader only helps the market leader. Not charging overdraft fees on debit cards, for example, will become a table stake, what you need to play in the game. Market leaders are the ones who are given credit for table stakes.

Additionally, Bank of America’s competitors just lost an opportunity to steal share from the largest pool of customers in the industry. The competitors will be forced to make a change and get nothing for it. No BofA customers will switch for something they already have.

Another opportunity lost. Sounds like the banking industry.

It is something a brand strategist might ask, of course, but I’ve often ask myself, “Why?” each time I read about a merger or acquisition, such as today’s news that MetLife acquired Alico from AIG.

There are sound business reasons to acquire companies, merge with others and seek to expand your horizons. In MetLife’s case, the acquisition was about penetrating the Asia market. It might have been seen to Met Life as the most cost-effective way of doing so.

However, when companies are considering expanding into a new market, acquisitions feel a little lazy and impatient. Why not just enter that market with your own brand, and leverage your own equity? Why doesn’t MetLife just move into Asia without the acquisition?

The answer is often that the acquisition represents taking over physical assets, such as office, databases and personnel, as well as an instant client base.

But the trend of acquisitions and mergers, especially those in the shadow of the economic situation (see the banking industry), often ignores the hard work of building a brand that is so emotionally relevant it can pop into a market on its own and have long-term success.

Instead, there are CEOs who look at the need to have a stronger bottom line, so they spend. Then, once the growth has reached a plateau because they do not have a meaningful brand, they go to the next thing they can buy. It’s just not always smart, and is often the least economically feasible way to steal market share.

The way it should be: For those who know microbrews in the U.S., most are strikingly familiar with Fat Tire, the beer brewed by New Belgium Brewing Company in Colorado. We did work for them, and the power of the Fat Tire brand was that it could enter a market anywhere in the country and immediately have 10% market share – and would to grow.

The lesson is that acquisitions and mergers are not always the smartest and most lasting ways to ensure growth. Sometimes, you just need a brand to do it.

InBev, the Belgian company that owns Anheuser-Busch and, therefore, Budweiser, announced that it  posted $1.5 billion dollars in profit even though beer sales were flat.

Beer sales have been flat for years now, as the market has reached a saturation point when it comes to potential beer drinkers. There are simply more beer brand choices today then anytime in recent memory.

So what have the beer brands been doing? Playing defense.

This is particularly true of Budweiser. It has taken the expected market leader position by selling brand benefits that are minimum table stakes used as an excuse for preference. “Drinkability” is about as valuable as “free checking”  in banking.

It could be worse. Bud could start selling “Cold.” Oh. Wait a minute.  Coors owns that.

Bud needs to play a smarter game if it wants to grow share. Pretty soon, it will dawn on the legions of American long-neck  “Bud” drinkers that the brew is no longer the quintessential American heritage brew anymore since A-B InBev bought them.

Soon it will dawn on stockholders that InBev must take a hard look at the Bud brand promise if they expect its stock to be part of a growth portfolio. In the meantime, maybe Budweiser will wake up, realize the game has changed and call us for help before the shareholders demand it.

Last night I witnessed first hand the slow death of a company. On my way home from work, I passed a Borders book store. Ordinarily, I am accustomed to going to Barnes and Noble to search for my next book. But convenience being what it is at that moment, I checked it out.

I pulled into a mostly empty parking lot. That’s not too shocking because it was snowing. But it was a bit disconcerting nonetheless. I walked into the store and immediately felt like I had been transported to a wake.

The store was void of the quiet hustle and bustle of Barnes and Noble. In fact the only other consumer in the store kept eying me suspiciously as if to say, “So what are you doing here?” The store was laid out like a Barnes and Noble, but it was more like a $10 knockoff of a Gucci bag at the Silk Market in Beijing. Merchandise seemed to be stacked up all over the place with books intermingled in random categories. I only saw a single employee, a woman lazily standing in the checkout area, hoping me or the other suspicious shopper would bring a book up to checkout.

Borders is in serious trouble. Its stock is basically worthless, and it is going on its fourth CEO in five years. It is hemorrhaging cash. The situation is so bad that last month a major investor said on CNBC that a bankruptcy at Borders a was a “low-probability event” and that bad news caused its stock to rise 37% (granted it was only trading for about $1.00 a share so it rose $0.37).

What Borders has failed to do is give consumers a reason to shop there. (From my experience last night, I will not go back unless something drastically changes.) Although many believe Barnes and Noble to be the death knell and bane of the “local bookstore,” it have given consumers reason to use it, even if it is only the availability and diversity of titles. Moreover, B&N has also managed to change with the times, modifying its business model to account for changing consumer preferences and methods of delivery.

If Borders is to survive, it must give me and the rest of the book shopping market a reason to shop there. A reason that is both different and better than Barnes and Noble. Not simply a $10 knockoff.

If advertisers are smarter than they used to be, the dollars handed out for the endorsements of this year’s crop of Olympic champions will be lighter than in the past. Call it the new “Tiger” rule.

Simply identifying your brand with a celebrity athlete superstar is not as simple as it was when Nike tied it shoestrings to the high-flying Michael Jordan years back. There needs to be a legitimate and meaningful link to the athletes, otherwise it looks contrived and lacks punch.

One would hope that the recent fall from grace by Tiger Woods would make testing the waters a bit more worrisome too. After all, who looked more squeaky-clean then Tiger Woods? Who knows what lurks in the closets of the Flying Tomato or the Downhill Golden Girl? Personally, I would work on investing in a meaningful brand message and leave the endorsement routes to those that have really nothing to say.

So, Domino’s is crediting its new pizza recipe for its fourth-quarter success. Maybe so, but I’ll tell you what it really says: There’s a lack of brand loyalty among the pizza chains.

Domino’s got a lot of PR and top of mind awareness as a result of their mia culpa, but its brand promise remains the same. And it’s the same as every other fast food pizza restaurant: “Mediocre food fast.”

Let’s keep an eye on the long-term results because I have a feeling they will eventually disappoint because nothing has fundamentally changed in the brand’s promise except that they now promise to deliver barely “eatable” product.

The category must learn that Americans are hungry for experience. Not just pizza. Otherwise, these chains will be chasing their tail for years to come.

So many restaurants do not get that they have brands too, or should at least attempt one and fulfill its promise.

During a recent trip to New Orleans, I had the pleasure of eating at one that gets it right: The Commanders Palace. This is the well-known restaurant located on Washington Avenue in the Garden District. It’s no wonder that this five-star restaurant was voted the most popular restaurant in New Orleans 18 times. And it is also no wonder that some of the most well known chefs started their careers there, such as the much beloved Paul Prudhomme and the popular Emeril Lagasse.

The Palace is beautiful without being austere and the staff is highly professional, knowledgeable and attentive. The tables were decorated with white linen table clothes and napkins, and were impeccably set.

As we sat down, one of the wait staff noticed that two of the women in our party were wearing black slacks. He immediately replaced their white napkins with black ones so neither ended up with white lint on them after dining.

I must say, I have dined in many wonderful restaurants over the years but I can’t say that I have ever dined at one that was this observant or caring.

The level of excellence never wavered throughout the evening and, with each dish placed before me, I was blown away with both the presentation and taste.

The Commanders Palace understands its brand – it’s for those who honor a meal – when most in the restaurant industry do not. You don’t have to be a fine dining establishment to have a meaningful brand. Even McDonalds’ brand of “fun” resonates with a large populace.

But when you find any brand, whether a restaurant or something else, that has a brand promise (most don’t) and fulfills that promise (even less), it’s a pleasurable experience for me as a brand strategist. And it’s even better for those you serve.

Maybe it’s just the way of the retail world now. To increase earnings, you have to cut costs. Because only a very few – thinking Wal-Mart here – have accomplished it the old-fashioned way: By gaining new customers.

Today, Dillard’s reported an upswing in fourth-quarter profits, but this is truly a case of the emperor having no clothes. As most analysts have noted, Dillard’s increased its profit by cutting costs and reducing inventory, coming off a year in which Dillard’s closed stores.

The regional player has, in the words of the Wall Street Journal, “underperformed the industry for more than a decade in terms of same-store sales and sales per square foot.” Sounds like to me Dillard’s needs some assistance, and needs it quickly.

As I’ve noted in Chain Store Age, the problem for most retailers is that they try to copy the market leader to gain share. That does very little to move the needle because the market leader always becomes the default choice from the point of view of the consumer when everything appears to be the same.

Dillard’s is in the same situation. It’s difficult to come up with a difference, especially an emotional one, between it and competitors such as Macy’s and JC Penney. Those retailers are nearly identical from the perspective of the consumer, so retailers attract customers with sales (which cuts into margins) and by just being in a convenient location. In this case, Dillard’s loses out to the likes of Macy’s and JC Penney because those larger chains advertise more.

A new model may be in order for Dillard’s, which is something we’ve recommended for other retailers. In lieu of that, Dillard’s could become different and more memorable in the minds of consumers if its differentiators were tone, attitude and message. Then, it could even gain preference. Right now, its messaging and brand are lost in retail marketing because it sounds, looks and feels the same as that from the competition.

The bottom line might be looking better for Dillard’s, but it’s on the cusp of becoming irrelevant. A brand that says something about who the Dillard’s customer is could change that.

Last week while in London, my wife and I went to a restaurant at Piccadilly Circus called The Criterion for a pre-theatre dinner. Neither of us had ever been there before and the restaurant was quickly filling up with pre-theatre diners like ourselves.

It was a beautiful little restaurant with a glittering mosaic ceiling, high vaulted ceilings and gilded chandeliers and wall sconces. Everything you would expect from an upscale West End dining establishment.

The service was impeccable and the professional staff gave the promise of a formal dinner in the world’s capital.

That is, until the two 30-something ladies sat down at the table next to us with their three “birthday party” clad little girls in tow. I believe it was their clueless attempt at teaching the children how to behave while out to dinner, or possibly to “educate” them to the “better things in life.” Either way, all they succeeded in doing was to ruin the brand experience of every other diner in the restaurant — especially those (us) seated right next to them.

I had to nibble on my crown of lamb while three crying little girls spilled every beverage placed in front of them while their mothers pried in between our tables to mop up the mess, all the time whispering “What do you say to the waiter?” when steaks and other adult fare were placed before the children.

The real culprit here is a restaurant that does not understand their brand and should not allow the promised “experience of fine dining” by allowing children into the main dining room.

We preach to every brand we develop that, in order to be important to your target market, you must also “not” be for other markets. In this case, they believe they are a brand for everyone and therefore will remain unimportant to anyone.