By Michael Sims

The youngster in the Uppsala, Sweden, eighth grade class has a decision to make. In the United States, most boys his age have nothing more momentous to worry about than deciding to play baseball or football at recess. Per Lofberg has a bit more to contemplate. The Swedish school system of the mid-1960s is designed to channel students at an early age in one direction. They must choose between the “two-culture divide.” Lofberg can opt for either the humanities—arts, literature, and history; or the sciences—engineering, medicine, and biology. He picks the sciences because he might want to become a physician.

Just two years later, he must narrow his focus even more, so he chooses the life sciences—pre-med and biology—over advanced math and engineering. He is sure now that he wants to be a doctor. Toward the end of his high school years, he continues on the path by applying to medical schools. Not surprisingly for a gifted student, he is accepted.

But not everything goes according to plan. The socialization of healthcare has come to Sweden. Some physicians complain that the government is undermining much of the freedom that they formerly enjoyed, jeopardizing everything from operating a private practice to pursuing research. “Forget about medicine in Sweden,” one physician bluntly advises Lofberg. “It’s a dead area,” declares another. The teenager faces a new question: Can he change his future so suddenly?

His father’s example provides the answer. Jan Harald Lofberg was an estate and trust lawyer for Skandinaviska Banken in Stockholm and later head of the endowment for Uppsala University, the oldest university in the Nordic countries. But then his brother died. Rather than continue in law, Jan Lofberg made a career change while his son was in high school. He succeeded his brother in running Harald Lofberg AB, the retail and wholesale textile firm launched by his grandfather around the turn of the century.

If Per Lofberg’s father could make a dramatic change, so could he. He gives up on medicine and enrolls in the Stockholm School of Economics in September 1966. He also begins working in the family business.

The economics school is the sort of undergraduate business college that doesn’t have an equivalent in the United States. Like all of the young men around him, Lofberg wears a suit and tie to class. Students arrive punctually, dressed like budding bankers; the professor may drift in fifteen minutes later, at which point the students must rise respectfully. When professors speak to students from their exalted position at the podium, they address them as Mr. or Miss, and they themselves are always referred to as professor. On the rare occasion when students need to ask a professor a question after class, they run the risk of being scornfully reproached for the need to inquire further.

Slender, neat, always well groomed, known for being calm and balanced, Lofberg never goes through a hippie phase. He works hard but finds free time to devote to one of his favorite sports: golf. He and a new friend, Sebastian Tham, discover a shared interest in cooking. Besides hosting dinner parties, they even assist a course in haute cuisine. By all accounts, Lofberg becomes very good in the kitchen.

He and Tham are part of a half-dozen friends who plan to continue their studies beyond Sweden to prepare for employment opportunities in large multinational corporations throughout Europe. Tham plans to attend Insead, the famed international business school in Fontainebleau, France, near Paris. Lofberg gathers information from a dozen or so universities, including several in the United States. “The approach,” he has to admit, “was not scientific.”

Almost immediately, he perceives the hotly debated differences between the case-study method personified in schools like Harvard and the more analytical approach exemplified by universities like Carnegie Mellon. Harvard, in its promotional materials, defines its approach: The case method forces students to grapple with exactly the kinds of decisions and dilemmas managers confront every day. In doing so, it redefines the traditional educational dynamic in which the professor dispenses knowledge and students passively receive it. The case method creates a classroom in which students succeed not by simply absorbing facts and theories, but also by exercising the skills of leadership and teamwork in the face of real problems. Conversely, Carnegie Mellon espouses Management Science—the academic alternative to the case-study method—which has its roots in analytical decision making in complex, dynamic business environments. How do you solve a problem you’ve never seen before? Carnegie Mellon’s approach equips students with the fundamental tools and knowledge needed in uncertain, rapidly changing markets.

Lofberg confers with people who studied in the United States and later returned to Sweden. Eventually, he applies to about 10 schools, including Carnegie Mellon’s GSIA, now the David A. Tepper School of Business.

Without visiting the schools, he looks at the many brochures. He can’t help but notice Schenley Golf Course from an aerial shot of the Carnegie Mellon campus featured in the university catalog. “The idea of being on a campus that had its own golf course was pretty amazing,” he says. As soon as he arrives in Pittsburgh in 1971, he realizes that the catalog certainly did its job well; the 18 holes turn out to be less dynamic than he thought. But he soon finds out that the region around Pittsburgh probably has more golf courses than all of Sweden, and the sport becomes his regular diversion after classes.

The rest of his matriculation goes well. He is surprised by the friendly informality of American college life, which permits interaction among faculty and students. In dramatic contrast to his experience in Sweden, the faculty at Carnegie Mellon calls students by their first names, and students sometimes even reply in kind. Professors can be found around campus, sweaty and grass-stained, after playing touch football on the lawn. In addition to the friendliness, Lofberg also relishes Carnegie Mellon’s analytical approach to business, which reminds him of his science years throughout high school.

Although he enjoys his American university, he doesn’t lose touch with his background. He frequently calls Stockholm. Each weekend, he catches up with the Swedish newspaper Svenska Dagbladet, while surrounded by the pungent aroma of the flavored Borkum Riff pipe tobacco that also reminds him of home.

Aside from Schenley Golf Course, he is here because Carnegie Mellon is in the forefront of applying computer technology to business practices. In the early 1970s, computers are becoming a resource for quantitative analysis; the school provides a huge room with dozens of teletype work stations. When Lofberg types in a query, the big, noisy machine often delays—as if it’s thinking over the question—before replying in a sudden outburst, sometimes in the form of a 30-foot printout of perforated connected sheets. He also spends time laboriously punching out computer cards that he then must leave overnight at the computer center for processing. The procedure can result in either hundreds of pages of answers or a single sheet of paper shouting ERROR.

Lofberg has the kind of aptitude for languages that impresses his American classmates. He speaks French, German, and Russian and is always on the lookout for a chance to practice the languages with students or professors from the respective countries. He is already well versed in English because it has been a required course in Sweden since the late 1940s.

During his second year at Carnegie Mellon, he shares an off-campus apartment with a French classmate, Jean-Pierre Durant des Aulnois. On many Saturday evenings, the roommates cook French meals for friends. It is through one of the dinner parties, in February 1973, that Lofberg meets an American student named Margaret Putnam McDowell (nicknamed “Mouse”). Soon they are dating.

While in his final year at Carnegie Mellon, he interviews with the Boston Consulting Group (BCG). Only a decade old, originally founded as a consulting arm of the Boston Safe Deposit and Trust Company, the firm is flourishing as a global consulting network.

Its founder, Bruce Henderson, likes imagination and quantified data. He isn’t interested in hiring gray-haired suits who approach problems by muttering, “I’ve seen this a thousand times before. Here’s what you do.”

Because the company has clients in many countries, Henderson also needs executives who speak more than one language. Lofberg—multilingual and schooled in the analytical business approach—is an ideal fit for the company. And the company is an ideal fit for him, too. It will enable him to remain in the United States with his girlfriend but travel to Europe.

His first day on the job is the Monday morning after he graduates in the spring of 1973. The next year he marries Mouse, and she begins her long-running joke that he only married her for a green card. Lofberg remains a Swedish citizen but also is a permanent resident of the United States.

One of the few German speakers on staff, he is soon off to Munich to help open a new BCG office. Then Henderson sends him to Sweden to consult for Siemens, the flourishing medical technology company with its own global outlets. Lofberg jets back and forth across the Atlantic and often must travel to other parts of the world as he becomes the company’s expert on healthcare management. He deals with pharmaceutical manufacturers and distribution, the difficulties of communication among manufacturers and physicians and patients, the pitfalls of deciphering handwritten prescriptions, and the information technology needs of the mammoth industry.

He climbs up BCG’s corporate ladder, founding its New York office in 1984, where he monitors the company’s extensive consultation work in healthcare around the world.

It is this exposure to the variety of ways of approaching medicine that, remarks Lofberg, “sort of got me hooked on healthcare.” He also learns a great deal about information technology, which is becoming a dominant business in itself.

In 1988, a mail-order prescription drug company named Medco Containment Services wants to bring him on board as a senior executive vice president. The pharmaceutical industry at the time is reinventing itself. During decades of huge profits, it considered itself insulated against the need to evolve. Computerization and reduction of labor-intensive paper processing were already established in other fields such as financial services. But the pharmaceutical industry was lagging behind.

Lofberg accepts the challenge amid the changing healthcare landscape. Along the way, in 1993, Medco becomes a wholly owned subsidiary of the pharmaceutical giant Merck & Co. Lofberg is named CEO of Merck-Medco Managed Care just about the time when Internet-savvy dot-coms are planning how to take business from what they see as their more traditional competitors. Throughout his tenure, he demonstrates that he is unafraid of technology or change. He helps bring his company online, introduces technologies that prevent inaccurate prescriptions, consolidates prescription plans with treatment histories, and improves the distribution process. “The myth was that it was all about what you saw on the computer screen,” he tells Forbes magazine in an interview.

Merck-Medco ultimately administers prescription drug plans for more than 52.3 million Americans covered through employers, unions, insurance companies, HMOs, and state and federal programs. As the country’s largest online pharmaceutical distributor, it employs more than 11,000 people, operates mail-service pharmacies, and manages nationwide networks of participating retail pharmacies. Revenues under Lofberg go from $3 billion to $23 billion.

In 2000, having exceeded perhaps even the loftiest of expectations, he is given a new challenge by Merck, when he becomes president and CEO of Merck Capital Ventures, which invests capital in private Internet and other emerging businesses related to healthcare services. He welcomes the latest challenge, wanting to use his career of experience combined with his passion for analytical data to nurture healthcare-related companies that embrace information technology. He works, for example, with a fledgling company that is mining data to learn not only who is sick or who has been sick but who is likely to become sick.

“Healthcare is basically about information,” he says. “It’s all about accessing and assembling information in an intelligent fashion.” Interestingly, he doesn’t consider himself a computer person. He says he’s a businessman who learned to incorporate technology into business—thanks, in part, to his introduction to computer technology at Carnegie Mellon. “Even in my day, I think Carnegie Mellon placed more emphasis on that than any other university.”

Nowadays, he also finds time to explore what he was channeled away from back in eighth grade, trying “to understand more about the humanities that I didn’t study when I was young.” He’s finding time to read Greek and Roman history, visiting art museums, and traveling to sites related to classical history.

Given his success, he doesn’t question the choice he made back in eighth grade or in high school.

Neither does his former Carnegie Mellon roommate, Jean-Pierre Durant des Aulnois, who is now director of operations for Capgemini, a worldwide information technology conglomerate. He believes Lofberg was destined to be a success. “He has always been highly driven,” he says, “very balanced, but knowing what he wanted and usually getting there.” Lofberg’s Stockholm schoolmate, Sebastian Tham, an investment banker and founder of the Paris-based Vega Invest, agrees. “He was always remarkably well organized and was planning ahead. In fact, somebody once suggested that Per was in many respects an incarnation of ‘economic man.’”

Michael Sims is a freelance writer and author. His latest nonfiction book, Apollo’s Fire (Viking), will be released nationally this fall.