Friday, October 09, 2009

Tahoe Ticker Column 13: The People of Health Insurance

As I write this I've just finished a 3-day workshop with 40 mid- to upper-level managers of one of the biggest health insurance companies in the US. Since April I've done 4 of these as well as other work here, and have met a lot of these people, and that has affected my view of issues of health care reform greatly.

Don't get me wrong – I'm still solidly for universal health care and, at the very least, the public option. What's changed, though, is that, having worked intensively with these people I really can't abide the demonization of the insurance industry that I hear from others who share my views.

I guess it's possible that there are greedy, rapacious executives who are out to screw the public in the name of outrageous profits, but I haven't met them. I've watched the CEO of this company – a guy who is often quoted in the debate and who is well known in the industry and in Washington – talk with the managers I work with and take their questions, and I believe he's for real when he says he is out to (a) provide the best service to their customers (b)provide that at an affordable price and (c)find a national solution that works for everyone and provides health care for all.

At the end of each 3-day program we ask the participants to write a "letter from the future" based on the idea that it's three years from now and they and the company have achieved success beyond their wildest dreams. None – that's not one – of the 150 people I've worked with so far has written about profits, market share, or denying claims. They write about health, conquering obesity and smoking, and wellness.

Please don't bother writing in to tell me I'm na├»ve or that I've been coopted unless you've spent as many days as I have interacting as intimately with these people as I do. I know everything that's wrong with business, the capitalist system in general and the health care industry in particular. So do they – when we ask them, before the program, to assess how the company is doing in terms of trust and working with their customers and health care providers, they invariably say "I'm doing well, my immediate work group is doing OK (though not as well as I am individually), and the company is doing terribly." They don't trust "the organization" any more than you or I do, but they are committed to fixing it and to creating a real partnership with customers and providers.

My point is there is no enemy in this fight except maybe those lawmakers and lobbyists who, for whatever reason, seem to think it's their job to take an extreme position and hold it. Nothing is gained by demonizing the people in the industry; like the Beatles' "Nowhere Man," they're a lot like you and me.


imnxcguy said...

Hi Ed,

Love your columns. But I, too, would be "for real" and "provide the best service...." if someone was willing to pay me 3+ million (Pacificare Health) to 22 million (Aetna) dollars to make billions of dollars for their industry. CEO's are paid that much because they are making commensurate amounts of profits for their insurance companies, which are making commensurate dividends for their (mostly institutional) investors. Yes, the people are just like you and me, and are probably all great folks. Except a LOT richer.
Keep up the great blogs!

Terro said...

Thank you, Ed, for a fair-minded blog on the health insurance industry. Unlike imnxcguy, you are looking at results and not fixating on compensation for executives or others employed in the industry.

The health care industry earns anywhere from 2-5% (high) yearly profits, which are far less than many other U.S. industries. If the industry succeeds in providing quality care to more and more Americans, this is certainly worth the candle. And healthcare is incredibly complicated, more complicated than most of us (myself included) really understand. And it follows that those who labor in the industry are a little different from the rest of ...not just "richer," but more knowledgeable, and we need to respect that.

Ed Gurowitz said...

I think you're both right - the people I wrote about are not making millions - they are paid a competitive wage with good benefits. The upper executives, including the CEO of whom I spoke are well-paid, but that's the current state of the art with C-level executives - you pay them or lose them. The company is making money, sure - that's what private corporations do - and the way to regulate the relationship of service quality to earnings is through comptetition. That's why I favor a public option.