Leadership in Health Care - Part of the Problem and Part of the Solution

By Dana S Kellis MD PhD MBA FACP

“The greatest leader is not necessarily the one who does the greatest things.

(S)He is the one that gets the people to do the greatest things.” Ronald Reagan

fixingushealthcare.com

Saturday, December 22, 2024

Dear Mr. President, Honorable Members of Congress and Distinguished Staff and Fine Citizens,

The nation has focused its attention on the tragic, brazen murder of a major health

insurance company’s CEO by a young man leaving a life of privilege and promise to carry out the killing. While details remain incomplete, he may have had overwhelming frustration with the insurer’s policies and practices in covering the health care needs of its insureds ꟷ although the killer did not have coverage from that particular company.

As shocking as this down-town New York City murder may have been, the choice of

various celebrities and others to both support the killer’s actions and call for additional violence against health care executives stirs similar emotions of disbelief and distress. Few acknowledge the CEO victim gained respect and admiration of his team and acquaintances for his dedication to family values outside of the office and also to using his office to try to improve the care experience for patients the company insured.

In discussions with health care executives following the murder, I’m told death threats have markedly increased to C-suite executives in health care organizations in the wake of the murder. As increasing numbers of Americans suffer complications of disease epidemics sweeping our country, and as these Americans find they can no longer access the care they need due ultimately to economic concerns (lack of insurance, massive coinsurance, unaffordable deductibles, out-of-network costs, etc.), health care leaders will find patients even less understanding as to why they and their loved ones can’t get the treatment they need.

Two of the grand ironies in this popular call for mayhem come to mind. First, health

care executives can do very little to “fix” the crisis we face. Our health care (non) system is too complex, has too many interconnected subsystems, and has too many powerful interests with divergent interests for any single individual, company or even group of companies to make meaningful improvements. Importantly also, there exists no overarching leadership nor accountability for the (non) system’s function. Undoubtedly, the vast majority of health care executives could truthfully claim personal dedication to improving the status and treatment of patients. Second, America just elected a billionaire businessman known for his aggressive business practices as President of the country, suggesting respect if not outright admiration by the majority of the electorate for business leaders who successfully enrich themselves and their stock/stakeholders using capitalism. One can appreciate health care leaders’ dismay at being held out as pariahs in this American free-market love fest.

What can we learn from this tragic constellation of events?

• First, Americans do not accept nor support free-market health care. The murder of an insurance company CEO, accompanied by a popular outcry of support for the accused murderer is a shrill wakeup call for American health care. We as a country cannot countenance trading pain and suffering for corporate profits, which a free-market system ultimately requires. Yes, we tolerated such a system while our poor neighbors suffered; now that pain has come to our own homes, and we no longer accept the trade-off.

• Second, transforming our free-market (non) system to a government-sponsored/single payer system will require great leadership at all levels of health care. We will need leaders who focus not on financial performance, but on quality and access and population health; servant leaders who can achieve transformational changes to our health system.

• Third, few Americans, even among those working in health care, understand how our

  health care (non) system functions. This ignorance, purposefully or accidentally

  fostered by providers and insurers and politicians may make meaningful change difficult or impossible. Possibly the first task of our new health care leadership cadre will be to educate politicians and the electorate as to the health care crisis we face. Fortunately, change will bring not only better access to care. Change can also bring lower costs and better quality to the American consumer.

It is said we should never waste a good crisis. The tragic impetus of the United Health Care CEO’s murder must help us build momentum towards saving health care from the melt-down towards which it is traveling.

Respectfully submitted,

Dana S Kellis MD PhD MBA FACP

fixingushealthcare.com

Copy to: We The People at fixingushealthcare.com