2 more healthcare leadership lapses and 1 undecided
by Miki SaxonI’ve written a number of posts abut the lack of leadership in healthcare and the resulting problems with links to useful articles. I’ve even managed to discuss them relatively calmly and sans four-letter words—or at least edited them out. (My focus isn’t surprising, since I’m one of the 47 million uninsured.)
Three new articles prompt today’s post.
The first was an article, including multiple links to additional information, at Health Care Renewal by Roy M Poses MD. It shines a light on just how little unethical and/or illegal actions impact a career these days.
On September 10th, according to Bloomberg, “UnitedHealth Group Inc.’s former chief executive officer William McGuire agreed to pay $30 million to settle a lawsuit brought against the company and individual defendants over backdated stock options.” But don’t waste your sympathy on Mcguire, who still has around $800 million in stock options to fall back on.
On September 11th, “the Minneapolis Star-Tribune reported Stephen Parente, director of the Medical Industry Leadership Institute in the Carlson School of Management said the school had given him the go-ahead to explore the idea [to be “executive in residence”] with McGuire, former chief executive of Minnetonka-based UnitedHealth Group… “We don’t really care about the stock options.””
How’s that for a great leadership stance?
On September 18th, The Star-Tribune reported that the University of Minnesota is disavowing any plans to make McGuire a faculty member.
Looks like someone with at least a half a brain figured out that having an ethically challenged “executive in residence” wasn’t a good idea.
The second highlights yet another onerous practice of healthcare providers called “balanced billing”—only this one’s often illegal.
“Balance billing most frequently occurs when medical providers participating in a managed-care network believe the plan’s insurer is imposing too deep a discount on medical bills or is taking too long to pay. California, New Jersey, and 45 other states ban in-network providers from billing insured patients beyond co-payments or co-insurance required by the plan. Similarly, federal law prohibits providers from billing Medicare patients for unpaid balances… Many states also shield insured patients from balance billing by out-of-network hospitals and doctors in emergencies, since patients usually don’t control who treats them in those situations.”
Illegal or not, when collectors threaten to trash your credit people pay up. Better to call your State’s Attorney General and scream bloody murder. And if you’re unfortunate enough to live in one of the five states where it’s not illegal maybe you’d better get your network together and lobby for a change.
The third brings us to a new take on managed care.
“Consider what is happening in New England. Blue Cross Blue Shield of Massachusetts, that state’s dominant insurer, and financially struggling Caritas Christi Health Care, its second-largest hospital network, want to switch from a system that charges patients for every medical service to a managed-care-like flat fee per patient. The yearly fee would be adjusted for age and illness…
According to Dr. Stuart Rosenberg, head of a group of 1,400 doctors at Beth Israel Deaconess MedicalCenter in Boston, “70% of U.S. doctors who are specialists would be loath to enroll in a system that emphasizes primary care.
At least a third of those trillions is wasted on unnecessary care, according to the nonprofit Dartmouth Institute and other researchers, and medical experts blame widespread fee-for-service plans. These encourage volume over quality—doctors and hospitals have a financial incentive to perform more and more tests and operations whether they’re needed or not.”
Will it be better? Who knows, but at least they’re trying.
Consistent through all the problems, as well as the barrier to potential solutions, is the MAP (mindset, attitude, philosophy™) of greed and mememe that permeates our society.
In fact, that MAP is the one constant thread I see tying together the debacles on Wall Street, in healthcare, education, religion and a host of other problems.
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