January 4, 2011

A Health Insurance CEO Navigates the System

I work for a regional BlueCross BlueShield Plan in Central New York. The CEO of my company has been in the business for a long time. He makes lots of money. He has a lot of contacts in the health insurance and medical arenas. Heck, he’s been to the White House and met with President Obama. If I were to try and think of someone well-prepared to navigate the American health care system, he’d be pretty darn high on my list. 

But right now, he has a role more important than CEO -- the role of devoted husband to a wife who has terminal cancer. He elected to share their story in Bloomberg Businessweek last month, and it’s a story that is both touching and enlightening. Here are a couple of excerpts:
  • On his own preparedness for navigating the system: “I’ve spent almost 40 years on the business side of the health-care industry, including the last seven as chief executive officer of a health plan. I believed my network of contacts would serve us well. I presumed there were unambiguous answers to questions about the best treatment plan and the best providers. What I learned was that for uncommon diseases like Linde’s, if not all diseases generally, clear answers often don’t exist. I will never forget one doctor telling me that the information I sought wasn’t available and that I would have to trust my gut. This is pretty incredible when you think about how much as a society we spend on health care.”
  • On our ‘best course’ moving forward: “As a society, we need to be honest about treatment limitations. Patients should be well informed about what the industry knows and doesn’t know. There should be candor about the likelihood that care will make them worse instead of better. Patients should be empowered to be the treatment decision makers. In recognition of the uncertainty patients face, we need to compassionately acknowledge their pain and fear. We need to counsel that aggressive intervention isn’t always the best course of action.” 
Some folks say that  illnesses are ‘equalizers’ – they treat everyone the same, whether rich or poor. But I believe our health care system came out as an additional equalizer, beyond his wife's illness itself, in David’s case.

As he and his family now deal with the reality of his wife’s decision to seek palliative care instead of any additional aggressive treatment, their story should be required reading for all those who profess to know what’s best for us.