Saturday, March 12, 2005

Managed Care CEO Blames Patients for High Costs

Charles Baker, the CEO of Harvard Pilgrim, a large, and heretofore well-reputed non-for-profit managed care organization in Massachusetts (and formerly in Rhode Island, until our local Blue Cross drove them out), "told executives they need to get employees involved in their medical spending decisions," according to the Boston Globe. He also said "if everybody keeps doing what they're doing, we will probably never get our arms around the medical expense trend." "There really has to be some disruptive activity."
My comments: if you want to give employees more involvement in medical spending decisions, that's fine. But will you also give them more involvement in decisions made about where they get their health care coverage, and which physicians and other professionals they go to for their care? Just blaming employees, i.e., people, for rising health care costs comes close to blaming the victim, given the little control that employees have over what sort of health care insurance they can get, and given the restrictive nature of many contemporary commercial managed care plans.
To the credit of the Globe, the article provided some pithy dissent. Katherine Putnam, President of Putnam Machinery Co, responded that too much "healthcare spending goes to administration, not to providers of care. Furthermore, administration "would be an easy thing to cut."
I agree, but by putting administrators (of managed care organizations, of hospitals, of corporations acting as employers, etc., etc.) in charge of cutting costs, can one expect that they are going to cut administrative costs? The implication, of course, is that patients and health care professionals have to have a bigger role in the governance of health care organizations. Otherwise, administrators are going to just continue seeing to their own.
Incidentally, the Globe identified Harvard-Pilgrim CEO Baker as a "possible Republican gubernatorial candidate." That might give voters an opportunity to show what they think of his prescription for cutting health care costs.

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