tag:blogger.com,1999:blog-7476621888383604834.post8201428436802170379..comments2024-02-15T03:26:38.897-05:00Comments on Health Care Organizational Ethics: Insurance Executive Compensation and Medical EthicsJim Sabinhttp://www.blogger.com/profile/03087828142188534542noreply@blogger.comBlogger4125tag:blogger.com,1999:blog-7476621888383604834.post-88455605133731743352011-04-14T22:10:30.887-04:002011-04-14T22:10:30.887-04:00Dear Anonymous -
I'm sorry for the delay in p...Dear Anonymous -<br /><br />I'm sorry for the delay in posting your comment and responding to it - I was in Hawaii for two excellent weeks and am now in DC for a meeting.<br /><br />I agree that consumers (and others) can use the fact of executive compensation to avoid coming to grips with the real drivers of health costs. But that said, I think there's an unavoidable problem when a hard working nurse or primary care physician who is barely making a middle class income looks at the income of the CEO of their hospital or of the insurer they are haggling with. It adds to the "us versus them" feeling that is such a common component of our human natures.<br /><br />I'm not a scholar of the sociological and economic literature on income equity, but what I've read persuades me that it's "healthier" for a society to have less income discepancy/more income equity than we have in the U.S.<br /><br />But you're definitely correct that executive compensation is a very minor part of the cause of our runaway costs.<br /><br />Best<br /><br />JimJim Sabinhttps://www.blogger.com/profile/03087828142188534542noreply@blogger.comtag:blogger.com,1999:blog-7476621888383604834.post-63555690907436419462011-04-06T14:30:49.107-04:002011-04-06T14:30:49.107-04:00I work for a health insurer so I was really caught...I work for a health insurer so I was really caught by your comment that: <br />my back of the envelope calculation, if the top 50 executives at Massachusetts Blue Cross Blue Shield worked for free and received only a handshake on retiring, there would be no visible impact on the cost of insurance for members and employers.<br /><br />But you are right that we cannot get this message across about the relative costs of health care vs. compensation when people don't trust our ethics even as nonprofits. <br /><br />Consumer groups hype the compensation because it's easier than tackling the sheer scope of medical spending. <br /><br />Who will people believe? That will determine whether we get real reform that reduces spending and improves quality while covering everyone, or "insurance" reform that does nothing about costs.<br /><br />Your "no margin no mission" is true for nonprofit insurers, too -- it doesn't work to pay more in claims than we collect in premiums.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-7476621888383604834.post-41817090123177956392011-03-21T16:38:55.235-04:002011-03-21T16:38:55.235-04:00Hi Roy
Great to hear from you. As always, your pe...Hi Roy<br /><br />Great to hear from you. As always, your perspective is illuminating.<br /><br />I hadn't thought of the correlation you suggest between the offer of a very high (by health care standards) salary and the desired leadership style. I think you're probably right.<br /><br />But I think that even if a CEO is guided by excellent ethical standards, the tradeoffs required in meeting patient needs and staying within a budget create enough tension so that mega million compensation will elicit distrust and alienation.<br /><br />When I was Associate Medical Director of the not for profit Harvard Community Health Plan HMO in the 1980s, we paid folks in positions like mine a relatively small stipend on top of our regular clinical salary. Our rationale for doing that was to maintain group solidarity, not primarily to save the dollars.<br /><br />Best<br /><br />JimJim Sabinhttps://www.blogger.com/profile/03087828142188534542noreply@blogger.comtag:blogger.com,1999:blog-7476621888383604834.post-61736548524631632742011-03-21T15:38:30.507-04:002011-03-21T15:38:30.507-04:00Albert Schweitzer and Mother Theresa never would h...Albert Schweitzer and Mother Theresa never would have accepted compensation remotely that large.<br /><br />The issue is not how much money gets drained out of the insurance company in the form of executive compensation.<br /><br />The issue is what sort of incentives the compensation creates. Executives attracted by the possibility of making millions are not likely to be good at stewardship in the sense you use the word. Furthermore, a company that offers millions to its hired executives is likely to make those millions contingent on a style of leadership that is not conducive to good stewardship.<br /><br />See http://hcrenewal.blogspot.com/2011/03/some-dare-call-it-corruption.htmlRoy M. Poses MDhttps://www.blogger.com/profile/00497209843184497847noreply@blogger.com