If you think the American health system is in need of serious reform, look around the world and you'll see we're not alone.
"It's at the top of every political agenda," said Errol Pickering, director general of the International Hospital Federation, a London-based group that represents hospitals in 90 countries. "In Britain, it's page-one stuff every day."
Mr. Pickering was in Dallas this month for the World Health Forum, a conference in which healthcare leaders from 16 countries made recommendations about the development and distribution of drugs and medical devices. The meeting was organized by the federation and the Health Industry Council of the Dallas-Fort Worth Region.
One recommendation was that nations adopt core medical-care benefits, a cornerstone of President Clinton's healthcare plan. Several countries, including Belgium and Norway, already have such core benefit packages. Another recommendation was the use of formal health technology assessment teams to weigh efficacy with cost.
Since the U.S. healthcare system is regularly hailed as the greatest in the world, Outliers asked participants whether other nations look to us as a model. Not necessarily, they said.
"You have the best and worst," said Helge Worning, M.D., medical director of hospital administration in Glostrup, Denmark. "If you look at the most advanced medicine, you are second to none," he said, adding that the U.S. system can be wasteful. "The worst thing to do in medicine is to apply all techniques to all people."
However, Ajay Kumar, M.D., a senior hospital consultant with the Indian hospital system in New Delhi, also noted that the United States is "doing 80% of the healthcare research in the world; that's why your costs are so high."
High opinion of healthcare. Healthcare may be losing an understanding mind on the Supreme Court now that Justice Harry Blackmun has decided to retire this summer.
The 85-year-old Mr. Blackmun is probably best known for writing the opinion in the landmark 1973 abortion rights ruling Roe vs. Wade. But he's on record saying the most enjoyable moments in his storied legal career came before he joined the nation's highest court when he was counsel for the prestigious Mayo Clinic in Rochester, Minn., from 1950 to 1959.
During his Mayo days, Mr. Blackmun is credited with finding a religious order to buy Rochester's downtown hospitals from the Kahler Corp., which now owns hotels. By January 1954, the former Colonial Hospital opened as Methodist Hospital, where only Mayo physicians treated patients. "We had to borrow money to make the first payroll," Mr. Blackmun said of the deal in a 1989 interview with The Mayo Alumnus. "I like to think Methodist Hospital is the brick-and-mortar contribution that I made to Rochester." The close-knit Mayo-Methodist relationship culminated in 1986 when the hospital merged with the Mayo Foundation.
Mr. Blackmun, who was appointed to the Supreme Court in 1970, called his Mayo days "the happiest days of my professional life." The article also noted that the justice may have had opinions leaning toward healthcare professionals. Said Mr. Blackmun, "I acknowledge that I have always had a sympathetic attitude toward the medical profession and for the medical mind."
Disconnection. The executive suite at Ameritech Health Connections is losing another charter member. This time it's Gail Gulinson, 44, who came to Ameritech from Baxter International in March 1990 as the first hire in the telecom firm's diversification into healthcare information technology.
Ms. Gulinson said she resigned as vice president of marketing earlier this month after deciding she wanted to return to the start-up arena of healthcare business, which is what brought her to Ameritech in the first place. "I was torn between staying with something I birthed and something I really love to do," she said, adding she had no start-up prospects as of last week.
Ameritech added marketing to the list of responsibilities under Al Vega's name. Mr. Vega, who was vice president for sales with the Ameritech Knowledge Data division, becomes senior vice president for corporate operations, which encompasses sales of Ameritech's regional health information network and Knowledge clinical product lines.
Ameritech replaced its president in January, accepting the resignation of Joseph Sullivan and hiring John Slotterback (Jan. 17, p. 24). Two weeks later, Lydon Newmann resigned as president of the Knowledge Data division, which was merged into the Health Connections operation (Feb. 14, p. 50).
On the move again. A year after her departure from public sector healthcare administration, Alethea Caldwell, most recently executive vice president of BCC Services, a Blue Cross of California subsidiary, again is in pursuit of new opportunities in the healthcare field.
Ms. Caldwell, 52, who resigned last year as director of the Arizona Department of Health Services to oversee corporate services for the managed-care companies of the Woodland Hills, Calif.-based insurer, says she has stepped down from her executive vice president position in order to facilitate a restructuring taking shape within Blue Cross.
Although she's been dividing her time between a consulting stint at BCC and other independent consulting assignments, Ms. Caldell said she wants her next job to employ the knowledge and expertise she's acquired in all segments of the healthcare industry, "probably in some form of consulting."
Ms. Caldwell believes there's much to teach fledgling healthcare delivery networks about combining professional and institutional-care delivery with financing. "It's not an aspect of the movement (to organize delivery networks) that healthcare executives easily understand," she said.
Ms. Caldwell, who expects to complete her consulting assignment at BCC by the end of the month, said her next biggest challenge will be deciding whether to continue in the business as a solo act or as a partner in an established firm.
For now, the former healthcare system CEO (Hobart, Ind.-based Ancilla Systems) and ex-Arizona public health official turned hospital chain board member
(HealthTrust-The Hospital Co.) will go it alone.
Still ticking? While many observers are pronouncing President Clinton's healthcare reform plan dead, consulting guru Larry Lewin doesn't see it that way.
"There are only so many ways to skin a cat," Mr. Lewin, chairman and chief executive officer of Fairfax, Va.-based Lewin/VHI, told New York City hospital administrators last week. "It's easy to find solutions if you don't try to solve all the problems." He predicted there will be "more convergence" of opinions as healthcare reform efforts move forward.
