Two Los Angeles-based groups have taken opposite tacks in addressing consumer complaints about managed care.
Jamie Court, director of Consumers for Quality Care, has dumped buckets of dried beans in front of HMO executives to protest what he calls the dominance of "bean counters" in healthcare. He also wrote a barrage of hyperbolic press releases during the campaign for Proposition 216, a sweeping ballot initiative (defeated last November) designed to curb managed care and hospital downsizing. During that campaign, journalists received a daily fax called "casualty of the day" on alleged victimizing of patients by HMOs.
On the other hand, Peter Lee, director of the Center for Health Care Rights, spoke at a recent meeting of the California Association of Health Plans of the need for consumer groups to partner with HMOs.
Lee said Court's tactics are "counterproductive" in the attempt to resolve consumer problems in healthcare. Diatribes against managed care only serve to undercut the necessary trust between patient and provider, he said.
The center is conducting a pilot project in Sacramento, Calif., to determine what works and what doesn't work for consumers both in managed- care and fee-for-service plans. Staff from the center will work with consumers and health plans to resolve problems, and the Lewin Group will study the program to see if it has value to extend to a larger population, Lee said.
Bigger bucks.Who's the biggest kid on the healthcare lobbying block? According to an annual survey of interest group executives' salaries, former U.S. Rep. Willis Gradison, president of the Health Insurance Association of America, topped all healthcare lobbyists with an income of $666,110 in 1995.
The seventh-highest-paid interest group chief executive in Washington, Gradison topped American Hospital Association President Richard Davidson, who at $603,588 in salary was 11th overall, and Patrick Hays, president of the Blue Cross and Blue Shield Association, at $567,313 and 12th overall.
The only other provider group exec to make the top 50 was James Todd, M.D., retired executive vice president for the American Medical Association. Todd was 33rd in 1995, with a salary of $478,499.
On average, healthcare trade group execs had the fourth-highest salaries of the 10 broad sectors broken out by the Beltway-insider magazine National Journal, in its review of salaries from interest groups' 1995 tax filings.
The survey also found that healthcare could boast of the third-highest-paid woman chief executive of an interest group: Karen Ignagni, president of the American Association of Health Plans, who earned $332,831 to place 81st overall.
By the skin of its teeth.Louisville, Ky.-based Vencor sneaked onto the Fortune 500 list this year for the first time.
The operator of long-term acute-care hospitals grabbed the last spot on Fortune magazine's annual ranking of companies based on sales. Vencor reported 1996 revenues of $2.6 billion. The company runs 38 long-term acute-care hospitals in 18 states. Vencor joins four other Kentucky companies on the list, including Louisville-based Humana, which rose 66 rungs to No. 213 with $6.8 billion in revenues. "I think it's great news," says Mike Bosc, a spokesman for the Greater Louisville Economic Development Partnership. "There is something about lists that people love to follow."
Quotable."I bristle at the phrase `no margin, no mission.' I'm not arguing with the validity of economics, but I'm hoping that we put mission first. If we have no mission, there is no need for margin."-Rev. Donald M. Hallberg, a board member of Advocate Health Care of Chicago speaking to a conference of Catholic healthcare executives in Chicago last month.
Just between us cavemen. "Gossip is good!" declared renowned Harvard biologist Edward O. Wilson during a novel seminar at VHA's annual leadership conference in San Diego last month.
A vital social lubricant, gossip ensures cooperation among "clan members" by enabling subtle behavioral correction, Wilson explained during a packed educational session titled "What Nature Can Tell Us About Fostering Healthy People, Communities and Organizations."
Researchers observing remote stone-age cultures that survived into modern times have found they devote surprising energy to gossiping.
"They gossip all the time, and a main focus is judging the character and reliability of one another," Wilson said. But most hospital workers, Outliers suspects, could have learned as much from a trip to the cafeteria instead of New Guinea.
Although gossip remains the bane of healthcare executives the world over, employees' "paleolithic genes" are unlikely to yield to management directives to cut it out. Seems that much of what we like to call human nature is really instinct that's coded by our DNA, Wilson said. And that includes gossip.
Modern humans, he said, inherited much of their social repertoires from ancestors who millions of years ago lived in hunter-gatherer bands numbering 20 to 100 members. They probably invented gossip to keep tabs on one another. And it seems to have worked so well that the genes underlying the behavior have persisted to this day, he said.
A giant among evolutionary scholars and a two-time Pulitzer Prize winner, Wilson conducted groundbreaking studies of ant societies that helped demystify the genetic motivations behind such admirable human traits as altruism and heroism.
Hats off to VHA for cutting through the latest management fads with Wilson's timeless insight into what really makes us and our organizations tick.