Last week's cover story on the "changing of the guard" in healthcare (May 8, p. 30) offered a notable mix of pride, optimism and lamentation.
While most of the retiring chief executive officers interviewed by reporter Deanna Bellandi looked back fondly at their careers and forward with hope for the industry, some expressed regrets and worries.
Several noted the increasing dominance of money and finance. One person, Sister Mary Roch Rocklage of the Sisters of Mercy Health System, grumbled about how some professionals "got hung up in the structure and the corporateness" of healthcare as opposed to ministry. She observed the fragmentation in the industry between groups such as physicians, nurses, hospitals and payers. "Everybody is kind of pulling in their oars, and they're in it for themselves," she remarked.
Scott Parker of Intermountain Health Care bemoaned the lack of progress on expanding coverage for the poor, saying the nation has failed to "come to grips with our responsibilities."
It's hard to escape these unpleasant truths about the industry and the U.S. healthcare system. In the last decades of the last century, we saw the rise of a zero-sum-game mentality. Providers often responded to payment pressures by squabbling among themselves, protecting their piece of the pie to the exclusion of other concerns. The primary activity of the industry sometimes seemed to be a kind of futures trading. Huge blocks of patients were exchanged like railroad cars full of pork bellies.
And, as Mr. Parker pointed out, the people with little or no money earned mostly neglect.
Still, much has been achieved. Healthcare has evolved at warp speed from a cottage industry to a modern enterprise. "Miracle" treatments now are common. Despite Medicare payment restrictions and industry restructurings, hospitals continue to gain efficiency and make money. Some even thrive.
As for the future, technology holds the promise of creating value for patients and lessening the zero-sum imperative. And a booming economy gives us the means, if not the will, to guarantee healthcare coverage for all citizens.
As Mr. Parker added, "Stay optimistic. There are always the doomsayers predicting calamity and disaster. They've always been there, but they are never right."