When I reviewed the results of our second annual ranking of the 100 Most Powerful People in Healthcare, one theme jumped to mind: control. Controlling something of value makes you powerful, and that's what the people on our final list of 100 have in common.
The federal government is projected to spend $516.8 billion on healthcare services this year through its various health insurance programs, including the two biggies, Medicare and Medicaid. That represents nearly one-third of total healthcare expenditures expected in 2003. That's control, and that's why so many public officials-topped by President Bush himself-made this year's list of the 100 Most Powerful.
In fact, 23 elected or appointed federal employees made the list of 100, including 10 of the top 25. (Dozens of others on the list previously held federal jobs and now hold important positions in the private sector.) These are the people who wield the most influence over how that $516.8 billion will be spent. And their reach goes far beyond deciding what dollars go where. Many of those 23, like the various heads of federal health agencies, have the power to impose, delay or eliminate costly regulatory requirements on both healthcare providers and suppliers.
The other commodity in most demand today is manpower. Whoever controls the flow of workers into the healthcare industry is powerful and, therefore, it's no surprise to find so many nurse executives on the list, given the nursing shortage. As reporter Michael Romano discusses in his cover story (p. 6), eight representatives from nursing organizations made the list; just three nurse executives cracked the 100 Most Powerful ranking in 2002. With the nursing shortage expected to worsen over the next decade, nurse executives will grow even more powerful as they control the nation's supply of nurses, demanding better wages, benefits and working conditions. It's in their best interest to keep the supply of nurses just slightly behind the need for nurses, and they'll be vigorously fighting creative attempts by other sectors of the industry to bolster the nursing ranks, such as importing help from other countries.
Also making a splash on this year's list are managed-care executives. If you thought the age of managed care was over, guess again. Maybe the concept failed as a cost-containment mechanism, but it sure controls a lot of patients and dollars, as reporter Laura Benko revealed in last week's cover story (Aug. 18, p. 6). The top executives of eight managed-care companies or trade associations that represent health insurers made this year's list.
So, if you want to make a run at next year's list, think about running a large managed-care company, leading a group of nurses or getting elected.
To recap how we came up with this year's ranking of the 100 Most Powerful People in Healthcare, Modern Healthcare asked readers to nominate candidates they believe have the power to influence the healthcare delivery system.
We then asked readers to visit modernhealthcare.com from May 5 to June 13 and nominate people who they believed should be on the ballot. We received a total of 8,476 votes for 865 individual people. The 300 people who received the most nominations made up the final ballot.
We then asked readers to visit the magazine's Web site to vote for 10 people on the ballot of 300 who they believe are the most powerful. Readers submitted 13,606 ballots with a total of 136,060 votes cast. The 100 people who received the most votes made the final list with the ranking determined by number of votes received. However, the magazine reserved the right to resolve voting irregularities.
If you have any comments or suggestions about the results or the survey process, write me at: David Burda, editor, Modern Healthcare, 360 N. Michigan Ave., Chicago, Ill. 60601; call 312-649-5439; or send an e-mail to [email protected]