Too easy on McGuire
You served up a marshmallow in your coverage of UnitedHealth Group and managed-care competition in your April 24 issue ("AMA: Near-monopolies abound"; "UnitedHealth sets off waves," p. 12).
It looks like Modern Healthcare is fawning over another chief executive officer in writing that UnitedHealth Group's William McGuire had made an "unprecedented call" to stop receiving options.
It's as if after the Securities and Exchange Commission announced its investigation of the stock-option grant program at UnitedHealth, the company's board formed an outside investigative committee and McGuire faces a shareholder lawsuit for backdating options to the low point of the stock price over the past 10 years, he announces, "I will steal no more." He sure doesn't say he will re-price his current options.
He sounds like the CEO of Northwest Airlines, who publicly announced at about the same time that executives deserve huge pay increases because there are not enough of them, but there are too many pilots, so pilots' pay needs to be cut 20%.
I know you can't analyze every event as a watershed, but this one might qualify. The American Medical Association's analysis showing monopolization of the insurance market sure connects to the profits and executive compensation of the monopolies such as UnitedHealth. It is not news that UnitedHealth profits by cutting compensation to providers, reducing services to patients and pricing insurance so fewer people can afford it.
The news is that McGuire exploited his shareholders with schemes to hide profits to give himself and his cronies the highest pay in the land. Likewise, he shortchanged the shareholders while posturing to the employers, patients and politicians that UnitedHealth is improving healthcare and we should all buy its insurance. The Fords and GMs that bought UnitedHealth's "managed care" and complained about healthcare costing them $2,000 a car ought to give McGuire a call and ask for a loan. With $1.5 billion on top of the tens of millions he personally received from having his minions "managing" a large part of their healthcare, maybe he owes them a dollar or two in their time of need.
Nurse pride ...
I thought Michael Romano's special report on male chief nursing officers was great ("The new CNO," April 17, p. 24). I have always used an example from the airline industry. When it changed the title "stewardess" to "flight attendant," it brought in the guys.
However, nurse attendant just does not sound right. I agree we should stick with nurse. They should be proud of their profession.
Assistant to the president/CEO
Pomona (Calif.) Valley Hospital Medical Center
... male CNO data
In response to your story on male chief nursing officers, the staff at Billian's HealthData Group discovered some interesting facts.
In the total universe of hospitals for the years 2002-06, the position of vice president of nursing/patient-care services and/or director of nursing/patient-care services was held by a male an average of 8.9% of the time.
This statistic is much greater than the 5.7% of total male nurses in the U.S. today. It is still far less than females in the same position, but it shows a steady growth for males rising to the level of CNO in the past five years.
Billian's HealthData Group
I'm sure you have considered this before, but perhaps you could explain why a ranking of the 50 Most Powerful Physician Executives in Healthcare would be determined by an Internet-based vote (April 24, p. 28). This strikes me as not particularly objective, unless it is accompanied by something else based on some other criteria to define "powerful."
Assistant professor of radiology
University of California at Davis Medical Center
Get off the junk
Todd Sloane tackles a complex subject when he tries to sort out the motives of healthcare reformers and the technical, social and economic realities of the era ("Transparent motives," March 27, p. 28). Rhetoric is part of the change process, and it's the mother's milk of politics. Newt Gingrich and others are provoking the conversation; that means they're throwing out game-changing ideas, some appropriate and others perhaps a bit out of our comfort zones.
Sloane should get off the junk about the messengers he dislikes and get on the arguments that, collectively, must engage ongoing evolution of the payment schemes and delivery of services.
Traverse City, Mich.