Thursday, March 28, 2013
Two Voices from My Past: Paul Ellwood, MD, and Regina Herzlinger, PhD
The past is prologue.
Paul Elwood called me last night from Wyoming to inform me my computer had been hacked, and he was receiving emails asking for money to get me out of Belgium. I was pleased to hear from him under any circumstances. We had a delightful conservation. Paul, at age 86, spoke with a clear voice. He reminded me of his role in reshaping health care. He has been an advisor to multiple presidents and persuaded President Nixon to pass the HMO act, which required businesses to offer HMOs. He was also a principal advisor in the Clinton reform effort. Paul said he was re-entering the health reform arena, and his chief interest was what to do with Medicare Advantage Plans. He thought Obamacare might be on the brink of becoming unraveled and wanted to do what he could to rescue it, and some its ideas, like Accountable Care Organizations. He reminded me that he played a role in forming UnitedHealth, and he was astonished it was now a $115 billion corporation. He said he still thought the future resided in large integrated, capitated, salaried community-based physician groups. I said I would like to interview him about the current state of health care, which he played such a pivotal role in creating, and he agreed to give me a hearing.
Regina Herzlinger, the first tenured woman professor at Harvard Business School, is the subject of a flattering interview “Opening the Door” in the March issue of the HBS Alumni Bulletin. It is largely about how she opened opportunities for woman teachers and students at HBS. I came under her spell as a student at a graduate course in 1976. Later she wrote the foreword for my 2007 book Innovation-Driven Health Care: 34 Key Concepts for Transformation (Jones and Bartlett). Her claims to fame are being selected as the best teacher at Harvard in 1997 and a series of books, notably Market-Driven Health Care: Who Wins, Who Loses in the Transformation of America’s Largest Service Industry (1997); Consumer-Driven Health Care: Implications for Providers, Payers, and Policy Makers, Consumer-Driven Health Care (2004); and Who Killed Health Care: America’s $2 trillion Medical Problem – and the Consumer-Driven Cure. As the titles indicate, Regina thinks the final solution for America’s health care will be informed health care consumers. Of Obamacare, she says in the interview; “I agree that the individual mandate is essential. But with Obamacare, agents who don’t know our individual needs are selecting plans on our behalf and that’s not consumer-driven health care. Obamacare establishes health-care exchanges, or markets but a consumer-driven system would require transparency in health-care quality and costs Can you imagine shopping in a supermarket where you don’t know products’ prices or ingredients?”
Tweet: Paul Ellwood, MD, father of the HMO, and Regina Herzlinger, champion of consumer-driven health care are still active in health reform.