HIMSS15

April 14, 2015 -- I spent a fascinating week in Chicago attending HIMSS15, a healthcare technology show. There were 38,000 of us; the scale was immense. And so are the dollars in this industry. Each day ended with a parade of black Escalades ferrying the assorted C-level types from the convention center to their hotel suites. Is this what -- in healthcare -- we have become? Is it what we want to be?

Among the Armani suits were health insurance executives. Bruce Broussard, CEO of Humana was one of the keynote speakers. He talked about "responding to consumers' wants and needs." Evidently, insurance people must create the illusion that they add value.

The first fallacy is that their relationship with patients is -- by definition -- anything but adversarial. They do their job "best" when they deny care, because the constituency they serve is not actually patients. Humana is a corporation; its primary purpose is to serve -- again, by definition -- its stockholders. There is nothing wrong with that; it's how capitalism works. Why pretend otherwise?

The second fallacy is that patients are the consumers. The definition of a consumer is one who makes a purchasing decision; one who is the target of advertising and sales. In health care, that's mostly doctors. The doctor chooses the drugs, the treatments, the procedures. It's mostly the doctors who are wooed by pharma and device manufacturers. A tiny portion of those advertisements are patient-directed (and some would argue that this shouldn't be permitted) e.g. sleeping pill ads on TV. Let's not pretend that patients are more than pawns in a high-stakes game played between medical vendors, payers, and the real consumers.

Broussard arrived by private jet. He describes Humana as "one of the nation's largest health and well-being companies." He is a master of euphemism. Indeed, his entire industry is. Do they add value? Quite the opposite! But I guess this doublethink enables them to sleep at night.

He showed us some slick, highly-produced videos of happy Humana customers, and recited drivel -- larded with folksy homilies -- about making consumers happy and healthy, some self-serving statistics about excess care delivery (we overspend on all our lucky customers), the ineptitude of Federal programs (only private companies like ours are capable of delivering decent care), and litanies -- now de rigeur -- about the need for change. All delivered with conviction and stage management, supremely polished. No mention of his bloated paycheck. Despite lots of brave talk about embracing change, that is surely the thing he wants least.

More than ever, it's clear to me that these parasites must go. They add no value. They are blood suckers, singing love songs while we bleed. Single payer is the only way forward.

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