CEO Corner with Georganne Chapin

In the more than two decades since I began running Hudson Health Plan, I have been speaking out on the health care so-called “system” we live with in the United States. Fundamentally, I’ve advocated for universal single payer health care, pointing out the terrible inequities and irrationality that plague our fee-for-service medical industry.

Like most people with a lot of opinions, I say, write, and think about much more than ever sees the light of day. That’s why my colleagues and I have relaunched the Hudson Center’s CEO Corner. It’ll be the place where much of what I write, say, and think can be found in one public forum. For example, for every letter to the New York Times that I submit, three or four are not printed. I’d like those to be out there. I want to have my say.

The basic premise is this: As CEO of a Medicaid-Child Health Plus managed care plan – in effect, a not-for-profit health insurance company – I have an insider’s view of the way health care is administered. For example, I am in a unique position to expound on what a terrible model insurance is for administering health care. I also see, hear, and – alas – sometimes am complicit in – terrible examples of how real people are harmed by our system. The CEO Corner will be built around several key themes.

National health care

First, even if national health care is "reformed," the work is not done. The compromised legislation recently signed into law may contain a step or two forward, but there are many, many steps backward and sideways in it, as well. I plan to speak out regularly on its inequities, red tape, and outright counter-productivity as they continue to unfold.

Medicaid

Second, as part of the Medicaid system, I recognize its shortcomings as well as anyone, and I will point these out from the inside – i.e., from a position of responsibility for administering state and federal mandates and somehow making the programs work for our poor and working poor clients. We must be good at it, as Hudson Health Plan was recently judged the best such organization in New York State, by a wide margin. However, there’s another aspect of the Medicaid system worth spotlighting. Byzantine though the politics may be, and as convoluted as its administration may be, compared to the simplicity of a Canadian-style heath service, some of what Medicaid achieves is admirable. It is frequently disparaged by demagogic politicians who trade on the idea that the government can’t do anything right. (For some reason, they seem to spare Medicare this criticism. Could it have something to do with the power of senior voters, most of whom are quite satisfied with their “socialist” medical care?) Often, the Medicaid critics are wrong, and when the situation demands, I will talk about it.

Quality health care

Third, health care inequity doesn’t stop with the insurance system, the cost of medical education, or the opportunism and greed of the many parties who have a stake in a system that is half again more costly as a share of GDP than that of any other developed country in the world. As anybody who has been caught in a vortex of bad medical care knows, what doctors and hospitals recommend and do too often has little to do with patients’ well being, and much to do with the financial imperatives of the institutions that stand to benefit from the proposed treatments and transactions. Too often, the “science” of medicine is simply an illusion – covering for the self-perpetuation of the culture and business of medicine, rather than on helping people stay healthy or get well.

Intactamerica.org

Another of my favorite subjects, and a florid example of American culture and money trumping science at the expense of people, is the widespread practice of infant circumcision, which violates every ethical standard for informed consent and medical necessity known to man. As the founding executive director of Intact America, a not-for-profit organization devoted to ending this practice, you will hear frequently about my well-known interest in and revulsion for this practice.

Streamlining access to health care

Finally, we must look at the bureaucracy currently plaguing the system. There is so much work to be done. And until we're ready for a single national health system, we need to streamline policies to reduce the churning in public programs and adopt automated systems to speed up information exchange and give everyone access to healthcare. That has become a primary focus of the Hudson Center, and we’ll continue working hard to bring Medicaid and other programs to those people who need them most.

Despite the difficulties, this isn't rocket science. Banks, retailing, and manufacturing have automated. We can do it in healthcare, too.

That's my opinion.

—Georganne Chapin, Founder of the Hudson Center

Read more about Georganne Chapin.