Podcast appearances and mentions of Samuel O Thier

Here at the Medicare for All Podcast, we love calling out all the bad actors in our healthcare system – greedy insurance companies, soul-less CEOs in Big Pharma,profit-hungry “non-profit hospitals”, and all our favorite villains. Mostly, we look at the ways those predators target sick people and poor people for exploitation, but today we're looking at what happens when they start fighting each other for a bigger piece of the pie? Specifically, we're going to explore the world of hospital consolidation – that's when smaller hospitals merge to form bigger corporate entities who can battle it out with insurance companies to secure more of patients' healthcare dollars! What does hospital consolidation mean for regular people? No spoilers, but it turns out that when giant healthcare monsters go at each other, much like when Godzilla took on Mothra, it's the rest of us tiny humans who suffer! https://www.youtube.com/live/LXBGMk8HEE8?si=9cIQ6G9wkwMSYLrZ Show Notes Like every major industry in this country, healthcare is full of big corporations that will stop at nothing to get bigger, using the time-honored capitalist techniques of mergers and acquisitions to become HUGE corporations. But, of course, we live in America, where bigger is always better – what could possibly be wrong with bigger, better healthcare companies? We start out this episode with a cautionary tale from Massachusetts that began in 1994, when two of Boston's biggest hospitals merge to create a mega-corporation called “Partners Health,” which over the next two decades bought up… everything. This was a response to a national wave of insurance company mergers and consolidations, which allowed insurers to squeeze both patients and providers under “managed care.” Hospitals, not wanting to be out-squeezed, fought back with their own mergers, ostensibly so they could negotiate with insurance companies. Of course, what actually happened was something much more nefarious – and secretive. In fact, we only know any of this happened thanks to the Boston Globe's illustrious Spotlight reporting team, who dug up the truth in a 2008 article. Basically, in 2000, Dr. Samuel O. Thier, chief executive of Partners HealthCare, and William C. Van Faasen, chief executive of Blue Cross Blue Shield of Massachusetts engaged in an unwritten agreement between the two entities without putting it in writing to avoid legal implications. The agreement involved Blue Cross Blue Shield giving significant payment increases to Partners' doctors and hospitals, and in return, Partners would protect Blue Cross from allowing other insurers to pay less, effectively raising insurance prices statewide. This "market covenant" marked the beginning of a period of rapid escalation in Massachusetts insurance prices, leading to a significant annual rise in individual insurance premiums. Partners used its clout to negotiate rate increases, pressuring other insurers to match or exceed the payment increases given by Blue Cross, leading to cost increases for consumers. In turn, Partners' significant growth and influence in the healthcare industry compounded the impact of this backroom deal, leading to a substantial rise in medical costs in Massachusetts. Partners employed aggressive tactics, resulting in major payment increases benefiting a few powerful hospital companies while leaving others behind. This led to significant payment disparities, with Partners' flagship hospitals earning substantially more than other academic medical centers. Partners is an outstanding example of the evils of hospital consolidation, but it's not an anomaly. This episode was originally inspired by our friends at the Minnesota Nurses Association (shout out to Geri Katz), who last year were fighting a proposed merger of Fairview Health with Sanford Health, two giant corporations with dozens of hospitals and clinics. Fortunately, the nurses and MN patients won this fight - merger talks were abandon...

“What does a good day look like?” That question — when asked of both terminally-ill and healthy people — has transformed Atul Gawande’s practice of medicine. A citizen physician and writer, Gawande is on the frontiers of human agency and meaning in light of what modern medicine makes possible. For the millions of people who have read his book “Being Mortal,” he’s also opened new conversations about the ancient human question of death and what it might have to do with life. Atul Gawande practices general and endocrine surgery at Brigham and Women’s Hospital in Boston. He’s also Professor in the Department of Health Policy and Management at the Harvard T.H. Chan School of Public Health and Samuel O. Thier Professor of Surgery at Harvard Medical School. He was recently named the CEO of Haven, a healthcare venture spearheaded by the leaders of Amazon, JP Morgan, and Berkshire Hathaway. He’s been a staff writer for “The New Yorker” magazine since 1998 and is the author of four books, including “The Checklist Manifesto” and “Being Mortal: Medicine and What Matters in the End.” This interview is edited and produced with music and other features in the On Being episode “Atul Gawande — What Matters in the End” Find more at onbeing.org.

“What does a good day look like?” That question — when asked of both terminally-ill and healthy people — has transformed Atul Gawande’s practice of medicine. A citizen physician and writer, Gawande is on the frontiers of human agency and meaning in light of what modern medicine makes possible. For the millions of people who have read his book “Being Mortal,” he’s also opened new conversations about the ancient human question of death and what it might have to do with life. Atul Gawande practices general and endocrine surgery at Brigham and Women’s Hospital in Boston. He’s also Professor in the Department of Health Policy and Management at the Harvard T.H. Chan School of Public Health and Samuel O. Thier Professor of Surgery at Harvard Medical School. He was recently named the CEO of Haven, a healthcare venture spearheaded by the leaders of Amazon, JP Morgan, and Berkshire Hathaway. He’s been a staff writer for “The New Yorker” magazine since 1998 and is the author of four books, including “The Checklist Manifesto” and “Being Mortal: Medicine and What Matters in the End.” Find the transcript for this show at onbeing.org.

About the Author   Atul Gawande, MD, MPH, is a surgeon, writer, and public health leader. He is CEO of the non-profit-seeking health care venture formed by Amazon, Berkshire Hathaway, and JPMorgan Chase to deliver better outcomes, satisfaction, and cost efficiency in care. He practices general and endocrine surgery at Brigham and Women’s Hospital. He is a professor in the Department of Health Policy and Management at the Harvard T.H. Chan School of Public Health and the Samuel O. Thier Professor of Surgery at Harvard Medical School.   He is the founding executive director and chairman of Ariadne Labs, a joint center for health systems innovation, and chairman of Lifebox, a nonprofit organization making surgery safer Globally.   Atul has been a staff writer for The New Yorker magazine since 1998 and has written four New York Times bestsellers: Complications, Better, The Checklist Manifesto, and Being Mortal: Medicine and What Matters in the End.   He is the winner of two National Magazine Awards, AcademyHealth’s Impact Award for highest research impact on healthcare, a MacArthur Fellowship, and the Lewis Thomas Award for writing about science.   (Source: http://atulgawande.com/about/) About the Book   The Checklist Manifesto is a book about how the most complex and complicated scenarios can be better managed with the structured approach of the simple (but powerful) checklist. It includes examples from operating rooms, flight decks, hurricane recoveries, kitchens and construction sites.   As life and work gets more challenging and specialised, this book documents the practical journey Atul and his team went on to develop a safe surgery checklist to reduce potentially fatal errors in operating theatres which was adopted in hospitals around the world. Ultimately the message is one of humility; no matter how experienced or clever you are, there is always a need for a process and a checklist to aid your own judgement. BIG IDEA 1 (3:30) - Checklist helps save lives and money better than humans. In the ICU having a checklist helps avoid complications on 178 actions for a typical patient per day. In an environment that can be stressful, a checklist helps systematize the process.   In investment, a checklist is very important in decision making. It helps people make more balance decision without having their emotion get in the way the can cloud the judgement.  Important and critical moments should have a checklist to be systems driven and consistent.   In this age of complexity, the checklist helps us keep things in check.   BIG IDEA 2 (5:23) - How to checklist. You need to check the checklist with different teams and cultures; know what is important and make sure the language is clear. Confusion can arise if the language is too complicated, too wordy or if there aren’t enough words because it’s too concise.   Two types of checklist are read/do checklist and the do/confirm checklist. Both types of checklist if well-defined and and well-designed will change the communication of the team in a scenario.   In designing a checklist it’s important to have the pause point to make sure that there are clear points where the checklist is deployed and clear stages in a process.  Vitally, it’s important to know everyone’s role related to the checklist. Which brings us to... BIG IDEA 3 (7:47) - Don't let the leaders run the checklist. For someone who have been doing something for years, ego can get in the way, for having to use a checklist. Know who’s role it is to run the checklist and don’t let that be the leader. While the leader doesn’t run the checklist, their judgement and experience that comes with time allows leaders to use them in a better, more structured way whilst reducing human errors. Click here to buy on The Book Depository  Music: Hyrule by Theevs Music    Let's Connect LinkedIn: www.linkedin.com/steph-clarke Instagram: @stephsbizbookshelf For full show notes, tweetable and 'grammable quotes, useful links and more visit www.stephsbusinessbookshelf.com   Enjoying the podcast? Please hit subscribe so you don't miss an episode and leave a review on iTunes to help others find us.

Morning Prayers service with speaker Atul Gawande, Professor in the Department of Health Policy and Management at the Harvard T.H. Chan School of Public Health and Samuel O. Thier Professor of Surgery at Harvard Medical School, on Monday, October 19, 2015.