Do the People You Serve Love You?

By Deb Boelkes

Year end is always a great time to reflect on our performance hits and misses. It’s a great time to ask yourself what went better or worse than expected, what should you do less of or stop doing, and what should you do more of or start doing to improve your performance and that of your organization?

With the precarious way the world is evolving, perhaps we should also add a few more questions to our end-of-year review list: Do your employees, business partners, and clients truly love you or are they simply putting up with you?  Is there anything you or your organization are doing (or not doing) that might lead to your staff, business partners or clients getting so fed up that they might initiate retaliatory action?  Is there anything you could do to alleviate the hostility?

Considering the recent United Healthcare CEO assassination in New York City, now might be a good time for business leaders to thoughtfully assess the nature of the interactions that your employees and business partners have with those you serve. Could any of the people you serve be so frustrated by your rules of engagement that they might strike back?    

Let’s consider the health insurance industry as an example. Health insurers are the middlemen between the public and healthcare providers. The insurers provide a financial safety net in the event you end up with a serious injury or illness. According to HealthInsurance.org:

Health insurance covers a portion of the cost of a policyholder’s medical costs. How much the policy holder pays via copays, deductibles, and coinsurance depends on the details of the policy itself, with specific rules and regulations that apply to some plans…. Private healthcare coverage can be provided by an employer (group insurance, including both large-group and small-group plans)…. Both public and private plans tend to use a managed care model (HMO, PPO, EPO, or POS plan, or sometimes a hybrid model), in which a private insurer will manage and oversee the provision of services, the quality of care provided, the reimbursement system, the provider network, and rules such a prior authorization or step therapy (for certain drugs).

Health insurers charge significant fees for their services. The amount of money the employer pays for an employee’s health insurance coverage typically comes from the compensation funds the employer would otherwise pay directly to the employee. While employees may believe the health insurance coverage provided through their employer is a no-cost perk—or is considerably discounted relative to private coverage purchased through the individual/family market— the fact is that employees pay for their employer-sponsored insurance plan coverage.

With employer-sponsored plans, the employer selects the insurer option(s) and the plan offering(s) to be included in the employee benefits package. Employees have limited options and choices in terms of the medical services covered; the monthly premium costs; co-pays and deductibles; the doctors, hospitals, pharmacies, and prescription drugs covered in-network; allowable costs for services, etc. The options, choices, and terms of coverage may not meet the needs of the employee (or their dependents) at a cost they can afford considering actual out-of-pocket costs can be much higher than stated or expected. Moreover, insurers retain the right to deny coverage of certain services.

I can personally attest that my own experience, as a (former) employee of Fortune 100 companies that offered enviable health insurance coverage, dealing with a denial of coverage by our company-sponsored insurance provider was usually a time consuming and exasperating endeavor.

Having experienced more than a few infuriating coverage or billing challenges—where the insurer and the various providers were not apt to communicate with each other to resolve my issue in a timely manner, if at all—I would inevitably initiate multi-party conference calls that included every provider involved in the process. If I was then still unable to obtain a satisfactory resolution, I would have had no qualms about escalating to increasingly higher levels of their management.

Sometimes the only way I could obtain an acceptable resolution was to meet face-to-face with the CEO of the errant service provider. Clearly, it’s not feasible for everyone to do that, but I never hesitated to do so when warranted because I firmly believe that senior executives need to know when their organizations are not providing acceptable levels of service. I do what I do in hopes that my escalatory actions will prevent countless others from having to deal with similar conundrums. It benefits no one when an executive with the power to correct flagrant service issues remains unaware that problems exist.

I believe there is also another issue exacerbating the public’s ire with healthcare Insurance providers: exorbitant CEO salaries.

In 2019 the Economic Policy Institute reported that the average annual pay of CEOs at the 350 largest public firms in America was $17.2M—a ratio of 278-to-1 compared to typical worker compensation. From 1978 to 2018, CEO compensation grew 940%, which far outstripped the growth of the S&P stock market (706.7%) and the growth of typical worker compensation (a mere 12%).  

Considering the annual salary of the President of the United States is $400,000 plus an expense account of $50,000—for an office which arguably manages some of the most complex and critical responsibilities on the planet—is it any wonder that people might be deeply resentful when their medical claims are denied by organizations whose CEOs are annually paid salaries like these:

• Humana’s Bruce Broussard is paid > $16M
• Cigna’s David Cordani is paid >$21M
• Molina’s Joseph Zubretsky is paid $21.5M
• CVS / Aetna’s Karen Lynch is paid >$21.6M
• Elevance (Anthem’s) Gail Boudreaux is paid >$21.8M
• United Health’s Andrew Witty is paid >$23.5M

How could anyone not feel resentful of an organization that requires them to jump through hoops to follow punitive arcane rules, only to then (sometimes well after-the-fact) be denied coverage for critical services for which the individual believes they have otherwise already paid in the form of monthly premiums, deductibles, out-of-pocket expenses, and their federal tax dollars which have gone toward subsidies paid to insurance companies.

Did you even know that the U.S. government pays 40% of its annual revenue to private health insurance companies?

According to the Congressional Budget Office (CBO), of the U.S. government’s $4.4 Trillion in revenue in 2023, $1.8 Trillion was paid to private health insurers.    

Once you grasp this seeming iniquity, does it come as any surprise that some individuals—especially those dealing with mental health issues and/or chronic physical maladies—elect to get even with those running the system?

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Bringing all this home now….

Regardless of your industry or marketplace, I encourage you to imagine yourself in the shoes of the people you serve. What would it feel like to be in their place, dealing with you and your organization? Are you easy to do business with? Do you provide extraordinary levels of service, above and beyond expectations? Are you really improving the lives of these people?

Next, look in the mirror and candidly ask yourself if the people you serve really do love you and your organization. Might anyone you serve have reason to feel wrath toward you or your organization?  

After pondering these questions honestly and humbly, take decisive steps to identify the most mission critical things that you and your team should stop or start doing to improve the status quo.

Strive to give the people you serve countless reasons to love you.

All my best wishes to you and yours for a blessed and prosperous New Year.