Not directly health care related, but the chart when you follow this link is fantastic. Follow through with me on this and you'll see where I'm going (health care, like finance, has become too complicated for the old guard).
Recent Trillin op-ed recounted a fictional encounter where the interrogator asks what happened on wall st and the interviewee states smart people took over wall street.
"Then, however, as college debts and Wall Street pay grew in tandem, the smart kids started going to Wall Street to make the money, leading to derivatives and securitization, until finally: “When the smart guys started this business of securitizing things that didn’t even exist in the first place, who was running the firms they worked for? Our guys! The lower third of the class! Guys who didn’t have the foggiest notion of what a credit default swap was.”
In the blog link, there's an interesting point about how what's valued in CEO succession, doesn't necessarily lead to a good CEO. "Even when you don’t have the generational issue that Trillin talks about, the problem is that the sociology of corporations leads to a certain kind of CEO, and as corporations become increasingly dependent on complex technology or complex business processes (for example, the kind of data-driven marketing that consumer packaged companies do), you end up with CEOs who don’t understand the key aspects of the companies they are managing."
I wonder if this is an issue in health care. Has health care delivery become so complex, doctors are so disengaged from the process of health care management and reform, that we've slowly gotten ourselves into the current mess that we are in?
I'm really stretching the parallelism here, but I wonder if there is something to it. That's why I guess I'm such a big fan of giving more power to MedPAC - a technocratic body that is independent from politics, and infused with seemingly intelligent and capable health care reform thinkers.
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