Health Care as a Commodity: Competition should be focus of health reform, lecturer says

In his speech, titled “Health System Reform and the Arrogance of Power,” Dr. Palmisano provided this definition of arrogance: “an attitude of superiority manifested in an overbearing manner,” often accompanied by an “offensive display of superiority or self-importance.” In calling for greater humility, he recalled the advice given by Donald Jacobs, then the dean of Northwestern University’s Kellogg School of Management, when he conducted a course for the American Medical Association’s board in 1998. “He said when somebody brings you a disconfirming opinion, you should not get reactive, you should not attack the person,” Dr. Palmisano said. “You should go up and hug the person, because that person might be bringing you the solution to the problem. It might be junk information, but you can be respectful and listen.”

Legal Reform

Dr. Palmisano also denounced court decisions that strike down limits on the amount of money that plaintiffs and their attorneys can seek in a malpractice suit. Such laws are usually found unconstitutionally restrictive, Dr. Palmisano said, but he believes state constitutions should be changed to allow the legislature to set caps on damages in malpractice cases.

During the question-and-answer period, J. Regan Thomas, MD, a Chicago plastic surgeon and professor at the University of Illinois-Chicago who is president-elect of the American Academy of Otolaryngology-Head and Neck Surgery, announced that the Illinois Supreme Court had, just three hours earlier, struck down as unconstitutional the state’s five-year-old law that limited compensation to injured patients for pain, suffering and other non-economic distress. “That’s certainly distressing news,” Dr. Palmisano said. “The trial lawyers will be very happy about that.”

Reaction

Although the speech extended well into the lunch hour, the vast majority of attendees remained until the end, and questions from the audience indicated support for Dr. Palmisano’s views.

At least one attendee, however, expressed a desire for more original solutions. “I have a great sense of disappointment as we see meaningful health care reform slip away,” said Jonas T. Johnson, MD, editor of The Laryngoscope and professor and chairman of otolaryngology at the University of Pittsburgh School of Medicine. “I am disappointed to think that organized medicine has failed to contribute in a positive way to progress toward universal coverage. The impediment seems to be a commitment to the economic status quo, an inability to embrace evidence-based practice, and an enduring distaste for our tort system.” ENTtoday