Crisis Management & Sicko

I've always been fascinated with the art of crisis management - how companies strategize and react publicly (and behind the scenes) to negative publicity. So even though this is going around, I thought it worth a link: an internal memo from BlueCross on how to deflect the criticism's of Michael Moore's new movie, Sicko.

I haven't seen the movie yet (new baby and all) so I won't comment on the accuracy or spin of the memo, or of the movie. But I do think it points up the very real split reality of health care in the US. On the one hand, we have the most advanced medical care in the world. On the other hand, we do not distribute that care equitably, liberally, or efficiently. On the one hand, we have a system (not really a system, of course, but a de facto structure) that does a pretty good job of taking care of people from birth until death - child and maternal mortality rates are low, and we pay great mind to elderly care, so that we may live as long as possible, without rationing. On the other hand, that system makes almost no concerted effort at preventive care or early treatment, where we could have the largest impact in saving and improving lives. This dichtomy makes health care a particularly difficult subject to get your arms around - there's always a clear and compelling case for exactly the opposite perspective. As this mildly misguided post from a Google employee makes clear, there is a case to be made for the good the health industry does. It's just not a very compelling one next to very human cases of woe and misery.

So while I think Moore is right and justified in assailing the health insurance industry for unfairness, I also think the insurance companies are justified in pursuing their mission - to provide reasonable amounts of care in a for-profit venture. The fact that this industry fails in the larger mission we expect of it - to ensure and deliver the absolute best available care to all people in all circumstances - isn't in fact their responsibility. That's a much greater role than the one they are legally obligated and structurally able to accomplish. That's a job for a larger government effort. As a health economist explained it to me: If there's ever a case to be made for market failure in capitalism, it's in health care.

Whoops. I guess I did have an opinion after all.