Contributor: John Barkett, WG’09
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The annual release of the National Health Expenditure projections is usually one of my favorite days of the year (sad…but true), but this February’s release left me pensive. It wasn’t the numbers themselves; 5.5% growth is what we’ve come to expect in health- care spending projections. Rather, it was a perspective I read accompanying the release that left me thinking about my own career and those of my fellow Wharton HCM alumni. In the essay, the economist David Cutler argues there’s nothing wrong with spending more on healthcare if we’re happy with what we get, but how can we be happy when such high spending drives inequality, and much of what we buy is waste?
Cutler is the reason I work in healthcare. I enrolled in his health economics class in college to satisfy my economics requirements, not expecting to be inspired by the coursework. But thinking about healthcare as a scarce resource – How do we provide good care, to the most people, when money is tight? – proved to be a problem I could not put out of my head. I spent my remaining electives taking healthcare courses, even completing an independent study on healthcare and ethics in which I wrestled with the reasons a society redistributes: Should we spend more to help others if we can? How much more? What if we could do more without spending more?
I knew I wanted in on the healthcare industry. I’d get to work on these big questions, plus demographic trends meant the industry was guaranteed to grow. I took an analyst job at a Medicare Advantage plan, and after three years applied to the Wharton HCM Program. I found my Wharton classmates to be similarly attracted to the prospect of earning a good living, working on big problems, and helping vulnerable people. That same spirit continues to animate the alumni with whom I interact through the WHCMAA, but it is most present in the current class of HCM students, who are as motivated to do well by helping others be well as any of us ever were.
I’d argue this win-win – to help one’s self by helping others – is shared by most of us in the healthcare industry and reflected in the mission statements of our home organizations. If true, then Prof. Cutler’s argument presents a paradox: How do the good intentions of individuals and firms lead to an inefficient, inequality-driving system? Resolving such a paradox requires asking tough questions: Do I contribute to waste in the healthcare system? Does my organization benefit from the system’s inefficiencies? Would I support policies that promote fairness but make it harder for my organization to succeed?
I know, I know, this is weighty stuff for a WHQ President’s Desk, but I’d like to know what you think. These are challenges our current students will face when they are leading healthcare organizations in a 20%-of-GDP economy a decade from now. They could benefit from alumni grappling with these questions today. Come say hi at the HCM alumni reception over reunion weekend, or shoot a note to email@example.com.
I hope to hear from you soon.
John Barkett, WG’09