Big Think Interview With David Goldhill | Big Think

Big Think Interview With David Goldhill

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David Goldhill:

David Goldhill is the CEO of the Game Show Network. his Atlantic article, "How American Healthcare Killed My Father", was considered by many to be one of the year's most provocative on the subject.

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TRANSCRIPT:

Question: What inspired you to write your article on healthcare?

David Goldhill: I had always had like, like] many politically involved people, an interest in[ healthcare; it's obviously such an enormous part of our budget. And as a businessman, you can't help but have been aware over the last 15 years or so of running companies of the cost of healthcare, both to a company and to your employees. But I think for me the real catalyst is what happened to my father, because I had a lot of thoughts about what was right and wrong about our healthcare system.

My father is an 82-year-old man who walked into a hospital with pneumonia and like most men his age certainly was vulnerable. But what I saw in his five weeks in the hospital, five weeks that ended in his death, was very surprising to me. As a business person, as a very aware consumer at those moments, because obviously the care was so crucial to my father's hope of survival.

My father died of an infection he acquired in the hospital. That's not unusual; although, at the time, I didn't realize how ordinary that is. A few weeks after his death, Atul Gawande happened to publish a piece in the New Yorker in which he talked about the estimated hundred thousand deaths a year from infections. The number just astonished me; I mean, a hundred thousand. You think of 5,000 people losing their lives in Iraq and Afghanistan and how big a number that feels. This is an annual loss of life in this country. I thought to myself, "That's extraordinary, that that's not a front and center of national debate. It's almost background noise."

But what his article is about was even more interesting. It was about a doctor who had developed a series of sterility protocols and was running around the country trying to convince hospitals to adopt them. They were basically costless: a matter of how you organize work rather than any actual spending. He was having a hard time getting through hospital bureaucracies and their relationships with physicians. That's what really set me off because I had seen in the ICU of a well-regarded, non-profit hospital an enormous amount of sloppiness and poor use of technology--in some cases no use of technology. My father twice was actually taken for procedures meant for other patients. A few hours before he died, when he was unfortunately well beyond the hope of recovering and it was very clear that he had only a few hours left to live, they came in to do a blood test. I remember saying, "Why are you doing a blood test?" It was clear that it was auto-piloted. So much was auto-pilot. You understand that perhaps at a local Burger King, you really don’t understand that at a hospital dealing with life and death issues.

But getting back to Gawandi’s piece, I thought to myself, there’s got to be a business reason that this happens. You know, I’ve run a bunch of different types of businesses in technology and media, and in all of them, for bad things to persist, poor products, bad customer service, high prices, any of the realms of inefficiency, something needs to structural explain it, a lack of competitors, a company structure that favors management or employees over customers. And for it to occur in an entire industry, it’s got to tell you something about the incentives and relationships between employees, professionals if you will, in the provider world--the institutions and customers--because for this to persist for such a long time, from a businessman’s perspective, means there is something wrong in the underlying structure and the underlying incentives.

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