NEGOTIATING THE HEALTH CARE MAZE

Even the most dynamic business minds and creative problem-solvers can be thrown for a loop by health care setbacks.

Under those circumstances, wealth and success suddenly don’t mean as much ‚Äì not just because an illness can refocus priorities, but because the abilities and insights that apply to the business world aren’t much help when it comes to negotiating the maze of the health care system. Successful entrepreneurs and business leaders not only have to confront a baffling system just like anybody else, but they often feel special burdens under these circumstances.

As with all things, being prepared can help ‚Äì and I’m not just talking about staying healthy and having good health care insurance. Having a process for getting useful advice and making informed decisions is also essential preparation for a health crisis.

An Ever-Changing Maze

We are all painfully aware of what a bureaucracy the U.S. health care system is, and with Obamacare under widespread criticism, we expect the rules to change yet again in the next few years. Maintaining coverage and accessing care under that coverage seem like they should be straightforward things, but it is easy to stumble over hidden obstacles.

There is also a positive aspect to the mutability and complexity of health care, and that is the constant innovation that is going on. New medications and surgical procedures, nanotechnology, genomics, and stem cell research are all making possible treatments that could not have been attempted a decade ago. That’s great in the long-run, but when dealing with an immediate situation these emerging techniques only add to the difficulty of identifying and assessing possible solutions.

Julian Flannery, co-founder and CEO of SUMMUS, an organization which helps its members access health care solutions through a national advisory network, describes the challenge this way: “When it comes to health care, as E.O Wilson famously said, people today are drowning in information but starving for wisdom. They need a way to cut through the noise.”

The Burden of Leadership

There’s no doubt that financial resources can help with access to health care, but successful entrepreneurs also face a number of special challenges when it comes to handling health care problems.

First of all, families – often extended families – routinely turn for leadership to those among them who have been the most successful. This may mean that when a health care situation becomes complicated, the burden will fall on you. These days, this tends to happen right when people are in the prime of their careers.

“Members of the ‚Äòsandwich generation’ most often have the need for health care guidance and expertise,” explains Flannery. “They not only have to look after their own needs, but often are responsible for children and their parents’ needs as well.”

Shouldering that responsibility is probably fine with most entrepreneurs, because successful people are used to taking charge. However, the second problem is that when it comes to the health care system, you don’t get to make the rules. In fact, that system often does not operate according to the rules of business as we know it.

Finally, another reason why successful people feel the burden of solving health care problems especially acutely is they are used to being experts in their given fields. Through their studies, experience, and continual monitoring of conditions, they are used to being able to solve any problem that comes up – in their own field. Suddenly being reduced to being a virtual novice in the field of health care can be very frustrating.

Steps Through the Maze

As is usually the case with complex problems, there are no simple solutions to the health care maze, but there are sensible steps you can take. Here are some thoughts to guide those steps:

• It’s a family affair. Making health care decisions may well extend beyond yourself and your spouse and kids to also include your parents who have moved down south or perhaps an elderly aunt or uncle halfway across the country. Therefore, you need to be prepared to think beyond your own situation and location.
• The best answers are not always local. Another reason why it helps to cast a broad net for information and contacts is that with specialized treatments being developed in a variety of locations around the country, the best solutions to a health care problem are often not found through local referrals. Come to think of it, because of your business activities, you may not always be near home, which is another reason to make sure your health care options are not limited by location.
• Good answers come from good questions. Getting a consultation with the right expert is a step in the right direction, but when it comes to those sessions, people often find themselves overwhelmed by the unfamiliarity of it all. It is important to be prepared with enough research to know the right questions to ask and understand what information you are seeking.
• The truth can take time. A common complaint about the health care system is that the top practitioners are often too hurried to have meaningful conversations with patients. This means that neither the problems nor the potential solutions are adequately explained. It is important to cultivate relationships that will result in more meaningful time being devoted when the need arises.
• Networking is not just for business. This all boils down to something that is very familiar to many entrepreneurs: networking. “Successful people know exactly where to go to get prompt access to great legal advice, but they often do not have the same kind of access to leading health care practitioners,” explains Flannery. Whether you develop a network of contacts and information sources yourself or access an established network, you need to be able to tap into health care advice as readily as you can tap into business advice. After all, solving a medical problem is even more important than nailing down that distribution deal, and may be more time-sensitive.

To a large extent, what all this comes down to is being well-organized. You can take the time to cultivate a broad-based network of go-to sources for health care advice, or there are also existing networks you can tap into. In either case, the key is to be prepared in advance.

Barbara GoodsteinPresident & CEO of TIGER 21