Leaders Must Lead
I told them that it wasn’t about the past or even the present, but it was about the future, and the future of healthcare is a huge unknown. No one likes the system. Big insurers are routinely blamed for its ills, and we don’t know what changes or reforms are coming that could dramatically change our business model. I also told the board that I believe our healthcare system is fundamentally broken, and all the players involved—hospitals, providers, drug and device companies, regulators and insurers—fight to maintain a status quo from which they are benefiting. While Aetna has figured out how to prosper in that system, we should be leading the inevitable change, not responding to it.
“If we’re not influencing healthcare and are just paying claims,” I said, “we’re dead.”
Skeptics of the CVS deal understandably wondered how we could truly transform such an ossified, complicated system. We’ve been receiving healthcare the same way for so many decades, it takes some moxie—or maybe blind faith—to imagine that it could be done any other way.
I have absolutely no illusions about how difficult the task will be, but I’m tired of people talking endlessly about “healthcare reform,” drafting white papers, holding conferences and expressing dismay. It’s time to act. If leadership means anything, it means seizing the moment, embracing a bold strategy to solve big problems and executing on it. That’s what the CVS deal was all about. It may take a generation, but it’s an opportunity to redefine how we deliver care and reconsider the very meaning of health and wellness.
For the effort to succeed, the implementation will be critical. A thousand details will have to be monitored, and you’ll need a maniac with the focus, the tenacity and the urgency to resolve them all.
I won’t be that maniac. There was only room for one CEO, and Larry Merlo was it. He had the bigger balance sheet, and his is the acquiring company; so he deserves to lead the new organization. If the Humana deal had gone through, I probably would have been in that spot, and I would have relished the opportunity. But that’s not how the cards played out. I could have maintained Aetna as an independent company and continued as its CEO, but it’s not about me or my legacy, and it’s not about what my predecessors had built. It’s about the future.
I spent 15 years at Aetna, and I consider my departure one more example of how sometimes leaders have to lose attachments for the greater good. It may hurt, but it was the right thing to do. New challenges await.