The Lesson Of Georgia’s 6th: What The New MD Anderson President Can Learn

By

Leonard Zwelling

According to all the news accounts, the race to fill the House seat vacated by Dr. Tom Price who became head of HHS, was the most costly in history. Yet, the result was the same. The Republican, Karen Handel, defeated the upstart young Democrat Jon Ossof in a largely red district that stayed red. Why couldn’t the money sway the voters in a district full of highly educated voters who almost went for Hillary?

In the end there were probably two reasons. First, Ossof chose to live outside the district with his medical school girlfriend. That was not smart. Second, and far more importantly, the Democratic message is still not clear. Despite having a target as big as President Trump, Democrats can still not articulate what they are for. This was probably true in Georgia and is certainly so in the rest of the US. If the standard bearers of the Democrats are Bernie Saunders, Nancy Pelosi and Elizabeth Warren, the Dems have a problem. The messengers are old. So is the message.

The Blue team is still trying to put together a coalition of the poor, the people of color, the Hispanics, the young, and the hyper-educated to arrive at a majority. This will not work. What they need are some new ideas to appeal to most Americans not in one of the above groups. The lesson from the voting on June 20 is that the GOP may have ideas you don’t like, but at least it has ideas. The Dems are a little short on articulating a direction in which they wish to take the country. If ObamaCare is your best argument for a health care policy, you have come up a bit short.

This is a good lesson for the next president of MD Anderson. You are going to have to be FOR something. Being against the last guy is not the answer.

So where is MD Anderson now that necessitates a change in direction and a good, terse statement of what that direction is, and it is not “making cancer history?”

For at least 20 years, MD Anderson has been using a business model of high prices for care supplying the revenue for all other aspects of its mission—education, research and prevention. That profit of a non-profit is called the margin and MD Anderson is lucky it isn’t being taxed given the degree to which it gives away care (small). Philanthropy is less than 10% of the budget and it is a fact that research grants cost the institution money as the indirect costs associated with most grants do not offset the actual overhead accrued in doing research. As payers have tried to control their costs—private insurers and Medicare—the revenue is slipping. This fact was juxtaposed with outrageous spending on the part of the last MD Anderson administration. That model had posited a second possible revenue stream. That was the money from drug development and the commercialization of research discoveries. Unfortunately, that is a long-game strategy and the past president was unable to make it real in five years. He also was unable to get the support of the faculty for his vision and no matter what the vision of the leadership is, the faculty must back it, if it is to be realized.

So now a new leader will be coming to Anderson. It is imperative that he or she not just be against what occurred before, although he or she needs to make it clear that the institution is going in another direction. He or she must articulate the strategy going forward that will secure the mission, eradicating cancer, if possible, fulfilling the core values of caring, discovery and integrity for sure and doing all this while keeping the place in the black.

This is a tall order.

The Democrats have still not accomplished this on a national level and so are still behind the eight ball in any close election.

It will be critical for the new leader at Anderson to have a vision, state it, and have the will to keep the train on the track while keeping the boat afloat. That may be one too many metaphors, but you get my drift. The new person better have some new ideas if he or she wants the backing of the faculty and without that backing, he or she has no hope of success.

Leonard Zwelling