Unnecessary Roughness

I’m back on my home beach after leaving Alligator Healthcare just ahead of Hurricane Dorian. Those kinds of thrills I don’t need.

Instead, it is now time for the thrills, despair and futility of Cal football. My fondest memories of my time as an undergraduate and graduate student in Berkeley include hiking up the hill with my pretty girl friend (who would become my wife) to the stadium. There I learned the value of tradition and the meaning of mediocrity as the Cal football team year in and year out struggled. Still, I held out hope that this would be the year we would go to the Rose Bowl. I am still hoping.

This week I again made the uphill hike to the stadium with my oldest son and an old friend, more slowly and with more determination. My wife, a realist, stayed home. She will be sorry. This may be the year we go to the Rose Bowl. The world needs more optimists and fewer realists. Except in my house.

In the years just before I hit the beach, Cal football was a source of additional frustration. Cal football was now sponsored by Sutter Health, a competitor to my organization. The stadium was plastered with Sutter Health signs. What’s more, sometimes Sutter representatives got to participate in the coin flip at the start of the game. Color me green for envy.

We more than held our own in the competition with Sutter and the other big guy in our service area, the Big K (Kaiser). As I have discussed elsewhere, we were nimble and they, like many Cal football teams, were ponderous. We were managed and governed locally and responsive to local needs. They were not. We more often than not scored a touchdown locally. They often fumbled. The home team won. The visitors lost. I could go on in this vein and it would be fun but I think you get the picture.

These thoughts were triggered by an article in the San Francisco Chronicle this week about a class action antitrust suit brought against Sutter in 2014 by employers and employer trusts that cover their employees’ health care costs. The trial begins this month. The plaintiffs contend that Sutter, because of its size, abuses its market power in negotiations with health plans and is able to force the health plans (the poor darlings) to agree to unfair contracts terms. Most of these plans dwarf both Sutter and the Big K in size but appear to want to be looked at the same way the USC football team looks at Cal–as victims.

Not to be undone, California’s Attorney General, who sues anything and everything, piled on last year with his own antitrust suit against Sutter, probably to compensate for all the years he served in Congress and did nothing. In football, this is called unnecessary roughness. In politics it is called grandstanding.

I know enough about antitrust law to understand that it is complicated for even the average attorney to comprehend, much less the average non-attorney like me. I do know that such legal suits are extremely expensive to bring to trial so the fact that Sutter is doing so indicates their faith in their defense.

Big systems like Sutter and Kaiser developed because of public policy decisions made by legislative bodies. Consolidation of hospitals and doctors into integrated systems was thought to result in more efficient and better quality care. No one really knows whether that is true and studies seem to be contradictory.

I do know that competing against Sutter and the Big K kept us on our toes. I also know that employers could do a lot more to control their health care costs but lack the courage to educate their employees and also confront their unions. In this game, the penalty is being called on the wrong team. We Cal fans know what that is like.

I never ever thought I would say this but GO SUTTER!