blog.fixkp.org

Daniel Garcia is the chief compliance officer of Kaiser Permanente, a sort of “chief investigator” for the organization. He was hired into that position, a position he helped create, in 2002. His history with Kaiser Permanente, however, dates back to 1992, when he first became a member of the organization’s Board of Directors. He continued to serve as an outside and independent director until he became chief compliance officer on February 1, 2002.

What is interesting about Mr. Garcia’s role at the organization is that he reports to the chief executive officer, George Halvorson and is also responsible for investigating Mr. Halvorson’s conduct. This reciprocal reporting relationship is not unique, however, and similar situations exist at many other organizations and companies. What is troubling, however, is the disturbing role Mr. Garcia played in hiring Mr. Halvorson, the significant resulting conflict of interest, and Mr. Garcia’s alarming history in Los Angeles politics, which is littered with serious allegations of corruption. In fact, it appears Mr. Garcia has never met a potential conflict of interest he didn’t like, but more on that in a moment…

When Mr. Halvorson was recently forced to address the mutual conflict of interest, he, again, mislead Kaiser Permanente employees by leaving out key details. Mr. Halvorson admitted that Mr. Garcia was “was on the committee that recommended that I be hired.” In fact, Mr. Garcia was the chair of the committee that hired Mr. Halvorson.

Mr. Halvorson went on to insist that “It’s…naïve, however, to say that Dan can’t subsequently do his job [as the chief of] compliance because of that prior committee role.” Mr. Halvorson insisted that he believes that demanding otherwise would mean that “any Board member on a search committee would be unable to make future decisions and judgments about people they had voted for in a search process.”

His straw man argument couldn’t be weaker. Here’s why…

It is extremely rare for an inside director to chair a search committee, let alone an inside director who also happens to be the chief compliance officer. A chief compliance officer should be be above reproach, and avoid even the appearance of a conflict of interest.

Dan Garcia was an outside director when he was appointed to chair the selection committee. However, when he later became the primary candidate for the position chief compliance officer (which would have changed his status to a non-independent director), he should have stepped aside as head of the search committee. He didn’t. Instead, he created an even more troubling situation: Mr. Garcia hired Mr. Halvorson, the man who would become his boss. Mr. Garcia did so under the pretense of still being an “independent director.” Mr. Halvorson, by then the (not yet announced, but designated) chief executive officer, turned around and approved Mr. Garcia’s appointment as chief compliance officer. Tit for tat?

Perhaps if Mr. Garcia had been qualified to become chief compliance officer, the conflict would be less obvious. Instead, Mr. Garcia had no executive-level compliance experience or healthcare experience. In fact, Mr. Garcia’s most recent executive position at that point had been as a real estate advisor for a movie studio. That apparently qualified Mr. Garcia to make well over $1,800,000 each year as Kaiser Permanente’s chief compliance officer.

Take a closer look at the timeline:

In July 2001, then-Kaiser Foundation Health Plan chief executive David Lawrence announced he would be retiring, and Mr. Garcia was selected by the board to be the independent director who would chair the search committee.

Over the following months, Mr. Garcia eventually became a candidate to become the organization’s new chief compliance officer.

By October 2001, Minnesota Attorney General Mike Hatch had announced he intended to launch an investigation into Mr. Halvorson and his then-employer, HealthPartners.

By January 2002, Mr. Halvorson had become the lead candidate for the position, meaning he likely began receiving briefings on the organization’s operations, and almost certainly began having input into any major decisions the organization was making, such as… The appointment of Mr. Garcia on February 1, 2002.

Mr. Halvorson’s appointment was then announced by Mr. Garcia on March 7, 2002, barely a month later.

Assuming Mr. Garcia wasn’t qualified for the position of chief compliance officer, perhaps his record as an attorney and politician alone would have been clean enough to assume he could be a sort of “chief ethics officer”? Sadly, no. From quietly recommending his future wife to a city position (without pointing out they had a relationship and while glossing over her previous conviction and short jail time for forgery), to serious allegations that he engaged in a “pay for play” relationship with Los Angeles real estate developer Ted Stein, to his troubling relationship with Leland Wong (who he subsequently was required to investigate at Kaiser Permanente), Mr. Garcia’s past is filled with allegations of conflicts of interest and abuse of power.

In a 2004 exposé, the Los Angeles Times highlighted Mr. Garcia’s lack of concern for avoiding conflicts of interest (let alone the appearance):

Under the City Charter, commissioners are required to disqualify themselves from voting on projects in which they have a conflict of interest or the appearance of a conflict. In a series of opinions dating back many years, the city attorney’s office has consistently held that a commissioner should withdraw ‘whenever the facts are such that the public might well question his objectivity.’ [...] But in voting on Stein’s zoning change, Garcia [voted to approve] the request.”

Mr. Garcia, who chaired the planning commission, voted to approve a string of other requests that Mr. Stein brought before the commission, without ever disclosing their past business relationship (until the Los Angeles Times came knocking).

It’s clear that Dan Garcia is neither qualified nor capable of serving as any sort of “chief compliance” or “chief ethics” officer. As a city politician, he time and time again resigned under the stench of corruption, moving from the planning commission to the police commission and finally the airport commission. By the time the Los Angeles Times did its exposé in 2004, Mr. Garcia was already firmly in place at Kaiser Permanente, protected by his boss (and the man he just happened to have hired), George Halvorson.

Making $1.8 million each year.

Tit for tat.

Please stay tuned. More information on the coming relaunch of FixKP will be posted very soon.

People ask me sometimes why I still care about Kaiser Permanente. It’s tough to put the reasons into words, except to say that I believe in what Kaiser Permanente stands for. Do you know what it’s like to believe in a country, and just not its current administration? It’s that way with me and George. Halvorson, that is. Mr. Halvorson is destroying the organization’s principles, credibility, and integrity. While that’s painful to watch, I know his time there is temporary, and I know the people of Kaiser Permanente can repair the terrible damage he’s done once he’s gone.

That being said, I spent a few minutes redoing the voiceover for the original Broccoli ad, and I’m calling it Broccoli People. I’m no Allison Janney, but I think one important change needed to be made to the ad. The original ad ends with “We are Kaiser Permanente, and we stand for health.” I’m adding one word: people. So, the new version, Broccoli People goes: “We are the People of Kaiser Permanente and we stand for health.”

It’s pretty obvious that George Halvorson believes in profit, not in health, and certainly not in Kaiser Permanente. But, the people of Kaiser Permanente, our doctors, our nurses, they do stand for health, and they do believe in the principles Kaiser Permanente was founded upon.

The San Francisco Business Times today called me a “persistent critic” who has become “no more enamored of the healthcare giant or its CEO.” I think, the distinction of the organization and its current administration is an important one, and a distinction the paper didn’t make. While I recognize and try to bring some light to the ongoing series of lapses in patient safety and care at Kaiser Permanente, I recognize those lapses are the result of George Halvorson’s mismanagement of the organization. Cutting costs, at all costs, is a dangerous proposition for a healthcare organization, especially one as integrated as Kaiser Permanente. (You can follow and discuss, more closely, the press reports of Kaiser Permanente’s lapses over at Kaiser Thrive Exposed.)

But back to the paper. The piece also seemed to imply that George Halvorson was safe in his job, a bit of a difference from a year ago when the paper mentioned that “Halvorson [has been] under fire…for a variety of financial and other challenges facing the Oakland-based organization.” This time around, the paper says that “there’s no sign that Halvorson is in trouble with…the board.” Considering he handpicked almost every member of the board, and considering the board seems to be about as concerned about governance as Halvorson’s last board, I’m not surprised. But, I wonder, has the San Francisco Business Times ever spoken with an independent Kaiser Permanente board member? Or, for that matter, has any newspaper in California spoken to any independent Kaiser Foundation Health Plan director?

The Business Times reprinted this bit from a recent entry: “Someday, soon, George Halvorson will be gone, and Kaiser Permanente will have member representatives on its board, it will have a physician as its chief executive…and it’ll have preventive medicine again as a core focus (not as an advertising gimmick).”

Someday, soon.

This story was originally posted at justendeal.com.

When Kaiser Permanente launched the Thrive campaign in 2004, it set out to redefine the way people thought about the organization. I wrote, back in 2005: “It makes a world of difference when you’re pushing forward with a cause and people know why you’re doing it. Our cause is helping people live healthier lives.”

There are 13,000 physicians, 30,000 nurses, dietitians, health educators, pharmacists, and other caregivers at Kaiser Permanente who do go to work every day to help our members.

Yet, as Kaiser Permanente spends tens of millions of dollars each year on the Thrive advertising campaign, the organization is increasingly rolling out health plans that seem to be more about revenue and profit than about preventive medicine (or even medicine, period).

It has been disappointing to see the promise behind Thrive weaken, because I recognized it as a campaign that could have really been transformational for the organization, and not just transformational for the organization’s external image.

Still, when I see a piece like Saturday, one of the two new spots for 2007, I realize there’s still hope for Kaiser Permanente, because for all the disappointing and disheartening stories of our failures, there are still so many people we help, every day. But, that’s another story for another day. So, Saturday. It isn’t flashy. It doesn’t try to sell you anything. It’s just a few shots from a day in the life of one Kaiser Permanente member, who happens to be a cancer survivor. It’s not too often that you can call a commercial “beautiful,” but Saturday is just that.

Here’s the longer, ninety-second version of Saturday…

There’s also a shorter, thirty-second version, which you can see here. (I think Saturday is the best spot from the campaign, even better than Signs. On the flip side, the other new ad, Kid Wisdom, is probably the worst. Go figure.)

My first major in college was public relations, so I pay attention to stuff like this maybe more than I should. But Thrive was, and I hope still is more than just advertising. It is a message. It could be a promise, a promise that if you are (or become) a Kaiser Permanente member, we’ll help you live your life healthier, and we’ll help you get better if something bad happens, and we’ll do all of this, in ways that most other healthcare organizations can’t or won’t. Someday, soon, George Halvorson will be gone, and Kaiser Permanente will have member representatives on its board, it will have a physician as its chief executive, it will have an empowered member’s ombudsman, and it’ll have preventive medicine again as a core focus (not as an advertising gimmick).

One day, soon, Kaiser Permanente will again stand for health.

This story was originally posted at justendeal.com.