"Linking Together: March to Save Our Care" Rally at the U.S. Capitol on June 28, 2017. Democratic Party Leaders and others spoke to defend the Affordable Care Act and to defeat Republican Party efforts to repeal so called "Obama Care" and replace it with "Trump Care" alternatives.
"Linking Together: March to Save Our Care" Rally at the U.S. Capitol on June 28, 2017.

Q&A: A health care exec who says people are ‘mistreated’

Dr. Robert Pearl
Dr. Robert Pearl

Name: Dr. Robert Pearl

Residence: Los Gatos

Profession: Physician, professor, author

J.: You served for 18 years as CEO of Permanente Medical Group, which is today a model for health care delivery systems. Why did you decide to step down?

Dr. Robert Pearl: I thought it was the right time to focus my energy on how to transform and change the American system of health care, not simply that of Kaiser Permanente. I published my first book, “Mistreated: Why We Think We’re Getting Good Health Care — and Why We’re Usually Wrong,”  in May. It’s a bestseller, and I’ve been speaking about it all over the country.

What prompted you to write this book?

My father, Jack Pearl, suffered life-threatening complications due to preventable medical errors. His doctors in New York assumed that his doctors in Florida had administered a vaccine he needed, and vice-versa, and it turned out none of them had. A series of events, which I describe in my book, led to his premature death. The medical system he relied on — not Kaiser — was broken, and I was pretty confident that if they had had an electronic records system that was comprehensive and all his doctors had worked together, he would not have had to die. In the bigger picture, I wanted to address the disconnect between what many Americans believe about the health care they are receiving and the data that shows that they deserve, and can have, far better.

What’s wrong with our country’s way of health care?

The American health care system resembles a 19th-century cottage industry. It’s fragmented, with doctors scattered across the community. It’s paid on a piecemeal basis, where physicians are paid for volume whether it does any good or not, and they’re using technologies that are half a century old. As a result, our nation spends 50 percent more than any other country in the world on health care and our results are in the lower half of the 20 most industrialized nations. We’re last in life expectancy among those nations, and second to last in childhood mortality. In the U.S. today, hundreds of thousands of people die unnecessarily every year, like my dad, from medical errors, failures of prevention and complications that could’ve been avoided. It’s inexcusable given how much we spend, and most people are unaware of it. The perception that we have the best health care in the world doesn’t match the data.

Your respect for parents and grandparents is evident in your book. What role does your Jewish heritage play in your values and pursuits?

The Jewish belief in the sanctity of life and the importance of helping others goes back thousands of years. I think the value placed on teaching in Jewish culture is also one that I’ve very much incorporated, so I would say my Jewish background has influenced me extensively both in my intellectual pursuits and in the values I bring to medicine.

All the profits from my book are going to the medical service group Doctors Without Borders. I’ve participated in a number of international medical service trips to operate on children with birth defects, and as the CEO of Kaiser I sent teams of volunteer physicians to Sri Lanka after the tsunami, Haiti after the earthquake and to Liberia to treat patients with Ebola.

Your book is being widely read and media are paying attention to it. Do you feel like anybody up on Capitol Hill is listening?

They are, but the challenge is that the government has not seen improving the delivery system of health care as something they wanted to, or could tackle — they’re just debating coverage. Much of why I wrote the book was to touch the patient in all of us. It’s my belief that when people understand what they don’t have, and what’s possible, they’re going to want it and demand it.

Were you surprised by Sen. John McCain’s “no” vote on the last GOP health care bill?

I was not surprised; he understands very well that the real problems of our system had not been addressed. To me, the coverage part is not the answer. The delivery system is the key to reform. Health care is too vital for it to fall inside bipartisan politics. My hope is that by transforming the American health care system in ways that my book argues for, hundreds of thousands of lives can be saved, and then my father’s death will not have been in vain.

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Laura Pall
Laura Paull

Laura Paull is J.'s former culture editor.