Column: Roger's Soapbox

Stupidity: A Medical Mystery

By: | August 29, 2017 • 3 min read
Roger Crombie is a United Kingdom-based columnist for Risk & Insurance®. He can be reached at [email protected]

Civilization began some 8,000 years ago. Yet we have never sorted out health care. Man on the moon? Instant worldwide communications? No problem.

Efficient health care for all? Not a hope.

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Three main systems have been tried. In the U.S., whatever help you can afford is available, but millions can’t afford any.

In the UK, everyone is entitled to free health care, but must wait their turn. In parts of the East, health care premiums are paid only by the healthy, but not everyone can afford to be well.

The U.S. situation is fluid, and I know little of the Orient, but I can speak on socialized medicine. And I shall.

Insurers live by the law of averages (and golf). Having enjoyed pretty good health over my lifetime, the law of averages dictates that I would eventually need more frequent medical attention.

This summer, I met socialized medicine and fought it to a tie.

In the UK, the National Health Service (NHS) provides free care to anyone in the country for any reason.

It’s a wonderful concept, but an often harsh reality. Serious underfunding renders people and equipment scarce. That’s a recipe for catastrophe, but in the main it works. It’s probably impossible to effect political change that would improve it meaningfully.

We worship money, but it’s useless if you’re unwell. For all the great medical achievements, the best we can offer around the world is half-assed medical care. What are we, just stupid?

The politicians who so callously underfund the NHS have private health insurance. I have private health insurance, covering only major medical. It would move me nearer the front of the line in case of urgency.

When the first disorder appeared a few weeks ago, I went to a private hospital. The receptionist asked why I had not gone to the NHS. I said I didn’t want to eat up its limited resources, and would rather pay for treatment.

Too bad. One may not, by law, see a private doctor before seeing one’s NHS doctor to seek a referral. “This is not America!” the receptionist barked at me. How I wished it were, Trump and all.

Off, then, to my NHS doctor’s office to make an appointment. A 10-day wait to see him was required. On appeal, I was allowed to see a trainee doctor a few days later. She solved the problem: mission accomplished.

An unrelated serious disorder broke out a week later. On my way to book a doctor, I took a turn for the nurse — my father’s perennial joke when illness threatened. And so to the NHS emergency room.  A doctor diagnosed a severe infection and prescribed antibiotics, which led to manifold allergic reactions. That meant a visit to an NHS walk-in clinic.

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That very afternoon, a new problem arose. I’m a wreck, baby. Back to the emergency room. After four hours waiting, my symptoms disappeared, so I did too. Days later, I was back at the clinic, referred to emergency (jamais deux sans trois) and given steroids.

In all, I’ve seen four different doctors and three nurses, and received four medicines. Total cost: $0.

Steroids supposedly induce rage.

Here’s some rage: We worship money, but it’s useless if you’re unwell. For all the great medical achievements, the best we can offer around the world is half-assed medical care. What are we, just stupid?

More from Risk & Insurance

More from Risk & Insurance

Risk Management

The Profession

This senior risk manager values his role in helping Varian Medical Systems support research and technologies in the fight against cancer.
By: | September 12, 2017 • 5 min read

R&I: What was your first job?

When I was 15 years old I had a summer job working for the city of Plentywood, mowing grass in the parks and ballfields, emptying garbage cans, hauling waste to the dump, painting crosswalk lines.  A great job for a teenager but I thought getting a college degree and working in an air-conditioned office would be a good plan long term.

R&I: How did you come to work in risk management?

I was enrolled in the University of Montana as a general business student, and I wanted to declare a more specialized major during my sophomore year. I was working for my dad at his insurance agency over the summer, and taking new agent training coursework on property/casualty risks in my spare time, so I had an appreciation for insurance. My dad suggested I research risk management for a career, and I transferred sight unseen to the University of Georgia to enroll in their risk management program. I did an internship as a senior with the risk management department at Sulzer Medica, and they offered me a full time job.

R&I: What could the risk management community be doing a better job of?

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We need to do a better job of saying yes. We tend to want to say no to many risks, but there are upside benefits to some risks. If we initiate a collaborative exercise with the risk owners — people who may have unique knowledge about that particular risk — and include a cross section of people from other corporate functions, you can do an effective job of taking the risk apart to analyze it, figure out a way to manage that exposure, and then reap the upside benefits while reducing the downside exposure. That can be done with new products and new service offerings, when there isn’t coverage available for a risk. It’s asking, is there anything we can do to reduce the risk without transferring it?

R&I: What emerging commercial risk most concerns you?

Cyber liability. There’s so much at stake and the bad guys are getting more resourceful every day. At Varian, our first approach is to try to make our systems and products more resilient, so we’re trying to direct resources to preventing it from happening in the first place. It’s a huge reputation risk if one of our products or systems were compromised, so we want to avoid that at all costs.

We need to do a better job of saying yes. We tend to want to say no to many risks, but there are upside benefits to some risks.

R&I: What insurance carrier do you have the highest opinion of?

I’ve worked with a number of great ones over the years. We’ve enjoyed a great property insurance relationship with Zurich. Their loss control services are very valuable to us. On the umbrella liability side, it’s been great partnering with companies like Swiss Re and Berkley Life Sciences because they’ve put in the time and effort to understand our unique risk exposures.

R&I: How much business do you do direct versus going through a broker?

One hundred percent through a broker. I view our broker as an extension of our risk management team. We benefit from each team member’s respective area of expertise and experience.

R&I: Is the contingent commission controversy overblown?

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I think so. The brokers were kind of villainized by Spitzer. I think it’s fair for brokers and insurers to make a reasonable profit, and if a portion of their profit came from contingent commissions, I’m fine with that. But I do appreciate the transparency and disclosure that came out as a result of the fiasco.

R&I: Are you optimistic about the US economy or pessimistic and why?

David Collins, Senior Manager, Risk Management, Varian Medical Systems Inc.

While we might be doing fine here in the U.S. from an economic perspective, the Middle East is a mess, and we’re living with nuclear threat from North Korea. But hope springs eternal, so I’m cautiously optimistic. I’m hoping saner minds prevail and our leaders throughout the world work together to make things better.

R&I: Who is your mentor and why?

My Dad got me started down the insurance and risk path. I’ve also been fortunate to work for or with a number of University of Georgia alumni who’ve been mentors for me. I’ve worked side by side with Karen Epermanis, Michael Rousseau, and Elisha Finney. And I’ve worked with Daniel Dean in his capacity as a broker.

R&I: What have you accomplished that you are proudest of?

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Raising my kids. I have a 15-year-old and 12-year-old, and they’re making mom and dad proud of the people they’re turning into.

On a professional level, a recent one would be the creation and implementation of our global travel risk program, which was a combined effort between security, travel and risk functions.

We have a huge team of service personnel around the world, traveling to customer sites to do maintenance and repair. We needed a way to track, monitor and communicate with them. We may need to make security arrangements or vet their lodging in some circumstances.

R&I: What do your friends and family think you do?

My 12-year-old son thought my job responsibilities could be summed up as a “professional worrier.” And that’s not too far off.

R&I: What about this work do you find the most fulfilling or rewarding?

Varian’s mission is to focus energy on saving lives. Proper administration of the risk function puts the company in a better position to financially support research that improves products and capabilities, helps to educate health care providers and support cancer care in general. It means more lives saved from a terrible disease. I’m proud to contribute toward that.

When you meet someone whose cancer has been successfully treated with one of our products, it’s a powerful reward.




Katie Siegel is an associate editor at Risk & Insurance®. She can be reached at [email protected]