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Keeping the Big Boss Healthy -- at a Cost

Maybe it's because I've never been an "executive" myself, but there's something rankling about these executive health centers that have been popping up in the D.C. area and across the country in the past 20 years or so.

The rationale for these centers is that busy executives purportedly need access to convenient and comprehensive preventive and diagnostic health care in a setting that befits their professional status and on a schedule that interferes as little as possible with their work.

Most executive health centers offer a full day's assortment of screenings plus physical examinations by a team of doctors. Typically they accommodate only a handful of patients per day and charge $2,000 or more. Many end the day with a soothing massage or other spa treatment. As you can imagine, insurance often doesn't cover the cost.

A publicist's note announcing the Feb. 2 opening of The Penn Center for Executive Health, part of the University of Pennsylvania Health System, observes that an executive's health can have a "ripple effect that impacts the bottom line." We've certainly seen that in the case of Steve Jobs's mysterious hormonal imbalance, which has plagued the pancreatic-cancer-survivor and Apple CEO recently. In light of Jobs's apparent ill health -- and suspicions that the whole truth is not being told -- investors have been unnerved, and the company's stock rises and falls with each new Jobs-health update. So, yes, a business leader's health troubles can have far-reaching ramifications.

I believe in capitalism and the free market, and I suppose that people who have $2,000 to spend on a single day's health care should be able to avail themselves thereof. And I'm not trying to pick on the Penn Center -- which is open to non-executives (if they can afford it) and doesn't offer spa treatments. They're just the ones who happened to send me a press release. In response to my questions, the folks there told me that the new Center is actually an extension of services that they've offered at another site for 9 years; the expansion is due to high demand.

Here's what Marilyn Howarth, medical director of the Penn Center for Executive Health, has to say:

Although the conditions of the current economy seem counterintuitive as the time to expand this program, The PENN Center for Executive Health is needed now, especially in this economy, because the mounting pressures executives face to keep companies afloat are causing many to become more likely to neglect their own health. ... The added cost that executives choose to incur pays for the convenience of having appropriate medical services arranged for them; the Center is open to anyone who wants to take advantage of the program. The revenue realized from this program is used to fund other programs, including those that serve patients who cannot afford medical care.

That last part is nice. Still, I think it takes quite a tin ear to be promoting such services at a time when many American families would treasure that $2,000 and stretch it to cover many months' medical care.

The image of some CEO checking in to an executive health center for state-of-the-art-screenings (and sometimes spa treatments) reminds me of those Detroit auto executives' taking their private jets to Washington to beg for bailout money. Sure, they were free to do so, and it might have made some sense in many ways. But after a sound bashing in the Senate and the media, the car guys made sure to drive to Washington for their next begging session.

Maybe the health centers should take a hint. I don't begrudge anyone access to the best health care they can possibly afford. But when that care is so superior to what's available to the rest of us, and when it includes an element of pampering that's foreign to most, the whole thing just seems elitist. Highlighting the stark contrast between the haves and the have-nots can only further polarize the already ugly -- and sure to grow uglier -- debate over health care in America.

By Jennifer LaRue Huget  |  January 28, 2009; 7:00 AM ET
Categories:  General Health  
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In public health we often talk about healthcare provided in a “culturally appropriate environment” How is this different?

Posted by: TED3MSC | January 28, 2009 12:52 PM | Report abuse

I agree that people who can afford it should be able to pay these prices for a day's health care; but the executives don't pay - the companies foot the bill and therefore the stockholders pay.

Posted by: JCharles1 | January 28, 2009 1:17 PM | Report abuse

I agree; many, if not most, of the services offered by these clinics lack evidence of clinical or cost effectiveness. I find two parts of your piece highly ironic:

1. Why do CEOs, who should rightly be concerned about the cost and quality of healthcare they pay for on behalf of their employees, think this is a good use of dollars?
2. Why do academic health centers, with a mission of educating the next generation of doctors and other health professionals, think these clinics are consistent with their mission?

Posted by: MDRoadRunner | January 28, 2009 1:44 PM | Report abuse

I completely agree with JCharles1. And I think consideration should be extended to what affect a company's reimbursement of the executives pay-as-you go health insurance has on the general workers plan structure and cost? I'd be interested in knowing the current statistics on companies that are cutting health care for common workers and the reimbursements for executives.

I wouldn't be surprised if there are discriminatory actions here. And are the executives paying taxes on these fringe benefits?

Posted by: mgway1 | January 28, 2009 2:15 PM | Report abuse

Extra-special health treatment and goodies for executives (paid in full by the company so as not to compromise the purity of the experience) are wonderful, and I speak from experience. It saves time and reinforces the feeling of being, well, precious! And doctor/doctor tends to not be so uppity when he knows that he is dealing with a bona fide tycoon.

"Mind if I smoke, Doc?"

"No sir. Go right ahead."

It sure beats waiting in a crowded clinic among all those sick people! Been there and done that, too. I, like any other person, prefer special treatment. Let's not call a spade an agricultural implement; let's call it shovel.

Posted by: squarf | January 28, 2009 3:01 PM | Report abuse

In 'Keeping the Big Boss Healthy-at a Cost,' Ms. Huget suggest that executives willing to pay $2,000 for a day of testing at The Penn Center for Executive Health and other such centers are somehow akin to auto executives flying private jets to Washington to ask for federal bailout money.
The executives seeking such health care do so because their time is extremely limited. The one-day service they seek makes them more likely to spare the time to get tested at all and as pointed out, it also helps to fund health care services for those who cannot afford it.
In comparison, the auto execs she cites are asking for direct taxpayer assistance for a cause we may deem worthy, or not. To suggest a correlation is indicative of a pathology that may, itself, require extensive testing.
These executives don't get better care than the rest of us. They simply get care that meets their schedules, saves time and helps support centers of excellence that serve all of us.
Yes, these are difficult economic times. Yes, the wealthy get thing we don't get. But paying for one-day services that may include, for example, a colonoscopy, shouldn't induce such envy.

Posted by: Betsy2009 | January 28, 2009 3:11 PM | Report abuse

If we somehow manage to overhaul our national healthcare system, will we really all receive equal care? Or will the wealthy, some doctors, and hospitals opt out and create "boutique" health care (Canada, often touted as a model for health care reform has a parallel private health care network for those dissatisfied with their health care system and able to pay for better, faster care. Sometimes Canadians come to the US for health care).

So... if need be,will we all be able to get in the Mayo Clinic at a fee we can afford?

Posted by: GWGOLDB | January 28, 2009 4:08 PM | Report abuse

The same arguments are used to justify private jets for executives. Just as GM about that one, please.

Posted by: george11 | January 28, 2009 5:04 PM | Report abuse

There are two issues.

1. Executive compensation. It's an issue. Let's save it for an article on executive compensation.

2. Pricey spa-style health care. Let's look at this one a different way:

Academic health centers have figured out that, if they throw in a bathrobe and a cup of Tazo, they can charge rich people thousands of dollars extra for health care.

Why is that bad again?

If rich, powerful people pay LESS for health care, that's a scandal. But if they pay more... seriously, isn't that all nice and populist?

Posted by: JayL1 | January 28, 2009 9:13 PM | Report abuse

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