“Thanks. Is that your job, the provider panel?”
“Along with the other duties that go along with being Mr. Halliday’s personal assistant. I understand you two haven’t met each other yet. We should take care of that right now.”
Will had seen some photos of the Excelsius Health CEO, but none of them conveyed the force of the man. He was slightly taller than Will, perhaps six-one, with dense, pure white hair, the weathered face of an outdoorsman, and eyes so intensely gray that Will wondered if he was wearing some sort of tinted contacts.
“So, Dr. Grant,” he said, impaling Will with those eyes. “After years of sniping at us in the press, you finally get the chance at an all-out frontal assault.”
Will was immediately en garde.
“I hadn’t intended any sort of assault, Mr. Halliday, just a dissemination of the facts as I know them.”
“Yes, of course, facts. That will be refreshing.”
That did it. Halliday had only one chance to make a first impression, and as far as Will was concerned he had used his poorly. They were enemies and would remain so until the man did something incredibly admirable.
“I had been led to believe that this evening was going to be a civil discussion of the issues,” Will said, feeling the heat in his face that used to follow being called Willard.
Halliday’s smile held no warmth.
“Dr. Grant, you are publicity director of an organization that is trying to hurt my company, if not put it out of business altogether. I intend to be civil with you only as it suits my purposes.”
“Well, well, well, I see that we’ve all gotten acquainted with one another,” Roselyn Morton gushed as she approached the four combatants.
She was a lusty woman, straight out of the society pages, meticulously coifed and wearing a form-fitting designer dress that aesthetically could have been a size larger, or even two. The four men introduced themselves and shook her hand, although it was clear to Will that she and Halliday had some prior connection.
Morton took several minutes to review the format of the evening, which she said was to be a brisk, issue- oriented presentation and discussion surrounding managed care. There was to be a fifteen-minute opening from each side, followed by ten minutes each spent addressing the points made by the other. Next there would be five questions for each team chosen by a Wellness Project committee from audience submissions, with a strict two- minute limit on the answers.
“If I tell either of you that time is up, I would like you to stop immediately,” she said. “Mr. Gold and Dr. Lemm may speak at any time, but the minutes they take will be counted against your side. Lastly, there will be five minutes for each team for summation. The side that goes first at the beginning will go last here. If all goes well, we’ll be done in an hour and twenty minutes. Questions?”
“Who goes first?” Will asked.
Roselyn Morton looked over at Halliday.
“Oh, I’m sorry, Dr. Grant,” Halliday said. “I was asked about this a couple of weeks ago, and said it was perfectly all right with me if your side went first.”
“Did Dr. Purcell know that?”
“I assume so.”
“Well, he didn’t say anything to me about it.”
“Gentlemen, gentlemen,” Morton pleaded, “supposing we simply flip a coin. Winner goes first. Dr. Grant?”
“Heads,” Will said, certain only that if Halliday wanted him to go first, there must be some disadvantage for him to do so.
“Heads it is,” Morton sang out.
From a spot beside the stage, Will and Tom Lemm watched the sellout crowd assemble. There were uniformed security people patrolling the main floor and up in the balcony, and Will knew there were police scattered about in street clothes as well. Reporters and cameramen filled the back of the hall.
“So, Will, what’s your take on Boyd Halliday?” Lemm asked.
“Clearly not a man who enjoys coming in second.”
“Do you?”
“I hope I don’t disappoint you, Tom, but my finish-first-at-all-costs phase caused me nothing but trouble and pain. Most of the time now I’m more than satisfied with just competing and trying my best, regardless of whether I win or not. In fact, except for in the OR, I think winning is often vastly overrated. Christ, is that the governor?”
“This is big stuff, Will.”
“Tell me again why I’m the one with the dueling pistol and you’re the second?”
“Because I’m dull and I can’t stand to lose. Listen, don’t worry. You’ll handle this guy fine.”
Jim Katz and his wife, Julia, entered with Gordo and his wife, Kristin. Behind them came Susan, who was unaccompanied but looked less drab and bookish than usual in a tweed wool suit. Cameron was the first to spot Will and pointed him out to the others, who smiled and waved. Then he left the group to give Will a bear hug.
“No kilt?” Will asked.
“Knowing your curiosity about what lies beneath, I dinna want to distract you. Are you ready for battle, Braveheart?”
“Gordo, the truth is this all sounded better when I said I’d do it than it does right now.”
“I can’t believe it. The lad is cool as kelp in the operating room, and here he is shaking in his boots.”
“I can’t help it if I’m allergic to humiliation.”
“Well, you better be entertaining. I told Kristin this was our night out for the month.”
“Hey, easy does it. I can’t handle any more pressure.”
“Well, then, make us proud.”
“I’ll try.”
“What’s this Willard thing?”
“A misprint.”
Roselyn Morton’s opening remarks were neutral enough, although at one point she did aver that excesses in the former system of fee-for-service health care gave birth to the need for major health-care reform, a conclusion that Will felt was debatable.
“Dr. Willard Grant.”
To polite applause, Will took the stack of notes he and Lemm had prepared, which included pages with the PowerPoint slides printed on them, and woodenly approached the podium. Clearly, he appreciated now, it would have been better to go second. With no idea what approach Halliday was planning to take, he would have to stick to the script he and Lemm had put together.
“It has been well over twenty years,” he began, “since the onset of myriad attempts to reform the fee-for- service delivery of medical care that many physicians grew up with. The current incarnation, an alphabet soup of various forms of managed health care, has pitted physicians and patients alike against insurance companies, physicians against other physicians, and even physicians against patients. There are lawsuits upon lawsuits, skyrocketing physician dissatisfaction, rampant early retirement, and an unprecedented malpractice crisis.
“Many managed-care programs feature coverage called capitation, in which primary-care physicians are paid a set amount to deliver care to a patient for a year. Any lab tests, X-rays, and specialist consultations are paid for from that up-front money. What remains at the end of a year is what the physician gets to use to pay the expenses of his practice and feed his family. The initial amount paid is hardly large, and primary-care physicians know they are in essence being paid to cut corners. If a doctor goes over the budget in his evaluation and treatment, the excess is his responsibility.”
Will glanced briefly at the audience for anyone nodding in sympathy and understanding with his points. If there were such people out there, he missed them. A few already seemed asleep. With the help of the PowerPoint tables and charts, Will illustrated that there are more uninsured now than there were before health-care reform began-more than forty million. He spoke of the more than 350,000 patients refused care in hospital emergency rooms last year because they couldn’t pay. He showed graphs comparing the per-patient cost in the U.S. versus countries with national health insurance, such as Canada and Great Britain. Careful to omit the three who had recently been murdered, Will listed the astronomical salaries and stock holdings of the top ten managed-care
