Bonus Add-on to EP483 (Part 1): Honoring Those in Healthcare Who Are Trying Every Day to Do the Right Thing, With Jonathan Baran

In this bonus clip from Episode 483 of Relentless Health Value, host Stacey Richter discusses the efforts of individuals working within large healthcare organizations to improve patient outcomes despite systemic challenges. 

Guest Jonathan Baran, co-founder and CEO of Self Fund Health, highlights how incentives within the healthcare system drive behaviors that often conflict with patient and member interests. 

The discussion emphasizes the importance of not generalizing the intentions of all employees based on organizational actions and encourages a deeper understanding of underlying incentive structures to foster meaningful changes. 

Self Fund Health, I am so pleased to tell you, as I am always so pleased to tell you, did make such a kind offer to help out Relentless Health Value financially. You and the tribe here are really, really great folks who I truly appreciate. Please support Self Fund Health if you are in Wisconsin.

This episode is sponsored by Self Fund Health.

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03:11 A brief background on Jonathan and Self Fund Health.

04:24 Why is it imperative that individuals stop identifying wholly with the organization that they work with?

05:48 Why is it important to be direct and call out the behavior without calling out the individual?

07:14 EP483 (Part 1) with Jonathan Baran.

Episode Transcript

Stacey Richter (00:02):
Episode 483, Bonus Clip.
Let's make sure we are honoring thosewho work inside large healthcare
organizations who are trying desperatelyevery day to do the right thing.
This is a clip from myconversation today with Jonathan
Baran.

Tom Nash (00:24):
American Healthcare Entrepreneurs and Executives
You Want to know, Talking.
Relentlessly Seeking Value.

Stacey Richter (00:33):
Okay.
This clip, you could call it a reel,I guess, because kids these days, but
I think it is a really important fouror five minutes or whatever, because
it's my guest on the pod this week,Jonathan Baran, and next week, actually.
And Jonathan Baran makes a veryimportant point, and this also comes
up, by the way, in the show with Dr.John Lee from a couple of weeks ago.

(00:54):
Large, consolidated health systems,large vertically integrated carriers, and
their PBMs and their GPOs in Switzerlandor Ireland or whatever, and some of
these large benefit consulting firms.
the hundreds of thousands of folkswho work in these places, some of
them for sure are on board for theride who don't really care about their
ultimate impact that they are having onpatients members or the non-healthcare

(01:17):
economy in the United States.
That's probably true.
It's also probably true that the majoritydon't actually understand what's going
on and the impact of their actions.
But there definitely is a cohort,there's a gang in there, and many
of this gang listen to the show, andthese folks are trying desperately
against every personal incentiveagainst lashback, against all odds.

(01:38):
They're trying to figure out how to gettheir organization to do a little bit
better for patients or members or plansponsors, actually, if we're talking
about anybody who works at some ofthese large benefit consulting firms.
We are not one with the stakeholderthat we work with, and if the object
is to do better by members andpatients, it's really incumbent on
us to understand what is going onin our very own neck of the woods.

(02:01):
We can't improve if we don't reallyunderstand what the problem is.
So the conversation that follows isJonathan Baran offering up a plea.
Really, on behalf of these folks ourknights, if you will, to please not
generalize the intentions and valuesof everyone who works somewhere and
assume that when a C-suite embarkson some margin focused endeavor, that

(02:24):
everybody who works at that placeis in full agreement with that path.
That's kind of like throwing babies outwith bath water territory, and ultimately
we need as many on our side as we can get.
I actually did a whole show on this called"The Narcissism of Small Differences".
If you're so inclined, pleasedo go back and listen to it.
Also, listen to the show with Larry Bauer.

(02:45):
It was a summer short froma couple of years ago called
Knights knaves and Pawns".
My guest for this shortsegment is Jonathan Baran.
He has always been a healthcareentrepreneur Today he is co-founder
and CEO of Self Fund Health, which iscommitted to challenging the expensive
healthcare system in Wisconsin.
This episode is sponsored by Self FundHealth, and my name is Stacey Richter.

(03:07):
Jonathan Baran, welcome toRelentless Health Value.

Jon Baran (03:09):
Stacey, thank you for having me today.

Stacey Richter (03:11):
So before we get started talking about a topic, I am so
looking forward to talking about, doyou wanna just give a brief background?

Jon Baran (03:19):
Yeah, absolutely.
And really truly, it is an honor to behere today because your podcast is one
I've listened to over the years, and ithas been one of the single best resources
for actually understanding what isgoing on in this healthcare ecosystem.
And one of the interesting things thatreally led me to your podcast is, I
really could not answer some of thesequestions like how healthcare worked.

(03:41):
How did it get financed?
Why is it so expensive?
It feels like one of the singlebiggest reasons that nothing changes
in healthcare is because all ofthe stakeholders actually don't
really have a good understandingof how the whole system functions.
So this is everything fromemployers to providers, to brokers,
to politicians, to executives.
And so my goal today is to hopefullyshed a little light on this because

(04:04):
there's this famous Charlie Mungerquote, "Show me the incentives
and I'll show you the behavior".
And my goal today is to talk aboutthe incentives and then how this
ultimately explains the behavior.
I'm not attacking individuals, I'm callingout the actions that are being driven by
the incentive structure that's in place.

Stacey Richter (04:23):
Thank you for the lovely compliment.
The one thing that is probably afoundational imperative as we go about
conceiving of and thinking about howanybody is going to, I was gonna say
transform, I kind of mean just improveat any level, the healthcare system is
that we as individuals stop identifyingwith the stakeholder that we work

(04:48):
with in this kind of a hundred percentoverlapping Venn diagram sort of way.
Because if anytime anyone says something,which may be, um slightly less than
neutral about the stakeholder whereany of we individuals work with, we
need to make sure that we understandthat this is not a direct attack on us.
It is a comment on what theincentives are for the part of the

(05:13):
industry that we work with or for.
And unless you know, you don't wanna bea solution looking around for a problem.
So step one in any sort of solutioning isto figure out what the problems are and
if everyone kind of takes offense at, andI don't want need to belabor this point,
but I think it's kind of inherent in whatyou're saying, that there are incentives

(05:35):
and we really need to understand what theyare because if we don't understand what
they are, then we can't figure out how toaddress probably some of the things that
we may be contributing to or a victim of.

Jon Baran (05:47):
100%.
And that's my goal withthis, is to be direct.
Because it's also to, I feel like we,we have this challenge in healthcare
where we oftentimes speak in platitudesand we always, we, we can't get to the
actual point and the root cause becausewe're too afraid to upset and to cause
someone to, you know, react accordingly.

(06:08):
And so that again, is the goal islike don't attack the individual,
call out the behavior, and then usethat behavior to then understand
the incentives and why they'reperforming in the way that they are.
Because once we understand that,then we have a hope at flipping
it and turning it around and doingsomething different as a result of it.

Stacey Richter (06:26):
Also, some of these stakeholders.
They are huge, huge organizations like,you know, you can't say this hospital
did this and, and think that somekind of democratic vote was taken, and
all the doctors and nurses are yeah,actually on board with that, right?
Like that is so often, I'm gonna say99.9% of the time really not the case.
And often it's quite surprising to somewho work at some part of the organization

(06:50):
to see what somebody else is doing.
So there's also just even beingaware of what is going on.
This is news that manyhave found they can use.
And if somebody is coming herefor some pretty, so I won't
use the word blunt straight.
I'm not sure what the right wordis, but that's what we do around
here is just no judgment flat outjust that this is what's going on.

(07:13):
Hey, thanks for listeningto this bonus clip.
Now do go back and listen tothe other show that was released
at this same time, episode 483.
You will find it in the feedreleased on this same day, part one.

Tom Nash (07:26):
Hi, this is Tom Nash, editor and producer of the RHV Podcast.
You've probably heard me say this podcastis sponsored by Aventria Health Group.
And that's true, butthere's more to the story.
Aventria is our day job, and the peoplethat make this show happen are Aventria
employees generously donating their timeand talent on top of everything else
they do to get each episode out the door.
So yes, Aventria underwrites theproduction, but in many ways, Relentless

(07:50):
Health runs like an unofficialnon-profit, a very, very non-profit.
Aside from the occasional and deeplyappreciated episode sponsor and our
wonderful listeners who donate to the TipJar, this show is scrappy and self-funded.
If you wanna keep this podcast independentand laser focused on educating,
informing, and driving real changein our healthcare system, we invite
you to become a monthly sustainingmember of Relentless Health Value.

(08:13):
We have a few of you who have alreadytaken it upon themselves to do this
already, and we are deeply grateful.
Maybe in the future we willbe able to cook up some perks.
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(08:35):
Maybe become a sustaining member.
Or if you or your organizationwants to sponsor an episode
or two, we'd love to chat.
Thank you so much for listeningand being a part of the movement.