Brother, Can you Spare a Latte? by Pat Conrad MD


Most if not all of us in medical training at some point were taught by hard experience the value of calm analysis, and separating emotion from making major changes in treatment regimens.

The urge by too many to rush in and “do something” has generally caused great misery, more so in the past century-plus, accelerated by the rush and rumble of industrialization and the Information Age’s ability to amplify emotion across geography and social strata as quickly as someone can hit “Like” on Facebook.

Dan Price, co-founder and CEO of Gravity Payments in Seattle wanted to do something about income inequality. Last year his financial services company processed $6.5 billion for 12,000 small business customers. Spurred by rent/student loan worries of a friend and employee who’s take home was $40K, Price made the radical move of drastically cutting his own salary while raising all of his employee wages to a base of $70,000/year. Price is the product of a strong family and devout religious upbringing that emphasized the twin practical imperatives of personal success and concurrent altruism. He is described as a very competitive and thoughtful youth, traits that led him to multi-millionaire status by the time he hit 30.

So he arbitrarily jacked the salaries for all of his workers, and received immediate acclaim from the mob media and the Harvard business school. He also came in for resentment from many who felt personally devalued overnight. Peers in neighboring firms felt pressured to follow suit in Seattle’s current climate of equalizing incomes, most notably the recent adoption of a $15/hr. minimum wage. Price “did not actively oppose Seattle’s minimum-wage increase, but a reason he urges other business owners to follow his lead on pay is to avoid more government regulation.”

Some clients mistrusted the move and Gravity lost some old business even as it gained new clients – clients whose accounts will not start to provide steady profit until next year. In fact Gravity gained so much new business that it had to hire additional personnel. Some of Gravity’s employees felt immediate tangible improvements in their living conditions; others in Price’s inner circle had second thoughts over being valued the same as newbies with less experience, investment, and motivation – both colleague and employee skepticism was derided as “selfish” – and quit. One employee who quit shortly after receiving a raise said, “Now the people who were just clocking in and out were making the same as me,” he complained. “It shackles high performers to less motivated team members.” Price was hit by a lawsuit from his sibling/co-founder, and more recently had to rent out space in his home to help pay his bills.

Does this guy have a future in health care? You bet he does!

Price could become a hospital administrator. Every hospital schemes to rope in new physicians with income guarantees that compete with already existing local practices.

He could become a vice president for Aetna or Humana. Third party insurance rates paradoxically suggest income basements by setting income ceilings, encouraging doctors to meet the minimum payment points per patient as they scurry to the next exam room. That’s perfect for a guy with experience in paying arbitrary salaries irrespective of value return (and he could easily back that logic up with a new round of quality indicators to deal with the inevitably poor morale and subsequent infighting as a way of maintaining overall creative control).

Price has made a national splash in taking an altruistic goal and pursuing it through a precipitous economic upheaval that led to a simultaneous increase in demand, increase in administrative cost, and disastrous revenue shortfalls. This experience alone makes him supremely qualified to become an ObamaCare czar. His willingness to use moral assumptions about others to rationalize policy is a bully tactic that would recommend him for a White house cabinet post, and later a gig on MSNBC. And his ability to take careful aim and blow a foot off so government won’t have to is a trait any moderate Republican would envy.

The vital point is that Dan Price, like our current health care overlords, did something.