Healthcare is growing increasingly costly and complex for patients, and there's no shortage of finger-pointing about who's to blame for this issue.
And it's with that backdrop that SCAN Group CEO Sachin Jain, M.D., is releasing his new book "The Moral Alibi" on Feb. 16. Through the book, Jain aims to call on healthcare leaders to acknowledge their role in normalizing what shouldn't be, and to take a more ethical approach to their positions.
It's a topic he's touched on extensively in the past, across contributions to his regular Forbes column, posts on social media and speaking engagements. And presenting people with the idea that they may be doing something wrong tends to ruffle some feathers, he told Fierce in an exclusive interview.
"For many years, I've been the lone man in the wilderness, kind of saying, 'Hey, Houston, we've got a leadership problem here. We have an organizational behavior problem here. We have a culture problem here,'" he said.
For health plan leaders, they're often out of touch with what patients are seeing and experiencing out in their daily lives. And losing touch with that can make it easier to accept things that may otherwise tug on their moral fiber, Jain said.
And he made clear that he doesn't consider himself above this challenge. Jain has held leadership roles at provider organizations, pharmaceutical companies, regulatory agencies and now at a health plan, and he's fallen victim in the same way to the "ethical erosion" that can set in.
He saw this shift at play in the response to an ad campaign that SCAN launched last year, which said that "health insurance is broken," and acknowledged many of the pain points enrollees face even in just signing up for insurance.
Jain said some in the insurance industry pushed back, arguing that the dysfunction in healthcare extends well beyond insurance.
"What an abdication of responsibility," he said. "For any of us to say, 'Oh, we're not broken. The whole system is broken'—sure, the whole system is broken, and I'm part of that system, and therefore part of my work is actually fixing the system."
There are plenty of good things that health plans can do for their members, he said. But there are also plenty of experiences that can color their perception in a more negative light, and executives shouldn't feel they can "sleep well at night" because of the positives while ignoring the negatives.
Jain pointed, for example, to the insurance industry's surprise at the vitriol and anger that followed the murder of then-UnitedHealthcare CEO Brian Thompson in December 2024, even as they view themselves as member-centric and patient-centric organizations.
He said part of how he's worked to see that broader, patient point of view is getting back to direct care. He now works two days a week in a local hospital, hearing from patients directly. He also keeps lines of communication open and responds when a member reaches out to him personally with a frustration or barrier.
Jain said he's also pushing to ensure that conversations about ethical leadership are front and center for the team at SCAN. The insurer's leaders recently gathered at an offsite meeting where they focused on ethical and moral renewal in their work.
"We are bringing these ideas to life every single day within the walls of the company," Jain said. "That doesn't mean we're more or less ethical than anyone else, but what I will say is we've started the conversation, and people are receptive to it because they too realize that sometimes we normalize the abnormal, and we don't necessarily take as much accountability for things that are in our control."
For leaders who want to rethink their approach to leadership along these lines, Jain said that part of his goal with the book is to arm them with the vernacular necessary to discuss the topic. He doesn't want to be the lone man in the wilderness forever.
He added that industry must also shift away from a culture of self-satisfaction to one that strives for more, noting that while healthcare experience worsens and becomes more expensive for patients, many of its biggest companies continue to grow and thrive.
People who work in healthcare tend to get into the industry with a desire to help people, and that motivation should carry through their careers in full.
"We sort of get co-opted by the dominant culture of healthcare, when in fact our innocent eyes were what should have been preserved and protected and maintained at all costs," he said. "We had it right when we first got started."