Where the Buck Stops: Personal Responsibility in a "Not Me" Society

Speaker Name: Robert Greczyn Jr.
Speaker Title: Chairman and CEO
Speaker Company: Blue Cross and Blue Shield of North Carolina
Blue Cross and Blue Shield of North Carolina Website

Robert Greczyn Jr.Good afternoon, everyone. I am honored to be with you today. It’s always exciting for me to have the opportunity for interactive discussions with our nation’s future leaders. I don’t plan to speak for too long, because I hope you’ll have questions for me when I’ve finished.

I can honestly say there is nowhere I would rather be on the last day of summer than right here in Boone. You have had a very difficult time recently with hurricanes Frances and Ivan, but this is one of the most beautiful places in our state – and Appalachian is one of the most attractive campuses in our state.

I’m fortunate to have three alumni of this university on my senior team: Brad Wilson, our general counsel and senior vice president, who spoke at today’s Executive Luncheon; Brad Adcock, our vice president of government affairs; and John Roos, our senior vice president of sales and marketing. I know firsthand the kind of talented leaders Appalachian State University turns out.

We’re at a time in our history when leadership is more important than ever. When you look around, it’s truly amazing how much change is occurring: cultural changes; political changes; technology changes; military changes. Without effective leadership, none of these changes can occur.

A time of rapid change can be very exciting, but it can also be intimidating. No one likes change, they say. That is because all change gores someone’s ox. It’s easy to look around and wonder how just one person can have any effect when it seems that our world lacks any constant. But there are things each of us can do. And when everyone does their part, the sum of those individual efforts – with the right leadership – can have a lasting impact.

Getting to a point where everyone does their part requires more than just a call to action. It will take a shift in a collective mindset that has developed because we have allowed an incredibly important trait to slowly leach out of our society’s character. That trait is personal responsibility. There was an email going around for a while that I think raises an interesting contradiction about personal responsibility in America. It’s an email that tells about the most ridiculous legal cases in the past few years. There was one story about a burglar who sued a family after getting locked in their garage while trying to rob their house. Supposedly he was stuck there for eight days since the family was on vacation, forced to live on dog food and warm Pepsi.

Another example told of a woman who sued a furniture store after she tripped over a misbehaving toddler and broke her ankle. The only problem was that the toddler in question was her own son. And perhaps most outrageous was the story of the man who sued Winnebago when his 32-foot RV crashed after he set the cruise control and then went into the vehicle’s kitchen to make a sandwich. It seems the manual didn’t tell him he needed to stay at the wheel.

Now, being a responsible person myself, I did some research and found out that all of these stories are urban legends. But all the same, I think they make an interesting statement about our society.

We may laugh when we hear outrageous stories about “other people” who don’t accept responsibility for their actions. But the truth is we see evidence every day that lack of personal responsibility isn’t just urban legend – and isn’t just “other people.” The sad truth is that many, many people in our society believe they should not be held responsible for the choices they make or the consequences of those choices. We see it on a personal level with the decisions we make in our daily lives. We see it on a professional level with lapses in ethics that dominated the news in recent years. And in my business – the health care business – we see it on an individual and institutional level.

Make no mistake: the “Not Me-ism” in our society is a huge problem. “They” are always at fault. In all my years, I have never met “they” but “they” are certainly a convenient group to have around so that the fault never lies with “us” or “me.” This is a problem that I hope you – as our nation’s future leaders – will make a priority to turn around. At the individual level, you’ve already taken an important first step: you’re here. You’re getting an education. You’re learning about business. You’re arming yourselves with skills that will prepare you to play a key role in business and in your community. I hope you’ll take these gifts and put them to good use.

Do something you believe in. Do something that in some way contributes to your neighborhood, your country or your world being a better place. When people ask who is willing to step up, let the answer never be “not me.” Keep learning. If you stop learning you stop growing, and in business when you stop growing – stop moving forward – you die.

No matter where you go from here, you’ll find that the business world moves very fast. There is virtually no aspect of business that is immune from competition. It will always be you against the other person in a battle of supremacy in which customers vote with their wallets, their loyalty or – in the charitable world – their contributions.

As you build your professional career, I hope you’ll accept the responsibility to become a leader in your community. Those of us who are driven to become leaders in the business world often do so because we have a passion for finding ways to do things better and for leading groups of people to achieve extraordinary results. If there is anywhere we can put these skills to better use than in our careers, it’s in our communities. This is something I believe in very strongly, and something I try to model as chief executive of the state’s largest health insurer. For my part, I’m passionate about higher education, so I serve as a member of East Carolina University’s board and as campaign chair for the UNC School of Public Health’s “Carolina First” fundraising effort. I believe that the fortunate have a responsibility to reach out to the less fortunate. This year I chair the Triangle United Way’s annual fundraising campaign.

Because these are institutions I feel strongly about, I felt a sense of responsibility to help ensure their success. It doesn’t stop with me, though. When you embrace personal responsibility yourself, you find that you become excited about making it part of the culture wherever you can.

It has been a goal of mine to ensure that employees at Blue Cross and Blue Shield of North Carolina have the opportunity to volunteer in their communities. Last year, our efforts to encourage employees and managers to volunteer resulted in nearly 23,000 hours contributed to worthy organizations in communities across the state. That’s something I’m proud of – and something our employees are proud of, too.

But it’s more than just something to feel good about. A culture of personal responsibility is arguably any company’s greatest asset. Who can ever forget the scandals of Enron, Worldcom and Tyco? I can tell you that when you’re the head of a large company – particularly a health insurer – folks are eager to make sure you never forget about those stories – and we never should. What happened in those situations is an excellent example of what happens when the buck stops nowhere. It’s what happens when a company’s leaders respond to a question of “Who’s responsible here?” by shrugging and saying, “Not me.” The fact is that the vast majority of companies operating in the U.S. today are good, honest companies.

They do the best they can to serve their customers and retain their customers, because they know that is what ultimately determines whether they succeed or fail. Most companies play by the rules and abide by the laws. It was just over two years ago that the Securities and Exchange Commission gave almost 900 companies the opportunity to refile their financial reports and required that CEOs and CFOs swear to their accuracy. Many expected that the SEC would be flooded with restated financial reports from companies all across the country. The fact was that only a handful – a fraction of a percent – of companies said they found errors in previously filed reports.

This shows that true leaders are not in short supply in corporate America. A true leader is one who stands up and says, “The buck stops here.” A true leader knows that, no matter where in a company a problem occurs, it’s his or her problem. A true leader never says, “not me.”

I want you all to be true leaders. True leaders embrace the principle of personal responsibility themselves. But they also take it a step further. They make accountability an expectation – a given – in the organizations they are involved with.

That means having a clear commitment to ethics, and compliance with rules, laws and regulations. It means having a well-defined mechanism for employees to report any concerns they have. In our company employees have numerous channels for reporting ethical concerns. They can also just email me, call me or stop by my office. You’d be surprised how many do.

I’m gratified that employees are comfortable bringing their concerns directly to me. That tells me that they trust me to take their concerns seriously and to do something about them. I believe that I owe it to myself and to the company to prove their trust is not misplaced. Let me tell you a quick story that is not an urban legend. Two weeks ago, I received an email from an employee asking if what she had heard was true. That is, did I really have an “open door” policy.

I told her I did. Well, a few other steps occurred, but the bottom line was simple. A concerned employee wanted to tell someone about some bad things two other employees were doing without getting herself in trouble. We investigated and the facts were clear. Two employees were fired before the end of that week, and the one who told me about the problem got a huge “thank you.”

Leading by example is a big responsibility, but it is not a difficult one to bear. Let’s be honest; doing the right thing is usually not hard. Probably your mother told you “If you never tell a lie, you never have to remember what you said.” She was right on. If you’re in a situation where doing the right thing poses a conflict, then you’re probably in a situation you should think about getting out of.

But most of the time, it’s a matter of asking yourself if you would mind if what you’re doing were reported on the front page of the newspaper. If you can’t confidently answer that question, you might want to take a step back and take another look at your situation.

Creating a culture of personal responsibility has implications beyond ethics. Imagine if even most of the employees in a company had the attitude that the buck stops with them. Imagine how much more quickly problems could be spotted, reported and corrected. Imagine how much productivity could be gained. And imagine how much better the end result – whether it’s a product or a service – would be.

When you think about it that way – and I would encourage you to do just that – personal responsibility as a tenet of corporate culture moves beyond the realm of the “desirable but not totally necessary” and takes on a significance for the bottom line. Another thing you’ll learn very quickly in the business world is that – whether you’re a public company, private company or a tax-paying not-forprofit company like Blue Cross and Blue Shield of North Carolina – the bottom line matters. It doesn’t matter how lofty your goals are if you can’t keep the lights on, make payroll and continue to grow and renew your company.

I hear a lot about these concerns from customers and from other business leaders in the community. I’m sure you are all aware that rising health care costs are now cited as one of the biggest challenges employers and consumers face. This is a serious issue and one where everyone doing their part can have a huge impact.

The health care industry is one where the principle of responsibility is front and center on two fronts. On the individual front, we’re facing a situation where consumers are being forced to take more responsibility for the health care decisions they make. On an institutional front, we are facing a true crisis. If we are going to confront the problems we face, then nobody – not physicians, not hospitals, not insurers and not the government – has the luxury of saying, “not me.”

First, let’s look at the individual side, because I believe that is where this crisis started. What I’m about to say might not be popular, but it’s true: As a society we are overweight, and we are lazy. People might not like to hear that, but the statistics don’t lie. An estimated 1-in-5 adults is obese, almost double the rate of 10 years ago. Children are not far behind. The prevalence of obesity among adolescents has tripled in the last two decades.

Type 2 diabetes is related almost entirely to a sedentary lifestyle and poor eating habits. It used to be unknown among children. It is now at epidemic proportions. In fact one third of new cases are diagnosed in children. North Carolina is one of the worst states in the country for obesity, diabetes and the lack of physical activity.

A study in the Journal of the American Medical Association reports that obesity can cut 20 years off the expected life span of young people. Obesity and diabetes are the health crisis of the 21st century. They may outpace the public health threat that smoking was to the past century. The Centers for Disease Control now says that this new generation of kids may be the first to have a shorter life expectancy than their parents.

The fact is that much of our current health costs and many of the things that ail us are related to behavior – and are largely preventable. It has long been established that 30 minutes of moderate exercise a day can reduce the risk of getting heart disease, colon cancer, hypertension and diabetes.

Of course our schools don’t have time for physical education anymore. Well, I firmly believe that children with healthy bodies learn better. If we all gave up one sitcom rerun per night to walk around the block, we’d have a better quality of life and would save money.

As health care consumers, we have abdicated our responsibility. We have acted as if we can live any way we want to and that medicine will be there to fix any problem for a small co-pay. The day of reckoning is upon us. For many consumers, that reckoning is coming in the form of higher and higher health insurance premiums or greater out-ofpocket expenses. For some it comes in the form of a notice from their employer that the company can no longer afford to offer health coverage or that dependents and families are being dropped from the plan.

Health premiums don’t just rise on their own. They rise because people are going to the doctor more often and leaving with more prescriptions than ever. They rise because physicians feel the need to order long lists of test to protect themselves from lawsuits. They rise because hospitals have to charge patients with private insurance more to make up for those patients who aren’t paying – and the number who aren’t paying is growing steadily. If we are to confront this crisis, it’s imperative that everyone understands that they have a part to play. The buck has stopped.

This being an election year, we’re hearing a lot about the uninsured. And we’re hearing two candidates each tell us that they have the better plan for reducing the number of uninsured and making health care more affordable for all of us. I’ve worked in health care my entire life, and I’m here to tell you that no one person and no administration can solve this problem. It’s too big and too complex. Facing this challenge will take responsibility at the personal and institutional level. For example, let’s look at a very hot topic right now: the number of uninsured in our country. Recent reports put the number of uninsured up around 45 million. That’s a big number, but what does it really mean? We can break it down into three categories.

About one-third of these individuals are eligible for existing government programs but are not enrolled. I think there is a lot of work to be done in making sure individuals who are eligible for these programs know they are eligible and know how to enroll.

It also makes good sense for states to use Medicaid/State Children’s Health Insurance Program funds to pay the employee’s share of employer offered coverage thereby avoiding the stigma of a “welfare” program.

A rapidly growing segment of the uninsured are those with middle and upper incomes – who in many cases can afford coverage, but choose to go without it. This group includes what I refer to as “the immortals.” Those are the young people who honestly believe they will never get sick or have an accident. Educational efforts that highlight the health and financial risks of being without insurance may be most effective with this segment. Armed with the right information, many in this segment may find that opting for health coverage is the more responsible choice than going without it. The final category of the uninsured includes those with low incomes. With this group, a combination of tax credits for small employers with lowwage workers, tax credits for individuals with premiums that represent a relatively large percentage of their incomes, and tax credits for the unemployed represent a possible viable solution. Our current health care system – with some modest changes – is very well equipped to deal with the problem of the uninsured, but it requires all entities stepping up and taking responsibility to solve the problem.

There has been too much finger pointing in health care these past few years. Physicians, hospitals, pharmaceutical companies and insurers all blame each other. Politicians demagogue the issue, but offer few real solutions. Why? Because no one wants to own the problem. It’s time for that to stop. That’s not leadership, and it’s not responsibility. The fact is everyone owns some piece of this problem – including every American.

There are 45 million people out there who demand that the players in the health care system stop saying “not me” and help begin to solve the problems piece by piece. I have a great deal of hope that by the next presidential election, we will have made some progress in this regard and the numbers will be headed in the other direction. Many of us who work in this industry may find that our futures depend on it. When it comes right down to it, I think bringing the concept of personal responsibility back into our society is bound to happen. The pendulum has swung too far in the other direction. The legal urban legends I shared with you at the beginning of my remarks are not real – but you can bet that there are many, many true examples out there that are just as preposterous – like the woman who sued McDonalds because her coffee was hot. Come on folks!

It’s time for us to say, “Enough is enough.” I’m a firm believer that one of the most effective ways to bring about change is to model good behavior. There are a lot of new leaders in this room today – which makes this a good place to start.

Make a commitment to yourself, your career and your future to always accept responsibility for your actions. Wipe the words “not me” out of your vocabulary. And when someone passes the infamous buck your way, grab hold of it and say “Thanks for bringing this to my attention. I’ll take care of it.” You’ll be amazed at how easy – and how empowering – it can be. Will there be times when you feel like you’re the only person saying, “I’ll handle it” when everyone else is saying, “Not me?” Of course there will. That is what will distinguish you – as a leader – from the rest of the crowd.

Being a leader gives you an unparalleled opportunity to demonstrate to others the differences small and large they can make by accepting responsibility, doing the right thing and stepping up. Everyone is this room is in an excellent position to contribute to a gradual, but very important change that puts personal responsibility back into our collective consciousness.

This challenge is as urgent as it is important. But, as I said earlier, I know first-hand the caliber of leader this university turns out. So I know you are up for it, and I look forward to seeing the difference each of you make.

Let me end by saying to you what one of my mentors said to me: “If you are going to be a leader, it is a good idea to occasionally look over your shoulder and see if anyone is following.” That’s good advice.

I thank you very much for your time and for the invitation to be with you today. I hope we can use our remaining time for questions and discussion.