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Paul Markovich

Paul Markovich

President and CEO of Blue Shield of California

Paul Markovich Has Big Healthcare Plans

The president and CEO of Blue Shield of California explains his ambition to create a better system for everybody.

By Jen Swetzoff

“Everybody needs healthcare, but the system is broken,” said Paul Markovich, president and CEO of Blue Shield of California. “We’re pricing what is a basic necessity as a luxury good, and that doesn’t work. My job is to figure out how to create a better healthcare system — one that’s sustainably affordable and worthy of our family and friends.”

If anyone’s up for the challenge, it’s Markovich, whose deep intellect and passionate determination are unmistakable. Growing up in Grand Forks, N.D., he excelled in the classroom and on the ice. After playing Division 1 hockey for Colorado College, where he received his bachelor’s degree in international political economy, he moved to Moscow to study Russian. He then attended Oxford University on a Rhodes Scholarship and earned his master’s degree in philosophy, politics, and economics.

Booz Allen Hamilton hired him to work with the financial-services practice in New York, but he soon started focusing on healthcare, fascinated by the industry’s business, financial, political, and social complexity. After four years with Booz Allen, Markovich moved on to join Blue Shield of California, where he has remained for nearly 20 years. In 2000, he took a step away to start his own business and to work for a smaller consumer-driven health plan. But two years later, Blue Shield recruited him to return.

“I thought about what companies were most committed to ambitious change, and had the patience and wherewithal to do it, in terms of having both local market share and money,” he said, “and I knew that Blue Shield was the right place for me to be able to make a difference.”

Now leading the company, Markovich is well positioned to make the kind of difference he has long aspired to. He and his wife live in the San Francisco Bay area with their 16-year-old son and 13-year-old daughter. During a recent conversation, he discussed his enthusiasm for his work and why he believes it’s important to also enjoy life outside the office.

Tell me a bit about your role at Blue Shield of California.

If you look at healthcare in the United States, it’s highly fragmented, incentives aren’t well aligned, there’s a lack of coordination, and there’s a lack of interoperable data standards. We have a bad system. And unfortunately, a bad system will beat good people. So, even if you’re well intentioned and you want to do the right thing, it’s very difficult to fight through a bad system as an individual. My job is to change all that and make it better.

What’s the most rewarding part of your work?

Seeing people grow, develop, and be successful. A lot of what you do as a leader is try to set other people up for success; when they have that success, it’s very exciting. It’s also rewarding when we, as a company, get something right and — just for a day or just for a moment — we have something that’s worthy of our family and friends. Seeing that outcome, seeing that difference, that’s always a highlight.

What are you most proud of?

With the introduction of the Affordable Care Act, Blue Shield of California has cut the uninsured in California by more than 50 percent. That’s a major step forward in trying to provide everybody coverage that they should have access to. To me, that’s by far our most important accomplishment.

What’s the biggest challenge you face?

Blue Shield of California has to simplify the system and make it more transparent, accessible, and useful, so that people can clearly understand the offerings, figure out what’s best for them, and make decisions. Most important, [we must] determine how to make healthcare financially sustainable for all the players, including the federal government, the taxpayers, and health plan providers. That’s unfinished business, and one of the biggest challenges.

How would people closest to you describe you?

Authentic, passionate, and persistent.

What do you think is the most overrated virtue?

Work ethic. Success isn’t about being obsessed with your work and doing it all the time. It’s about getting outcomes, building teams, and continuously learning. The competition for who just pours more hours of their life into their work is, I think, vastly overrated. I really think the best leaders have lives. There’s a lot more to life than the next conference call.

Where do you find yourself happiest?

With my family. I make a habit out of being home for dinner. Just sitting down and checking in as to how everyone’s day has gone and how everyone is doing, that’s a foundational element of the whole family dynamic. We also love traveling together as a family, and it’s not uncommon for us to visit places where there’s great food and great wine. For myself, I still play hockey once a week and exercise regularly.

What’s next for you?

I want to fulfill our ambition of having a system that is worthy of our family and friends and that is sustainably affordable. When we do that, and health insurance premiums are going up less than 2 percent a year, year over year over year, and we can demonstrate the quality of care that’s being provided, that’s when I’ll feel like we’ve done something.

What advice would you give to people starting out in their career?

It’s important to find your passion. If you aspire to lead, it’s demanding, it’s difficult, and there are challenges you have to face. What really builds resilience and the willingness to keep going in the face of adversity is passion for what you’re doing. Figure out what you like, what you’re passionate about. You’ll do your best and have your most enjoyable life when you’re getting joy out of your work.

Jen Swetzoff is a freelance writer and editor. Previously, she worked with Strategy& as the deputy managing editor at strategy+business magazine.

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