Doug Forrester has twice come close to occupying a major elected office. He was the Republican candidate for U.S. Senate in 2002, but lost to Democrat Frank Lautenberg; and for New Jersey governor in 2005, when he lost to Jon Corzine.
But don’t get the wrong idea. Forrester has had an active political and business life. He served on the West Windsor Township Council from 1979 to 1983, including a stint as mayor, and then as assistant state treasurer and director of the division of pensions under Governor Tom Kean in the 1980s. In 1990 the California-born, Harvard-educated Forrester founded BeneCard, a pharmacy benefits management firm that provides prescription drug coverage to mid-size employers. It was here that Forrester became familiar with serious problems in the provision of health benefits — chiefly the state’s health plan for public employees that, while expansive, lacked cost data that could be analyzed, audited, and used for planning.
Forrester came to understand that prescription information had to be integrated with medical data to best serve patient needs. Without such integration, he says, about half of prescriptions, when analyzed after the fact, turned out to have been sub-optimal – either medications were wrong, dosages were incorrect, or instructions on how and at what time to take the drugs were poor.
In 2003 Forrester and his BeneCard partner, Robert Ullman, founded Heartland Fidelity to handle risk for BeneCard clients rather than continuing to use an insurance company for this purpose.
A year later, Forrester became intimately familiar with the tangled process of insurance and benefits claims, after his 17-year-old daughter, Briana, was diagnosed with Hodgkins disease. With the bills came “an army of bureaucrats” whom Forrester suggests make the claims process deliberately messy. “It’s part of the game,” he says.
The experience compelled him to found Integrity Health, to design and manage self-funded programs for public and private employers, in 2008. Forrester founded Integrity Health to put the control of health benefit plans into the hands of employers. “We don’t offer a health plan,” he says. “A health plan is an insurance company’s product. We help the employer create its own plan and then do everything to manage that plan.”
“If you were to teach a college class in something you should have learned in college but didn’t, what would it be?”
In 2006 I was asked this question by the The College of New Jersey and I responded by offering a course entitled “Can Morally Wrong Be Politically Right?” It was principally a course on democracy and morality, exploring the delicate balance between personal freedom and social norms in a democracy, i.e., the importance and mechanics of tolerance.It also probed the value of democracy as a form of government to help the students understand why it is worth defending.
The final assignment was to answer the following question: what is the most seriously immoral act you believe should be legal and why? I wanted to hear from the students about the razor edge of their morality as it touches the legal system. What were their limits in allowing another to morally trespass before they called for government intervention and punishment?
Typical papers addressed the big questions one might expect: abortion rights, gay marriage, legalization of drugs, pornography, etc. What I found encouraging was the transformation reflected in them. At the beginning of the semester, I asked who supported democracy as a form of government; all hands were raised. I asked why and got puzzled looks. Even after some probing, it was clear only some vague sense of personal freedom attached to the idea of democracy. At semester’s end, it was clear from the papers that the idea of democracy had real meat on it.
The idea for the class was linked to a bumper sticker I saw (particularly during Republican primaries) which asserted “Morally Wrong Can’t Be Politically Right!” Really? I wondered. What does this mean? What immorality did this standard bearer have in mind? To what are they reacting? What are the political ramifications of people figuratively shouting this out to others?
Actually, this message goes all the way back to Plato and can be found inscribed on at least one state’s capitol building (Missouri). But it is clear these are fighting words now, not just a weighty observation. People’s moral oxen have been gored and they are out to put an end to the trouble-makers. Should they? How?
I wanted to address these questions because in college I took US democracy for granted; I don’t anymore. I’m convinced democracy is a fragile thing and, like Jacques Revel in his work Why Democracies Perish, I think the jury is still out on whether democratic sympathies and institutions will prevail in the 21st century.The danger is that we will slide into a philosophy of might makes right whether by a monolithic majority or a coalition of minorities which prey on the weakest. American students need to grapple with the inconvenient aspects of democratic theory and practice so they are better prepared to ensure freedom will grow and endure.
It won’t happen automatically because there is much in human nature to oppose it. The great American thinker Reinhold Niebuhr observed that humanity’s capacity for justice makes democracy possible and our inclination to injustice makes it necessary. He’s right. There is a powerful, predatory inclination in the human heart to dominate others. It is evident not just among criminals but among those we hold dear, especially the one we see in the mirror every morning.
Injustice breeds here because justice is inextricably linked with the affirmation of others as independent centers of value and decision-making. Injustice usually isn’t a gross assault on another or a violation of legal rights. It’s often an attempt to use power-government or otherwise-not persuasion, to silence non-conforming appearance and opinion. We are so busy justifying ourselves that we are blind toour bigotry.
The most common form of this inclination is to try to control the behavior of others for self-serving ends. Whether we demand some kind of obeisance or merely insist on an affirmation of our values, there is something in us which takes a dim view of another’s freedom to move contrary to our wishes.
Whether we realize it or not, this attitude can easily turn into a threat to democracy and the benefits of safety and diverse creativity which flow from it.
Religious and moral extremism comes to mind as a threat to democracy. But sadly, it is always the other fellow’s philosophy that is the problem. Muslims are the currently the favorite target of those opposing religious extremism on behalf of democracy. But one only has to read Chris Hedges “American Fascists” to understand how similar a threat are popular groups on the Christian Right. Lest we think religion is the problem, let me state that the worst examples I’ve seen of bigotry come from those proud to oppose religion.
What are we to do? To some, the choice seems to be a zugswang (a marvelous chess term in which any move worsens one’s position). Moral extremism, relativism or feigned indifference to public affairs present themselves as the only unpleasant alternatives. Barry Goldwater notwithstanding, extremism of any sort soon is exposed as anti-democratic. Relativism has no real intellectual credibility and feigned indifference to public policy merely cedes to others the power of policy-making.
Honest affection for the untidiness of democracy is what needs nurturing and this takes a hardy soul. It runs against the grain of what we want because it requires us to acknowledge the desires and seek to understand the contributions of others. It also requires us to participate in public affairs so that everyone, not just the privileged, have a seat at the table. Lastly, it calls us to treat others as we would like to be treated, not as we are treated.
These are public virtues and need to be taught. I think a good way to do so is to prepare college students to answer the original question in the affirmative: Yes, whether I like it or not, what I think is morally wrong can be politically right. This is true in the sense that I believe the moral authority of another to decide life’s basic questions trumps the government in all but a few well-defined areas we agree on. That agreement is the struggle of democracy and we need each generation to be prepared and thoughtful in their work.
#b#Integrity Health#/b#, 103 Carnegie Center, Suite 323, Princeton 08540; 609-606-7000; fax, 609-606-7008. Doug Forrester, president. www.integrityhealth.com.