by Tom Blair
Things got better. Couldn’t have gotten much worse unless they converted the actuarial tables to Roman numerals. I moved on to reviewing the underwriting performed in the fields. Bankers Life had a field office sales force that marketed insurance in more than half the states of the union. My job was to keep the sales force honest, make certain that they were charging an equitable rate for the services we were providing. Our premiums were based on our best estimate of the cost of providing insurance coverage; no excess profit. Later, on Wall Street, I learned another pricing theory: How much money do you have, and how little can I offer you for all of it. This business concept being introduced to America in the 1800s by Jesse James.
After my first year at Bankers Life I received my annual raise. It was 2.5%. I remember the number because pretty much everyone received 2.5%, as if they took the rainfall in inches one month and then declared that’s what everybody received as a percent increase.
By the time I finished my first year at Bankers Life I understood my father’s passion. Dad was an amateur radio operator. In our cellar of exposed floor joists and pipes, with its always-damp concrete floor, were his radios, his friends. Behind our house, looking for all the world like the clothesline for the Jolly Green Giant, were antennas Dad had carefully erected. Every workday evening, after conferring with Uncle Walter, Dad would descend to the lowest reaches of our home and deposit himself in a swivel chair next to our old kitchen table; the only illumination the yellow glow of radio tubes. If the ionosphere was stable and the sunspots quiet, his radio rays could bounce around the world, allowing him to converse with fellow amateur radio operators in distant lands.
Hour after hour Dad would sit at his radio, transmitting, “W3NG, CQ, W3NG, CQ.” His call sign being W3NG and CQ meaning that he wanted to speak with someone. If another amateur heard his signal, he would acknowledge Dad’s call sign and reference his own call sign. The two would then converse back and forth on the radio—where they lived, the weather, and God knows what of no importance. To confirm and document their radio linkup, my father and his new radio buddy would mail each other cards. These were similar to postcards each radio operator had printed up. My father had thousands, each one with a large W3NG on one side with his address and specifics of his radio equipment on the other. Dad would dutifully mail off a card to the fellow he had spoken with, hoping to receive a card back. Like a humble man’s mosaic of the world, two walls of our basement were completely covered with postcards; hundreds from Illinois and Iowa, some from every state, dozens from Canada and Mexico, many from Europe, a few from South America, one prized one from Africa, and two from Japan. Later, during my stays in England, I realized that my father descended into the basement as a British gentleman might stroll down the street to the corner pub after supper. The Brit didn’t go to the pub to drink, he went for camaraderie. My father wasn’t an actuary when he had a microphone in his hand; he was a man of the world with hundreds of friends.
I married sweet Alice the second summer of my tenure with Bankers Life. My real achievement at the University of Iowa was not a degree, it was stealing Alice away. We met in History 42 in 1964, the year the Ford Mustang was launched, another memorable event. On a scale of 0 to 10, I wasn’t more than a 6 and Alice was no less than a 9.5. We met when she was on the rebound and I was able to offset my large nose and lanky body with quick wit and a caring personality. We graduated in June 1966 and were engaged in early 1967 with a summer wedding right behind.
Just like in the movies, after the wedding we moved into our one-bedroom garden apartment. The good news is that it was air-conditioned with covered parking; the bad news was that furniture was minimal. For several years our living room lamps sat on the boxes they were shipped in—boxes Alice cleverly disguised as end tables by draping them with green “table” covers she made from discarded curtains.
JUNIE, 1831: Sunshine and I were married in the fall, partway through September. Marse Edward and Miss Louisa gave us all of Sunday off, but that wasn’t the best present they gave us. Marse Edward let Sunshine use some of his lumber so’s he could build a room on the back of the kitchen house, a room just for Sunshine and me. Of course it wasn’t just for us a year later. Our boy was born the next summer. I had a hard time. Almost bit clean through the new mama hickory branch.
After about six months of married life Alice came down with the stomach flu. We didn’t know why, but it continued. Finally Mrs. Lawson, the principal at the school where Alice taught second grade, suggested that she might be with child. On September 2, 1968, Andrew signed on as a member of our family, cared for by the smiling nuns at Holy Cross Hospital. One small problem. Alice had requested a daughter. No problem, reorder. On August 20, 1969, not quite twelve months after Andrew was born, our second child was hatched. Whoops! David became Andrew’s younger brother. This time we waited to reorder; wanted to get it right. On March 2, 1971, I met Jennifer, wrapped in her pink blanket. Alice had her daughter and I had two pals to share my electric trains.
In time the ghost of Edward Temple took pity upon me, and Bankers Life assigned me to a special project. I was tasked to learn as much as I could about the emerging managed health-care industry. First, if I may, a short synopsis of health care. For a thousand years or so the delivery of medicine worked rather efficiently. Sick people paid doctors, or medicine men, with money, chickens, or whatever they had. If they had nothing to barter, the doctor healed for free. In the mid-1900s health insurance appeared. This insurance was straightforward and had all the levers in the right direction. If you were really sick and were admitted to a hospital, the health insurer would pay the bill, or at least a major portion. The levers were in the right direction because no one wanted to go to a hospital just to have an insurance company pay a bill; most all tried mightily to stay away.
In the early seventies a new notion paraded onto the health-care stage, clothed in a low-cut dress and seductively named health maintenance organization, quickly shortened to HMO. The HMO fan club put forth an enticing argument. An HMO would provide a full range of benefits, from well-baby care to wart removal; thus, an individual would be more inclined to obtain preventive health care, avoiding the potential for a minor health problem swelling into a catastrophic event that demanded an expensive hospitalization. “An ounce of prevention is worth a pound of cure.” A congenital defect in the HMO theory, though; namely, all of a sudden people had a higher propensity to consume health-care services. Because the HMO was paying, warts were being removed that otherwise would have been tolerated for life.
To control costs HMOs attempted to manage utilization by inserting themselves between the patient and the physicians. All of a sudden an HMO employee with a heavy New Jersey accent was instructing a female beneficiary in Mobile to go to an OB/GYN whose name sounded as if he were an ambassador to the UN. Likewise with the physicians; another HMO employee, recently arrived from Haiti, was on the phone admonishing a fifty-year-old physician in Fresno, who had graduated at the top of his class at Harvard, that his practice patterns weren’t appropriate: “You should have provided a routine exam, not an extensive exam.”
As one of their products, Bankers Life offered health insurance. Not wanting to miss any new industry trends, they assigned me to study the developing HMO industry, and report back my conclusions … wow, they must think I’m smart. Great assignment. I could trash the actuarial tables and engage my creativity—a major portion of such creativity being applied to demonstrating to my new boss a need for me to travel to faraway lands … any zip code not in Iowa. The mother of all HMOs was the Kaiser Health Plan, thrown together by Henry Kaiser to provide health care to his California shipyard workers during WWII. I spent the better part of a day crafting a memo to my boss that justified my need to journey to the land of fruits and nuts. A month later I was on connecting flights through Chicago and then out to LA.
To say I was naïve insults the term naïve. With the address for the Kaiser offices in hand, I dutifully rented my Budget rental
car and pulled out of LAX heading east on Century Boulevard with the expectation that I would soon cross Sepulveda, the street on which Kaiser was located. Not realizing that LA was bigger than the third moon of Pluto, several stops for directions were required before I located my host HMO. Kaiser’s management offered few insights relevant to Bankers Life, but the LA trip had eye-opening attributes. Later that day my first night in a grown-up hotel, the Marriott at LAX. Great bar, great band, great-looking women. Most of them could have been in Charlie’s Angels.
The LA field trip was a warm-up for the Big Apple. A New York law firm specializing in health care, Epstein & Becker—later I used them when I sold to AIG—was hosting a conference on HMOs. Another sculptured memo to my boss pleading the absolute need to attend was followed by a nod of approval. Scheduled to leave on Sunday afternoon, I skipped church and spent most of Sunday morning packing and repacking in an attempt to arrange my shirts so they wouldn’t wrinkle; wanted to make a good impression with my conference counterparts from Cigna, Prudential, and Travelers. A couple of years later I learned that hanging a shirt in the bathroom with the hot water running magically made it appear just pressed. Later still I merely instructed the hotel butler to iron my shirts when he unpacked my bag.
To Chicago on an American 727 and then into LaGuardia on another. Grabbed my bag from a squeaking turnstile and headed to the curb. I knew things were different when I slid into the cab. Between me and the driver was thick bullet-proof glass, smeared with what appeared to be bodily fluids. English was neither the primary nor secondary language of my turban-headed driver. By pointing to the name Waldorf-Astoria on my typed itinerary, communication was established. Twenty dollars later I was in front of the Waldorf. Standing on the sidewalk I gazed down Park Avenue toward the Pan Am building. Like an early explorer at the rim of the Grand Canyon, silent awe. The lobby of the Waldorf-Astoria made me recalibrate my opinion of the LAX Marriott. Got myself checked in and called home—the first of probably ten thousand calls home made over the next fifteen years.
The conference was great, but not because of any insights gleaned into health-care policy. Rather, the words of one speaker made me rethink Bankers Life. The speaker was Phil Bredeson; he went on to become the mayor of Nashville, later the governor of Tennessee. Phil was an entrepreneur who had made a pile of money in the hospital business and then charged into the HMO arena. While his speech rambled, one line resonated. Phil declared that HMOs were not a social program, they were an industry. Everyone I had spoken to previously had referred to HMOs in the context of more benefits for the masses. Phil’s contention was that, if developed just right, an HMO could spew out wondrous profits for its owners. Phil spoke a language not heard in Des Moines.
Other Des Moines differences at the conference included a couple of expensive dinners—so expensive that their cost didn’t fit into the constraints of my travel per diem. Most of the folks at the conference were New York and Hartford types; their uniforms were different from those worn in the land of combines and silos. Their ties didn’t appear as if cut from cardboard and while my shoes looked like they might have steel safety toes embedded under the leather, theirs had fine stitching with elaborate wing-tip designs. Most of their shirts were adorned with gold cuff links, and a few were monogrammed. I’d never seen a monogrammed shirt. At first I assumed the initials were a manufacturer’s logo. And their suits were tailored and fitted for them; mine had that one-size-fits-all look. I was so impressed that I sauntered into a Manhattan men’s store, thinking I just might purchase a New York suit. In Des Moines, $89 bought a suit with two pair of pants. That would have just about covered the alterations for the pinstriped I coveted.
JOHN, 1942: Marched probably a quarter mile and then lined up in front of this building, then inside for our uniforms. I never seen so many clothes. Any size you needed. I couldn’t believe what I got. Six pair of socks, six skivvies, pants, shirts, jackets, shoes, and boots. I stared with my mouth open like to catch flies. I’d never had new shoes or boots. I’d never had much of anything new. And for certain sure never six of anything.
When I checked out of the Waldorf-Astoria, the concierge warned me that the cab ride back to La Guardia would burn no less than an hour and a half given the traffic at the time I was scheduled to depart. One of the fellows from Travelers suggested an alternative. A helicopter shuttle service had hourly flights from the top of the Pan Am building, a few blocks from the Waldorf, right to La Guardia. It would be a quick fifteen-minute trip, skimming over midtown traffic, with a stunning view of Manhattan. I had my father’s Argus C-3 camera, so I hoped to shoot some photos to dazzle my Midwestern friends.
I was scheduled to hop on the late-afternoon flight. The helicopter was going to cost $30 more than a cab, but this was a once-in-a-lifetime type of adventure for an Iowa boy. After a quick, but non-cheap, lunch at the Waldorf, I was walking down Park Avenue with suitcase in tow when I heard a crash from above, then screams, then blood. Didn’t know what happened, but somebody was dead. She was dead right there in front of me. Both pieces of her were dead, laying in an expanding pool of blood that flowed over the curb and into the gutter.
I didn’t take the flight home to Des Moines that evening. I spent another night at the Waldorf, only part of it in my room. For the first time in my life I drank three martinis, trying to wash away the pool of blood on the sidewalk.
Only after I read the newspaper back in Des Moines did I find out the full story. One of the struts on the landing gear of a helicopter that had just landed on the top of the Pan Am building collapsed. The still-spinning blades dropped down and dissected several of the disembarking passengers before one of the blades hit the concrete roof, broke off, and hurtled into the street below, killing the young woman on the sidewalk.
After a few days of regaling my young Bankers Life associates with my death-defying trip to New York, I began to ponder the conference. With more than a little hesitancy, with more than a little trepidation, I drafted a memo to my boss suggesting Bankers Life could use the savings from an HMO program to generate additional profits, versus providing more benefits for the same cost. It took me several paragraphs of preamble before I raised this new flag in my memo. No one saluted. A week of silence from above, then a transfer back to the actuarial department. I had defecated on Edward Temple’s grave.
I was toiling in the actuarial department for two or three years before I met Li. Bankers Life employed their own cleaning crews. They were white folks. Pretty much everyone in Des Moines was white folk. One day a new face in the cleaning crew picked up the trash in my office. Some type of oriental guy, maybe forty years old or so. An Asian in Des Moines was similar to a Martian in Manhattan. I’m not sure I’d ever seen one before in the Bankers Life building. He was a quiet gentlemen; walked in, kept his eyes low, dutifully emptied the trash can, and was silently off. Around the same time I started a night course on Mondays and Wednesdays. I remember the days because Monday Night Football hit the airwaves with Howard and Dandy Don. Real entertaining. The night course was advanced statistics, an evolutionary step in my career at Bankers Life. We’d have a break halfway through class; this is when I stole a quick cigarette. I only smoked when absolutely certain my parents weren’t within miles.
One night during my smoke break I saw an Asian man from another class puffing away. I made note of my second Martian sighting. A couple of weeks later the gentleman emptying my trash wore a bright-green shirt that was way too large for him. Later that night during my smoke break I saw the night-school Asian wearing a green shirt that was way too big for him. There weren’t two Martians after all. We nodded toward each other.
The next day when he came into my office to empty the trash we spoke briefly. Li was Vietnamese. He and his wife and three kids had stolen out of Vietnam when the Americans cranked up their helicopters for the last time and headed east. Iowa’s Governor Ray was one of only a few who had responded to President Carter’s plea to support Vietnamese refugees—those
who got the hell out of Dodge when Ho Chi Minh’s armies swept through Saigon.
During many two- or three-minute conversations I got to know Li. He had been a medical technician in Saigon, working in an American outreach program in remote villages. For the first month in the United States his family was supported by a church group; then he paid his own way. His wife worked in a dry cleaning shop and he had the job at Bankers Life, plus another one stocking at the Safeway from 3:00 to 11:00 a.m. Two nights a week he was taking a course to brush out the accent in his English.
Li’s goal was to see his kids well-educated and professionally employed. He hoped that at least one of them would become a doctor. Later I learned that all three of his children were girls, a surprise. A female and a physician didn’t compute in Des Moines. Until the sixties Bankers Life would only hire single females. If a woman working at Bankers Life married, she had to resign immediately. In my world back then, women weren’t professionals. Of course I rethought this when I saw Margaret Thatcher pull up her pantyhose and kick the Argentines in the balls. I had the opportunity to meet Margaret and plead Hank’s case in Williamsburg years later. Sorry, getting way ahead of myself.
Li made me ponder my future. My father was living a good life. I knew this because he said he was; but it was a life of postcards and actuarial tables. Likely I would mirror my father’s existence. I would work hard, but not too hard. I would enjoy my vacations and holidays, I would welcome my annual 2.5% raise, in thirty years I would have a subdued, nonalcoholic retirement party, during my retirement I would spend more and more time enjoying a hobby of no consequence or passion, then die and slowly rot in the ground. I looked at Li and he was, as we would say in Iowa, shoveling the manure with a short-handled shovel. He wasn’t coasting; he was working two jobs, his wife was working another; they had a goal. And the goal wasn’t to go from two to three weeks’ vacation after ten years of employment. They were striving to achieve an unreachable goal. They were pulling themselves up the American success ladder.