CEOs are divided on speaking out in polarizing times

Gabriel Perna | February 24, 2020

Key Takeaway:
*More CEOs are speaking out on social and political issues, potentially driving a wedge between their organization and divided consumers.

*CEOs, such as Michael Apkon of Tufts Medical Center and Eric Dickson of Umass Memorial Healthcare, aren’t afraid to speak out about the woes of the American health system—even in an election year.

*Veteran health care executive John Figueroa doesn’t think CEOs should speak out on matters that do not pertain to their business.

“Republicans buy sneakers too.”

Michael Jordan’s supposed quote on politics defines how a number of business and health care leaders had traditionally felt toward speaking out on polarizing topics. While it’s unclear Jordan ever actually said those words, his actions for a period of time were clear cut: It’s not worth angering half of your customers by taking a stand on social issues. Your politics isn’t your organizations’ politics.

Of course, recently, Jordan has been more outspoken on divisive topics, with both his words and his wallet. The basketball legend’s 180 represents a larger changing shift in opinion on how employees and society at large views the CEO’s role in speaking out on socially important issues.

In a recent survey of the global workforce, Edelman found that 92 percent of employees say CEOs should speak out on issues of the day. Three-quarters of respondents say CEOs should take the lead on change instead of waiting for government to impose it. Weber Shandwick has similarly done research in this area and found that activism is becoming something employees expect of their leaders.

 “People are looking to you as a leader and people are looking to you when asking the questions, ‘What’s best for society and our community?’ Not just what’s best for the businesses you lead,” says Umass Memorial Health Care CEO Eric Dickson, MD.

Perhaps it’s this mentality that led Merck CEO Kenneth Frazier to resign from President Trump’s business council after his comments about Charlottesville. It also may be the mentality that Northwell Health CEO Michael Dowling has when he took out an ad in The New York Times, describing gun violence as a public health crisis. Northwell has committed $1 million toward gun violence prevention and urged other health care CEOs to follow his lead.

“Gun violence is a national tragedy and public health crisis that demands we use our political capital and advocacy. Health care CEOs and the 18 million men and women who are part of the nation’s health care workforce can be an incredibly powerful voice for change,” Dowling wrote in the letter.

Outside of health care, there have been pertinent examples as well: Salesforce CEO Marc Benioff, Patagonia CEO Rose Marcario, PayPal CEO Dan Schulman and many others. Just last week, Amazon CEO Jeff Bezos made a $10 billion commitment to climate change—a move that has drawn critics from both sides of the political spectrum.

The CEO who supports Medicare for All

Umass Memorial’s Dickson is no stranger to making waves for having a controversial stance—especially among his fellow CEOs. In December of last year, Dickson stood up in support of Medicare for All. This kind of belief is rare in most CEO circles, never mind in health care. When you add in the factor it’s an election year and this is one of the most divisive issues on the campaign trail, it’s a surprise he would say anything at all.

To Dickson, his open support for Medicare for All comes from a belief that it’s best for his community and the country’s larger health care problems.

“When you’re put into the role of CEO, you have fiduciary obligations to your organization. And as policy changes and possible things come out, everybody’s first reaction is ‘What’s best for my organization?’ Instead of stepping back and saying, ‘What’s best for society as a whole?’ Sometimes you’re conflicted with – this may not be good for UMass Memorial Healthcare or the organization I lead vs. what is best for society. This is one of those things. Medicare for All, as it’s designed and as people talk about it, might be bad for UMass Memorial Health Care, but I think it’s the right thing for society,” says Dickson.

Michael Apkon, MD, CEO of Tufts Medical Center, another Massachusetts-based CEO, has also spoken out about health care policy and his frustrations with the current system, through an op-ed in The Boston Globe and an interview with WBUR.

Apkon, who spent four years as the CEO of the Hospital for Sick Children in Toronto, revealed in the op-ed that administrative costs to maintain a health care organization in the U.S. are approximately 50-fold higher than in Canada. While he didn’t advocate for government-run health care, he said he doesn’t think the market can solve all the problems of this system.

I believe when you move toward giving opinions on things that don’t matter to your business, you begin to create a wedge with someone. Even if you think your opinion is 80 percent accepted, there is still the 20 percent that you’ve alienated.

John Figueroa, Former CEO of Genoa Healthcare, Apria Healthcare Group and Omnicare

“I’m not pushing for a solution. I’m trying to provide perspective on how this system is working and to change some of the beliefs people have that are not grounded in fact but based more in fear. Our current system soaks too many dollars away from bedside care and creates too many complexities for people trying to navigate the system. It’s led to too many disparities,” Apkon told Health Evolution. “We’re behind and we’re falling further and further behind.”

Pointing out that the Canadian system has significantly less administrative costs than the American system doesn’t mean he is a full-fledged single payer advocate. Rather, he says the market-driven approach of the American system has aggravated some of these costs and believes there must be a counterbalance, whether that’s in the form of government regulation or something else entirely.

Apkon wants a conversation on the pressing problems of health care, but that’s not how some people saw it. “Most of the negative comments to my op-ed and [radio] piece paint me as a supporter of government-run health care or a single payer system,” he told us. “That’s a misinterpretation of what I’m saying.”

To speak out or not?

To Apkon, any backlash to his comments is a price worth paying if he can get people discussing how to lower the cost of care in this country. “We’re privileged to hold positions that can be pretty influential. We’re also part of the problem. We’re a big cost center within health care,” he says, before acknowledging, “There are plenty of things I believe in that I won’t be public about. I may not even be so public about this if I didn’t think I had something unique to contribute, coming from Canada.”

Not every health care executive says it’s worth expressing your beliefs on controversial topics to the larger public. John Figueroa, with the Pepperdine Graziadio Business School, has been the CEO of Genoa Healthcare, Apria Healthcare Group and Omnicare over his career as well as the President of McKesson Corporation’s U.S. Pharmaceutical Group. He doesn’t think making broad public statements is a good idea in general.

“As a CEO, you have a responsibility to run your company for the consumers you serve as well as the shareholder component, whether you’re a public or private company, and your employees. Your responsibility is to do the best job you can do to make business successful. I believe when you move toward giving opinions on things that don’t matter to your business, you begin to create a wedge with someone. Even if you think your opinion is 80 percent accepted, there is still the 20 percent that you’ve alienated. As a longtime CEO, I’d refrain from any thing I thought did not pertain to my business,” Figueroa says.

He adds that if a divisive issue does directly impact your consumers then you should speak out. For instance, Genoa primarily deals in the mental health space and during his tenure as chief executive officer, Figueroa spoke out about legislation that potentially affected that patient population. Overall, though, he says speaking out can create more problems than it solves.

HealthEdge CEO Stephen Krupa agrees that speaking out on a polarizing issue is a fine line for CEOs to walk and doesn’t recommend the practice. “If you’ve got facts on your side and you’ve got an argument that makes sense and can be clearly shown to be making progress for not only your business, but for your customers and the role of your business within the community, it can be a valuable thing,” he says. But he adds that CEOs need to be careful and craft an exceptional message —otherwise it could backfire.

What’s even trickier, Figueroa says, is when a company’s employee base is imploring the CEO to speak out on an issue. While this has been increasing in the tech world (just ask Oracle), health care organizations have had employee uprising as well. He says CEOs, in this instance, must convince employees that it’s not in the company’s best interest to take a position—but acknowledges that it’s a hard place to be in.

“I haven’t had that experience,” Krupa says. “I feel for CEOs who find themselves in that position.”

About the Author

Gabriel Perna, Senior Manager, Digital Content

Gabriel Perna is the Senior Manager of Digital Content at Health Evolution. He brings 10+ years of experience in covering the intersection of health care and business. Previously, he was at Chief Executive, Physicians Practice and Healthcare Informatics. You can reach him via email at or on Twitter at @GabrielSPerna