Lawyers, Guns and Money

“Send lawyers, guns and money…”
Warren Zevon
The late Warren Zevon wrote many songs, some of which were, well…quirky. My favorite of the “quirky” songs is “Lawyers, Guns and Money.” While not nearly the quirkiest of his compositions (I would award that distinction to “Roland the Headless Thompson Gunner”), I’ve always enjoyed it.

I thought of the song when I read this story in the Orange County Register (follow up story here), about Dr. Michael Fitzgibbons, who sued hospital chain IHHI, claiming that IHHI had a role in framing Dr. Fitzgibbons for a serious crime. In 2006, Dr. Fitzgibbons had been arrested after police, acting on an anonymous and false report of a road rage incident found a handgun in the doctor’s automobile – apparently planted by a party or parties attempting to discredit the doctor. The jury found in favor of Dr. Fitzgibbons.

So that’s the part of the story about lawyers and guns. And it gets me thinking about the money. In general (and not even specifically referring to the above mentioned lawsuit) it seems to me that for a person or persons to be willing to engage in criminal activity in order to achieve their goals, the stakes (at least to that person) must be pretty high. In the Fitzgibbons case, I assume there was enough money at stake for someone to think extreme measures were a worthwhile risk.

On a national scale, there’s a lot of money at stake in health care – about 18% of the U.S. GDP. One need only look at the size and pace of various recent health care related acquisitions, mergers, combinations, etc. among health care providers and some health plans to realize that we are in a very dynamic period. It appears that the scramble for scale in the health care business, or the march to margin, or whatever else one wants to call it, will increase as the new health care environment works itself out.

It appears that environment is undergoing a tectonic shift. This new wave of combinations in health care is similar to watching a poker tournament and seeing participants depart the game. Those that remain at the table have larger piles of chips in each new round. Those “chips” in the aggregate represent that abovementioned 18% (and rising) share of GDP. As more players go all in, one wonders about the effects on individuals, businesses and the health care industry.

Patients and providers – not to mention taxpayers, have a huge stake in all this. The money is significant. The lawyers are working. Hopefully, no guns will be involved.

Be well.


As always, comments are welcome. This is a moderated blog, so comments will be vetted prior to posting.

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