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United Flight 3411 Is A Healthcare Story, Too

April 12, 2017, 5:03 PM UTC

O United flight 3411, I can’t quit you. Like millions of other news- and video-obsessed consumers, I have been held captive by the image of an airline passenger being wrenched and dragged like a sandbag off an overbooked United flight from Chicago to Louisville. I have replayed United CEO Oscar Munoz’s tin-eared and breathtakingly inadequate (initial) apology many times in my head—searching for a hidden sign of meaning as though I were that fill-in-the-blank Tom Hanks character in that fill-in-the-blank Dan Brown book-turned-movie. Munoz’s Take 2 apology also fell short, it seems to me—especially given that it arrived only after a cratering UAL stock price and widespread condemnation on global media and the Interwebs.

A small part of my obsession may be a pang of guilt: We put Munoz on Fortune’s 2016 Businessperson of the Year list (at No. 20)—though, if you read my colleague Shawn Tully’s striking profile on, you’ll understand why we did. And yes, good people can and do make dumb mistakes. We all do. I certainly do. (It’s one of my core specialties.)

But the larger part of my obsession, I suspect, is that there IS a hint of meaning to the Outrage at O’Hare, after all—Thank you, Tom Hanks!—and it reveals something important about many of the industries and institutions we deal with in our daily lives, including healthcare. And that is, when consumers don’t have a choice, they lose. Simple as that.

It may not look like it at first, but healthcare—just like the commercial airline business—is a hub-and-spoke industry. We’re often locked into a handful of hospitals (or fewer) by where we live and by the insurance coverage limitations we have. Our healthcare “networks” frequently send us to specific providers (for things like imaging, blood tests, surgical procedures)—and those providers call the shots when it comes to whether we can get an appointment and when, how long we’ll wait, and what the cost is.

Think airlines are the only ones that overbook and bump us with regularity? Or that slip in hidden fees for who knows what? Or that treat customers as captive prey? Not hardly.

So what’s the solution? Well, fellow healthcare revolutionaries, I would submit that the answer, in part, is to break up the oligopolies. And one way to do that may be to truly open up telemedicine and let providers and insurers trade freely across state lines. If we improve the mobility of care, we’ll drive down the price of care—and level the playing field a bit more between healthcare consumers and providers.

Honestly, I can’t quite imagine a situation where an elderly patient is dragged out of a hospital waiting room because his appointment is suddenly “bumped.” But then, I would have said the same about the airline industry before seeing the video of UA flight 3411.

This essay appears in today’s edition of the Fortune Brainstorm Health Daily. Get it delivered straight to your inbox.