“We need to reconnect the head to the body.” That was one of the themes that Bernard J. Tyson, the charismatic and visionary CEO of Kaiser Permanente, would return to time and again in his seemingly tireless efforts to rethink American health care. Tyson, who passed away in his sleep early Sunday at the age of 60, would often point out that we’d created, somewhat senselessly, two separate health care systems in the U.S.—“one for the body and one for the mind.”
That meant two sets of records and resources, two separate sets of protocols for insurance coverage, two groups of health professionals that rarely interacted. And worse still, we had injected a heap of stigma on the latter—treating mental illness as if it were something to be discussed in hushed tones, or to be kept hidden, as we poured compassion on those who suffered from a corporeal ailment or disease.
Tyson was determined to change that—adding mental health services directly into Kaiser Permanente’s primary care facilities and making what he called the “handoff” between specialists seamless and stigma-less. Just as a primary care doctor might recommend a patient with knee pain to an orthopedist, she might also suggest that a patient with anxiety or signs of depression chat with a mental health specialist—who, in this case, wasn’t in a different building, but rather down the hall, as Tyson told an audience at Fortune’s Brainstorm Health conference earlier this year.
It was a simple, even obvious notion, perhaps—and yet this was a dramatic departure from the way health care has been conceived in America.
But that effort—to see mental wellbeing as a necessary component of physical wellbeing—was also part of something much larger, what Tyson would call his “total health agenda.” His vision, which he shared widely over the past several years, was to create an ecosystem that would support a holistic approach to human wellness in concert with community wellness. Lasting human health wasn’t possible, he came to believe, in the absence of a healthy surrounding.
“We think all the ingredients are in place to move into other lanes that are directly linked to the health and wellbeing of people that would not fit neatly under the category of ‘health care,’ but that are part of the whole ecosystem of health,” Tyson told me during a visit to Fortune last year. “And we now know that the social determinants of health—many of the other categories that we haven’t really addressed concretely—impact a person’s health much more than medical care. One of the big ones is the thing called the zip code. Literally, you can see the differences in the life expectancy in one zip code versus another.”
A few years prior to this conversation—one of many where I’d gotten to know Tyson over the years—Kaiser Permanente hired its first community health officer. His mission wasn’t to think about the then–11 million members of KP’s health plans, but rather to look at the 65 million people who lived in the communities in which Kaiser operated. “His job was to help us understand the broader health infrastructure of those communities?” Tyson explained. “Are there the right food choices there with grocery stores? What’s going on with crime and violence and its impact on mental health and stress, and the ability to go outside and the freedom of movement? Is there an infrastructure that allows for exercise and being able to walk and play? What’s the school system like? And then finally, how are we doing with shelter, with housing, and with homelessness?”
Such thinking led Tyson and Kaiser Permanente—a massive integrated health plan and hospital system that today cares for more than 12 million members in eight states and the District of Columbia—to help create farmer’s markets in urban food deserts and to work with cities from Baltimore to Oakland on addressing the needs of their homeless populations. (In one program, KP worked with a Bay Area nonprofit to help more 500 vulnerable homeless individuals in their mid-50s or older, living under Oakland’s Interstate 980, to get needed health care and housing.)
In the spring of 2018, KP’s CEO created a $200 million “impact investment fund,” which was designed to let KP “go deep in their communities around the country,” and to “walk our talk,” Tyson said. “We know how to scale up,” Tyson explained. “We’ve got good quality information about the wellbeing of our communities, through our Community Health Assessments. So now we’re diving in. But we’re not doing it alone. We also have great competencies in building up relationships and bringing other voices together. So we’re doing it as part of public-private partnerships with the mayors in the cities that we’re targeting. We’re working with other businesses. We’re trying to create an ecosystem of likeminded companies and individuals who also have platforms in which they can push change as well.”
“Our homeless initiative is not a giveaway program,” he stressed. “You need to think about the return on investment. But the difference is, the return isn’t to make shareholders richer, the return is to put the money back to use. So the impact investment fund of $200 million is intended to make a return and the biggest return is the social good we can do.”
Tyson’s eloquence seemed to come easily, speaking without notes in a voice that was invariably conversational even when he was at a lectern on stage. Often, it came punctuated by a rich, deep laugh where you could hear the “ha, ha, ha’s” in full-throated succession. With his round eyeglasses and a week’s worth of gray beard spackled from ear to ear, he had the look of a favorite professor, jocular and instinctively wise.
To say that Bernard Tyson was good-natured, which surely he was, would miss the point, however. His nature, simply put, was good—and he felt an obligation to be candid about where the world felt short in that respect.
He was bold and forthright, on matters ranging from the cost of health care (“It was unaffordable, period,” he’d say) to homelessness (“The narrative that it’s okay to keep stepping over the homeless and going about our business in the richest country of the world is just something we cannot accept.”) to what it’s like to be black man in America.
In the wake of the July 2016 shooting deaths, one day apart, by police officers of two unarmed black men, Alton Sterling in Louisiana and Philando Castile in Minnesota, Tyson wrote frankly about his anguish and, yes, fear. The CEO, one of a handful of black chief executives at major American enterprises, had had “‘that talk,’ he said, with each of his three sons about what to do if they were stopped by a police officer.”
“The idea that I’m passing on the same speech to my sons that was given to me by my father says that the future will be a continuation of what I experienced, what my father learned before me and his father before him,” wrote Tyson. “This is totally unacceptable.”
The same man, who ran an enterprise with more than $80 billion in operating revenue, also spoke candidly to Fortune’s Ellen McGirt about the indignities he sometimes faced when he left the C-suite to walk down Main Street, as Ellen put it. “A recent list: Pulled out of the security line for a public pat down as he attempts to enter his own luxury box at a football game…Tailed by a nervous sales clerk. Asked to show identification when paying with a credit card in the grocery store.”
“The image of the black man in America is warped,” Tyson told McGirt. “And this is where courage comes in.” We need to confront it—and change it.
Part of achieving that, said Tyson, was to create truly inclusive workforces in America. “The diversity agenda for me is understanding the power of nuances. The power of nuances. I am not like you. I am different,” he told his fellow corporate chieftains at a gathering of Fortune’s CEO Initiative. “My life experience is different. And guess what? As a result of that, I have something to offer. So I’d rather have 12 different people sitting at the table with me, all with different worldviews—all clear that we’re going to solve a common problem. And once we decide how we’re going to go forward, we go forward as a team.”
“My journey has always been to be the different person in the room,” he told the group. “Since I started my career. I would go in the room, and I’d be the different person. Then I figured out how to make my voice known in the room.” That he did. And the world, thank heavens, is much better for it.
