Passing Thoughts

Kerry Weems: September 8, 1956 – August 31, 2023 Obituary

Jimmy Buffet: December 25, 1946 – September 1, 2023 Obituary

My friend and frequent 4sight Health contributor Kerry Weems died August 31, 2023, from a glioblastoma brain tumor. Diagnosis to death occurred in under seven weeks. All of us at 4sight Health are still processing Kerry’s sudden death, coming to terms with his loss and wondering how we can possibly fill the intellectual void created by his absence. Empty, sad and perplexed doesn’t begin to describe our current emotions.

A day after Kerry’s death, legendary songwriter and performer Jimmy Buffett died of a rare form of skin cancer. Even though I love Jimmy Buffett’s music, there’s no obvious reason why I would include him in my memorial tribute to Kerry Weems. You’ll have to read through to the end to discover why I have.

First things first. Kerry and I first met in the 1980s. Our wives were best friends at Grinnell College and remain very close. My wife, Terri Brady, spent three days with Kerry’s wife, Jean, and their three children at the Mayo Clinic during Kerry’s last week of life. Terri is a godparent to Jean and Kerry’s oldest child Peter.

When Jean was very pregnant with Peter, they visited us in New York City. Kerry insisted we go to Chinatown for a dim sum Sunday brunch. I’m still surprised Jean didn’t lose it in that very crowded and hot restaurant when our server delivered fried chicken feet. Kerry enjoyed every second.

Kerry Weems was a big man with a big personality and a big mind. He began writing for us during the dismal COVID-19 spring of 2020. Having been at the U.S. Department of Health and Human Services during the creation of the Office of Emergency Preparedness in the George W. Bush administration, Kerry brought invaluable experience and perspective to the national discussion on America’s uneven COVID response.

Kerry’s July 2020 commentary on pandemic preparedness detailed the bioterrorism roots of federal planning (regional threats) and its inadequacies for addressing the multifarious threats posed by the nationwide spread of a virulent infectious disease. I learned a great deal from Kerry.

More than anything, I enjoyed our intellectual exchanges. Kerry, Lindsay Morrison (our then-editorial director) and I would debate his ideas for commentaries vigorously. Our discussions went deep and covered wide-ranging healthcare topics. Nothing was off the table including regulatory capture, federal budgeting and drug pricing reforms. Unlike typical CMS administrators, Kerry gained Medicare’s top job by rising through the ranks at HHS. His ability to dissect federal budgets and interpret actuarial tables was unparalleled. Kerry literally knew where all the skeletons were buried.

In early 2022, Kerry wanted to write about how excess COVID deaths were generating savings for the Medicare Trust Fund. Essentially, the million-plus Americans who died from COVID minimized the need for subsequent and expensive acute care interventions. This enabled CMS to extend the Trust Fund’s life by two years. I told Kerry I had the perfect title for his commentary. “Death Math” published on February 21, 2022. A subsequent commentary, “Dead Seniors Save Congress from Tough Decisions,” expanded on the first commentary’s themes. In both commentaries, Kerry made perfect sense out of Medicare’s arcane accounting mechanics and framed how policymakers should interpret and explore excess-death data. An outstanding analysis.

Kerry’s iconic description of academic medicine as “high priests and cathedrals” captures the mystery and hypocrisy embedded within America’s leading healthcare institutions. He offered this tidbit of wisdom in response to my tough commentary on academic medicine’s undeserved sense of privilege and the organizational dysfunction it creates. I still find “high priests and cathedrals” a useful shorthand reference when evaluating potential policy reforms for medical education and research.

Great writing is often a team sport. Kerry loved to debate ideas and welcomed our feedback and edits. The proof of Kerry’s analytic and writing excellence is his 4sight Health content library. His commentaries stand the test of time. Even though Kerry is gone, his commentaries live on.

Back to Jimmy Buffett. Some special songs link to specific times and places. I will forever associate Jimmy Buffett’s iconic “Margaritaville” with Atlanta and the summer of 1977. My brother Doug and I lived for soccer that summer. We played on an international team sponsored by the Greek Orthodox Church. Win or lose, the whole team would go to an Irish pub called Charlie McGruder’s after the games. We’d drink cheap beer, snarf free popcorn and belt out songs like rugby players.

We learned drinking songs in at least half a dozen languages. “Margaritaville” was a big hit that summer and became one of our go-to songs. We performed it with gusto and often received encore requests from onlookers. The song’s catchy tune, simple lyrics and poignant story about a down-and-out guy recovering from a bad breakup resonated then and still does today. Margaritaville’s tune, tempo and mood became the basis for a 4sight Health song titled “Healthcare Dystopia: A Patient’s Lament” about a down-and-out guy struggling with diabetes. The lyrics still haunt me.

Kerry’s first 4sight Health commentary carried the provocative title of “Understanding Despair, Capture and Profiteering in American Healthcare.” Its theme of healthcare pressing down on the common person parallels the message our “Healthcare Dystopia“ song attempts to convey. Kerry’s head and heart always aligned.

Kerry’s “understanding despair” commentary examined America’s rising number of deaths from despair — from suicide, drug overdoses and alcoholism — within the context of healthcare business models that often pursue profits at the expense of patients’ health. Here’s an excerpt describing the incumbent’s “rent-seeking” behavior:

The healthcare industry annually spends over one-half of a billion dollars lobbying, employing a regiment of nearly 3,000 lobbyists. Basic economics would tell you that the healthcare industry’s investment in lobbying is paying big dividends.

At a minimum, the “rents” benefit at least covers the cost of lobbying. In reality, lobbying generates a return multiple far beyond its cost. That return comes at the expense of American people.

Kerry Weems never forgot the ordinary Americans who struggle to navigate a hostile and expensive healthcare delivery system. He understood their burden and worked to ease it. Kerry tirelessly advocated for value-based reforms that could generate better care outcomes at lower cost with better customer experience. That work, of course, remains far from finished. America has just lost a giant healthcare revolutionary in Kerry Weems. While we mourn his loss, let’s double down to advance his life’s work.