Courage to Challenge Conventional Wisdom

Why CEOs, not HR or insurers, who want to maximize shareholder and customer value must take charge of employee health and healthcare costs

Too many capable leaders defer to “experts,” especially in technical domains where learning enough to challenge prevailing views feels time-consuming, risky, or just plain uncomfortable. Yet real experts should welcome being challenged. That friction sharpens thinking.

The historian Thomas Kuhn explained why in The Structure of Scientific Revolutions: breakthrough ideas rarely come from insiders defending the current paradigm. They emerge from those who notice anomalies others dismiss. Business thinkers such as Eric Von Hippel of MIT and the late Clayton Christensen later showed the same pattern in innovation: durable change begins by questioning assumptions everyone else treats as fixed.

Yet social norms, and professional insecurity, still discourage general managers or even CFOs from challenging orthodoxy, especially in healthcare.

That reluctance is costly.

Being Unafraid to Fail

Challenging conventional wisdom guarantees occasional failure. Many prevention and wellness efforts needed redesign before they succeeded. No one could show me a proven path. Tenacity mattered more than certainty.

The leaders who succeed treat missteps as data, not defeat.

Integrative Thinking: Reframing “Impossible” Tradeoffs

Roger Martin, former Dean of the Rotman School of Management, calls this “integrative thinking:” refusing to accept that goals are inherently incompatible and instead asking questions that reveal a better model.

Progress begins when leaders reject false tradeoffs and search for evidence that a different paradigm is possible.

Finding the Evidence for an Alternative Paradigm

In the pre-AI era, leaders I admired hunted patiently for data that contradicted accepted wisdom. It took time and rigor.

Today, AI dramatically accelerates that process, helping leaders surface patterns, anomalies, and evidence in hours rather than years. AI doesn’t replace judgment; it amplifies it.

Building a World-Class Culture of Health

When I was asked to lead HR at Pitney Bowes in 1990, I didn’t intend to challenge orthodoxy. I had no choice but to do so.

On my first day, the CEO gave me five “incompatible” mandates:

• Runaway healthcare costs
• Poor employee health
• Weak access and uneven quality
• Low satisfaction
• Unsustainable free benefits

Our Benefits team and outside consultants said it couldn’t be done. Conventional wisdom rested on two assumptions:

1. Better health and quality require higher spending
2. Employees would never accept shared responsibility

My task was to find evidence that health could improve while costs declined, and to build trust so employees would see shared responsibility as beneficial, not punitive.

The Breakthrough: Delinking Spending from Outcomes

That evidence came from Dr. John Wennberg at Dartmouth. Over decades, his research demonstrated that higher healthcare spending rarely produces better outcomes.

Better management of care, not more care, drives health.

Once employees understood that truth, cost sharing became part of a credible, trusted system.

Seeing the System Whole

Enduring solutions begin by defining the right system.

Our benefits program wasn’t a “healthcare system.” It was a health-management system. That shift changed everything.

Most health is created outside the clinic. Lifestyle and environment drive roughly 80% of costs. Healthcare intervenes when self-management fails.

So we looked upstream.

Beyond Prevention: Social Determinants of Health

In the early 1990s, prevention meant screenings and immunizations. But Sir Michael Marmot of the University College of London showed something more powerful: health outcomes are shaped by education, work design, autonomy, stress, and social cohesion.

In his Whitehall studies of the British Civil Service workforce and leadership cohort, the strongest predictor of health wasn’t pay or title, it was control.

Later, as CEO, I saw something Sir Michael Marmot had not emphasized enough: the outsized role of CEOs themselves. Leadership tone shapes stress, financial wellbeing, trust, and meaning at work. Chronic stress magnifies illness. Supportive environments reduce it.

Health does not start in HR. It starts at the top.

Choosing Better Care—Not More Care

Three truths are still misunderstood in U.S. healthcare:

1. Quality varies widely by provider and region
2. Most plans pay for volume, not outcomes
3. Primary care is reimbursed to treat illness, not prevent it

We responded by steering employees to top performers, building on-site clinics, and investing in navigation and excellence, paying more for value, not volume.

Start with Root Causes

Our clinicians practiced true root-cause analysis. I experienced it personally when our Medical Director avoided the easy answer, another antibiotic, and uncovered the real cause of a repetitive bacterial facial infection. Our nurse practitioners, trained in Mayo Clinic motivational interviewing, learned how to diagnose why behavior change fails and how to help people succeed.

Work Backward from Outcomes

We asked a simple question: What does “healthier” look like?

Then we worked backward.

The result was one of corporate America’s earliest true cultures of health: better outcomes, slower cost growth, and deep trust.

Healthcare costs stabilized at 20–25% below benchmarks, with parallel gains in absenteeism, disability, and injury reduction.  We achieved this despite a workforce that skewed toward lower-income, less healthy service employees in our Management Services Division.

We also redesigned work itself, reducing unnecessary driving, limiting overtime that destroyed sleep, and reshaping facilities to promote movement and healthier social norms.

Health improved. Costs fell. Performance rose.

What This Means for CEOs—Now

The challenge my CEO gave me 35 years ago still confronts every self-insured employer today.

That’s why we built MoveFlux and the MakeUsWell Network, to combine AI-accelerated insight with hard-earned human judgment to solve those same “incompatible” goals at scale.

The approach helped produce a Harvard Business School case study led by Michael Porter and Jennifer Baron in 2009. What once took decades can now be done faster, smarter, and more precisely.

A Call to Action for CEOs

If you are a CEO, or report to one, ask yourself:

• Who truly owns employee health in your organization?
• Are you managing healthcare costs, or letting them manage you?
• Have you accepted tradeoffs that no longer need to exist?

Health is not a benefit line item. It is a strategic operating system.

If you want to explore how AI-enabled, evidence-based integrative thinking can help you improve employee health while bending the cost curve, I invite you to start a conversation.

👉 Let’s rethink employer health together.👉Contact me directly at mikeceo@moveflux.com to continue the discussion. 

Harvard case reference:https://www.hbs.edu/faculty/Pages/item.aspx?num=36829