Playing With Matches

If you happen to meet Michael Turpin at an airport and he’s furiously tapping away on his BlackBerry, there’s no sense politely waiting for him to finish what he’s writing. Just go ahead and interrupt him because it could be a while before he’s done.

Turpin, the 49-year-old executive vice president of insurance brokerage USI, is probably writing the next column for his local newspaper, the New Canaan (Conn.) News. After pounding out thousands of words on his BlackBerry, Turpin emails his musings to himself for editing at home. Then off they go to his editor for publication in two local newspapers and on his blog (usturpin.wordpress.com). His columns often reveal something embarrassing about his 1970s adolescence in Southern California (English Leather cologne and “man-boobs,” for instance), or they might comically describe the joys and humiliations of a California father parenting three New England-bred teenagers. In one column, he chronicles his attempt to connect his children with their pioneering West Coast roots by re-creating for them his nostalgic memories of camping in the wilderness of the Sierra Nevada. To his teenagers, however, the “perfect day” he planned “is considered a cruel, modern version of the Bataan Death March.”

Every now and again, Turpin’s writing turns serious, pontificating on the political history of faraway places or the failures of the healthcare system at home. He sees healthcare through a kaleidoscope, having spent 28 years in the insurance business, both as a property-casualty and benefits broker in the U.S., Europe and the Middle East and then as an executive at United Healthcare, the health insurance giant, before circling back to the broker side of the table at USI. His manifestos on healthcare reform are influenced not just by his professional experience, but also the 27 hours he spent on a gurney in a British hospital while suffering from pneumonia and an abiding left-of-center belief that every person deserves access to a basic level of healthcare. “I feel pretty compassionate about the 50 million Americans who don’t have coverage,” he says.

Michael Turpin is a difficult man to pigeonhole, so it’s best not to try. This could stem from his upbringing. He was the third of four sons, any one of them as capable of landing in the slammer as the Senate. Turpin’s mother was a New Age spirit with a high tolerance for mischief and the ability to elicit her sons’ deepest secrets with a sideways glance. She was the perfect foil to his demanding U.S. Army trained father, an archconservative advertising CEO who believed in hard work and corporal punishment to keep the four boys in line. But even he has a soft side that emerges in Turpin’s writings. When the hard-working but slow-moving Michael didn’t make his high school basketball team, his father, a college hoops player, shared all the lessons one can learn from hard knocks and then told him the coach was an ass.

Turpin studied film and literature at Claremont McKenna, an elite liberal arts college, where he also excelled on the baseball diamond. He landed in the employee benefits business at least in part because the Los Angeles office of Johnson & Higgins needed a good third-baseman for its team to succeed in the competitive Century City softball league.

Turpin’s an aspiring novelist and a history nut who collects lead soldiers. While he’s still committed to his day job, he rebuffs the New York literary agents urging him to write a memoir. He’s an avid reader, trading books with a small circle of friends that includes Silda Spitzer. Yes, that Silda Spitzer, wife of the disgraced New York governor who, as attorney general, did his level best to demonize insurance brokers. Turpin became friendly with Silda when he served on the board of a youth service nonprofit she started. He’s not as close with Eliot, but the Turpins and the Spitzers have gone out to dinner.

“To this day, the fact that I even fraternize with the Spitzers has raised eyebrows in 90% of the people I know,” Turpin says.
Raising eyebrows is a Turpin specialty. And it shouldn’t be especially surprising, given his talent for disrupting whatever the existing state of affairs may be.

“You bring him in when the status quo needs to be destroyed,” says Dard Hunter, a principal in the San Francisco officer of Mercer, the human resources and benefits consulting subsidiary of Marsh and McLennan Cos. In the mid-1990s, Hunter and Turpin were practically joined at the hip, first building the Johnson & Higgins benefits business in Northern California. Their trial by fire came in attempting to integrate wildly disparate organizations when Marsh acquired J&H and then, a year later, Sedgwick, another large competitor.

Even in his 30s, Turpin exhibited a keen ability to bring people along as he turned their world upside down. He did it by getting to know them, communicating a vision they could relate to and setting out a clear path for getting there. “He’s very perceptive to the human condition,” Hunter says.

Maybe it’s the writer in him that makes him that way, the observer whose antennae are always tuned to his surroundings. But more likely it’s a combination of traits inherited from his intuitive mother and lessons absorbed from his British-born wife, Caroline, a former D&O underwriter with Chubb who is “naturally predisposed to think about other people first.” But he deserves at least some of the credit. After years of hijinks, he made a deliberate decision after college to change his default mode from selfish to service.

“He’s unusual in that he’s a humanist first and an insurance professional second,” says Dan Jones, a former CEO of Marsh’s European operations who is now with the London-based specialty insurer Beazley. “For him, the thrill of the job is definitely more in the people side of things.”

After Turpin’s success in San Francisco, Marsh dropped him into Europe and the Middle East to help Jones develop middle-market brokerage operations in countries that historically had been large-account shops catering to multinationals. He hopscotched across Europe, trying to convince country heads, who were like lords of the manor, to shift resources in pursuit of small, local accounts—and not just their property-casualty business, but benefits, too.

They battled against tremendous resistance, but Jones knew Turpin had the business acumen, the people skills and the psychological stamina to get the job done. They had worked together some years earlier, but more important, they’d spent long days and nights in deep conversation while hiking the mountains of California.

“What do you learn about someone when you climb mountains with them?” Jones asks. “Mike and I learned that we had each other’s back, and that stood us in good stead in business. When things get ugly, you know you can trust each other’s motives.”

After leaving Marsh, Turpin stirred things up at United Healthcare. He started out running the middle-market business, but his long experience with mergers and acquisitions made him an obvious, if unorthodox choice, to lead the Northeast region as United Healthcare struggled to assimilate its latest acquisition, Oxford Health Plans.

After United Healthcare’s early mistakes acquiring PacifiCare in California, Turpin had to put the fears of medical providers to rest and ease the concerns of regulators in New York. “Mike was an artful and skilled negotiator on behalf of the company,” says Ken Fasola, a former United Healthcare executive who is now CEO of HealthMarkets, a provider of supplemental insurance, and Insphere, its distribution arm.

Even as Turpin was smoothing the paths outside the four walls of United Healthcare, inside he was shaking things up. Despite its national presence, much of the control rested with local offices that geared their operations around local agents. Having spent his career with a national benefits brokerage, Turpin could see the problems. He crystallized the need to make it easier for large brokerages to do business with United. “He developed programs and products that are still in place today,” Fasola says.

He also helped the insurer see the benefits of collaborating with large hospital systems and the power of partnering with brokers to sell clients on the idea of investing in wellness and disease management programs.

“That was a paradigm shift back then for us to think we could partner effectively with members of the community to move our mission forward,” says Jeff Alter, who succeeded Turpin as head of United Healthcare’s Northeast business and is now CEO of United Healthcare Employer and Individual Business. Collaboration is now an important part of United Healthcare’s business strategy. “I don’t know that he gets full credit for it, but he was a trailblazer.”

Turpin remains a trailblazer in the employee benefits world, but since October 2008 he’s been blazing trails for USI. Since it was purchased by a private equity affiliate of Goldman Sachs, USI has set out to become “the Tiffany-brand consulting broker for the middle market,” Turpin says.

The word Tiffany just doesn’t sound right coming from the lips of a man more apt to break china than show off its sparkle. But it doesn’t really matter because, in addition to giving Turpin $15 million in the last 20 months to invest in producers, attorneys, clinicians, underwriters and health management technology, USI has given Turpin something else that he craves: a soapbox from which to espouse his views on healthcare and agitate for changing how benefits brokers do business.

His critical assessment of our nation’s healthcare failures spares no one—not consumers, government, hospitals or Wall Street. He casts his most stinging indictments at the employers whose business his firm covets, the insurers whose products it sells, and his peers in the benefits business who have “gotten fat and lazy.”

“Mike is more gifted than most at telling the emperor he has no clothes, and ours is certainly an industry with its share of emperors,” says Hunter. “It takes a skilled communicator to tell the emperor he has a problem without the emperor taking off his head.”

So far, so good.

The way Turpin sees it, too many benefits brokers built a comfortable business by cozying up to their clients and insurers without dealing head-on with the fundamental problems driving up their healthcare costs: employees whose health problems fester undetected or unmanaged and then blow up out of control.

Executives at most small and middle-market businesses have little interest in meddling in their employees’ health affairs, and their brokers have gone along, trimming short-term costs around the edges with higher copayments and more coverage restrictions.

“I think the brokers and the agents out there have historically been too willing to proceed at the pace of their customer,” Turpin explained, in one of his more measured comments during a recent interview at USI’s New York City office. “They’re not evangelical enough. They’re not pissed and angry at the inequities and the perverse incentives that exist, in some cases including their own compensation.”

Turpin thinks more middle-market employers would have better results if they could self-insure like most large companies do and reap the benefits of health promotion programs in the form of better claims experience and lower premiums. But only two carriers offer self-insurance to smaller companies, and most health insurers won’t even give fully insured employers access to their own claims data.

When Turpin tries selling this idea to employers, “I see ambivalence,” he says. “Half of them are saying, ‘Screw this. I’m in the business of running my business, not in the business of managing healthcare.’ And employers under 300 employees have been trained to think that way because they’ve been in these fully insured pools where, regardless of what their claims experience is, if they can get it, they end up with 17% and 20% increases.”

Turpin’s criticism of his industry and its customers is not the only thing that sets him apart from many of his colleagues. While Turpin finds plenty to fault in President Obama’s signature healthcare law, he voted for the guy (much to the chagrin of his conservative father) and fundamentally disagrees with those pressing for repeal.

“Brokers and agents need to be honest with themselves that reform is necessary,” he says. “However imperfect, it needs to move forward, but we need to focus our energies on improving it and agreeing that without reform the nation is sunk.”

He’s promoting steeper penalties for employers who don’t offer insurance; the availability of a low-cost insurance plan heavy on preventive care and management of chronic illnesses; a “medical home” model of care in which the primary care provider plays a crucial role in coordinating and managing care; rewards for employers that actively engage in creating a healthy workplace; biometric testing for all; and health insurance premiums that are ratcheted up or down depending on a consumer’s willingness to take steps to improve their health.

“When you start getting into this stuff,” he says of incentives and penalties tied to behavior, “you are starting to play with political and social fire.”

And by the looks of it, Michael Turpin couldn’t be having more fun playing with his matches.