SCAN CEO Sachin Jain to publish book 'The Moral Alibi' on ethical healthcare leadership

SCAN CEO releases book urging greater ethical leadership in healthcare

Sachin Jain, M.D., CEO of SCAN Group, is publishing a new book titled The Moral Alibi, due Feb. 16. In the book, Jain presses healthcare leaders to recognize how they may unintentionally normalize practices that harm patients and to adopt a more ethical posture in their roles. He has raised similar concerns in his Forbes column, social media posts and public talks.

What Jain is arguing and why he feels compelled to speak out

Jain says healthcare is becoming more costly and complex for patients, and that leaders across the industry too often point fingers rather than accept responsibility. He told Fierce in an exclusive interview that his book is meant to call on leaders to acknowledge their part in creating and maintaining the status quo.

"For many years, I've been the lone man in the wilderness, kind of saying, 'Hey, Houston, we've got a leadership problem here,'" he said, describing an organizational and cultural problem in healthcare. Jain frames that problem as one of ethical erosion—a gradual shift in behavior and expectations that makes it easier to accept practices that should be questioned.

He does not exempt himself. Jain noted that he has held leadership roles in provider organizations, pharmaceutical companies, regulatory agencies and now at a health plan, and said he has experienced the same drift in judgment. That willingness to name his own vulnerability is core to the message of his book: ethical lapses are not confined to a particular role or organization.

Examples Jain points to within the industry

Jain referenced SCAN’s own advertising last year, which bluntly stated that "health insurance is broken" and acknowledged enrollment and access pain points members face. He said some peers in the insurance industry pushed back, arguing dysfunction extended beyond insurance into the broader system.

"What an abdication of responsibility," he said. "For any of us to say, 'Oh, we're not broken. The whole system is broken'—sure, the whole system is broken, and I'm part of that system, and therefore part of my work is actually fixing the system." Jain also pointed to the intense public reaction after the December 2024 murder of then-UnitedHealthcare CEO Brian Thompson as evidence that the industry can be surprised by the level of anger and distrust patients and the public feel.

How Jain stays connected to patient experience

To counteract becoming disconnected, Jain has taken concrete steps to remain close to the experiences of members and patients. He works two days a week in a local hospital, which he says allows him to hear directly from patients. Jain also keeps direct lines of communication open to members and responds personally when a member reaches out with a problem.

Within SCAN, he is pressing to make conversations about ethics a routine part of leadership work. Company leaders recently met at an offsite to focus specifically on ethical and moral renewal, an effort Jain described as bringing these ideas to life within the organization.

"That doesn't mean we're more or less ethical than anyone else, but what I will say is we've started the conversation, and people are receptive to it because they too realize that sometimes we normalize the abnormal," he said.

Purpose of the book: vocabulary and accountability

One of Jain’s stated goals for The Moral Alibi is to give leaders the language to talk about ethical problems. He said he does not want to remain "the lone man in the wilderness" and hopes the book will help others recognize and name ethical challenges.

He criticized a culture of self-satisfaction that can exist in healthcare: companies may grow and perform well financially even as patient experiences worsen and costs rise. Jain argued the original motivation that draws many people into healthcare—to help others—should be preserved and protected throughout careers instead of being co-opted by prevailing industry norms.

"We sort of get co-opted by the dominant culture of healthcare, when in fact our innocent eyes were what should have been preserved and protected and maintained at all costs," he said. "We had it right when we first got started."

Why this matters for health plan leaders and the broader industry

Jain’s central point is that leaders who lose touch with patient experience are more likely to tolerate or rationalize actions that they would otherwise find objectionable. He emphasized that health plan executives in particular can be distant from what members experience day to day, and that distance makes ethical lapses easier to normalize.

By arguing that leaders must accept part of the responsibility for fixing systemic dysfunction, Jain is asking organizations that often defend their practices to instead examine where they fall short. The book aims to move the conversation from finger-pointing about who is to blame toward shared accountability and practical steps leaders can take in their own organizations.

What Jain and SCAN are doing now, and what remains to be seen

Jain is already implementing some of the practices he advocates: working in direct care settings, maintaining personal contact with members, and convening leadership to discuss moral renewal. He said SCAN is working to put these ideas into daily practice inside the company.

Specific details on the book’s contents beyond its stated goals—such as chapter topics, case studies or proposed policies—were not reported in the interview. Nor did the source outline any broader industry commitments or planned cross-sector initiatives tied to the book’s release.

Looking ahead

The Moral Alibi will be published Feb. 16. Jain hopes that by providing leaders with the vocabulary and a framework for thinking about ethical responsibilities, more executives will join the conversation and shift organizational cultures away from complacency. His aim is to prompt leaders to take responsibility for changes they can make within their own institutions rather than shrugging off problems as simply part of a broken system.

Whether the book will spur measurable change across payers, providers and other healthcare sectors remains to be seen. Jain’s approach combines personal accountability, visible engagement with patients and internal leadership work—steps he believes are necessary to reverse the gradual normalization of practices that undermine patient experience and trust.