How Aetna's former CEO found a blueprint for leadership in an ancient Taoist text

Elijah Nouvelage/Reuters

Former Aetna CEO Mark Bertolini.

• Mark Bertolini served as the CEO of Aetna from 2010 to 2018, stepping down after selling the healthcare company to CVS.
• He said he's followed the "Four Levels of Taoist Leadership," based on a verse of the "Tao Te Ching," and that the highest form of leadership to attain is becoming invisible.
• C-Suite Insider is a collection of exclusive interviews with leaders of the world's largest companies.

Every once in awhile, Mark Bertolini's son Eric will ask him, "Why are we still here?" Bertolini, who served as the CEO of Aetna from 2010 to 2018, and his son have both had brushes with death.

Bertolini broke his neck in five places in a 2004 skiing accident, leaving him with a disabled left arm; a year earlier, Eric managed to beat lymphoma. The teenager would later receive a kidney from his father due to complications following his recovery. The experiences made Bertolini more empathetic, he told Business Insider in February. One place he turned to was Eastern religions, and his readings even affected how he led.

"I talk about this thing on the 'Four Levels of Taoist Leadership,'" he said, referring to a phrase he coined. It's an ancient Taoist lesson adapted to principles you would find in a business class.

Bertolini explained: "The first level is your employees hate you. The second level is your employees fear you. The third level is your employees praise you. The fourth level, you're invisible because your organization takes care of itself."

It echoes a passage from the foundational Taoist text, the "Tao Te Ching," attributed to sixth-century-BC philosopher Lao Tzu. The following is verse 17, from Stephen Miller's translation:

"When the Master governs, the people
are hardly aware that he exists.
Next best is a leader who is loved.
Next, one who is feared.
The worst is one who is despised.

"If you don't trust the people,
you make them untrustworthy.

"The Master doesn't talk, he acts.
When his work is done,
the people say, 'Amazing:
we did it, all by ourselves!'"

Bertolini said he felt like he had achieved that fourth level in the last three or four years of his time as Aetna CEO, and he was ready to leave when he decided it was best to sell the company to CVS Health.

"That's the legacy I want to leave - an organization of people that get it: They make it better, they keep it going," he said. "I don't need to tell people what to do."