Excerpts from the interview are below. The full transcript is available here.
Question 1: Does Chapter 224 represent the right approach to addressing rising health care costs? If not, where does it miss the mark and what would you do differently?
“Overall, it’s going in the right direction. We have to see how effective it is because the devil is certainly in the details.”
“We need to focus on outcomes, and it seems to me that we’re so heavily investing in the old system, rather than creating and pushing new technologies that will create a new system. I’m not sure you can migrate from one to the other very easily because these are complex, established legacy systems. That’s something that needs to be further investigated and I don’t see that in 224.”
“Healthcare is a curious industry in that often patients have no idea what they’re paying for services, and sometimes the providers don’t. So, 224 changes that dynamic somewhat; more information is always a good thing when it comes to consumers making choices.”
Question 2: Certain provider systems in Massachusetts are reimbursed significantly more than others for the same services even though there are virtually no differences in quality. Does the state have a part to play in addressing these disparities?
“The state can play a part, but prices need to be available to the consumer, and consumers need to shop around and act like consumers. We have to figure out ways to align the interests of patients and providers.”
“Understanding these disparities is not always a result of looking at profit margins and revenues and such. When you’re asking if the state should take a step and truly manage the rates, market forces usually do a pretty efficient job once we break down some of these other barriers.”
Question 3: More than a dozen state agencies have a role in health care. Is there an opportunity to consolidate or rationalize them?
“This is something that we need to look at, not just in healthcare, but across a number of different areas within the state. We want to avoid redundancies and excess bureaucracy whenever possible.”
“A lot of this can be done through technology. That needs to take place. Like almost anything, when you do that, you tend to find efficiencies and you also drive better outcomes.”
Question 4: Government policy has encouraged adoption of electronic medical records. However many providers complain about the systems and the benefits have been slow to materialize. Should state government play a role in helping to realize the promise of health information technology?
“The state can incentivize the adoption of certain health information technologies and needs to work with the players in the space to create some standards to get people on the same page. We can offer economies of scale, where it lowers the implementation cost and allows for record sharing across different platforms.”
“The government certainly has helped standardize forms, and we can do that with healthcare IT to get it on the right path. We’ve got to try and drive that and make sure that the systems are integrated, and that they can communicate with each other. We don’t want these redundant efforts every time people are going in to the same systems.”
Question 5: Hepatitis C is 3 or 4 times more common than HIV. New drugs that can cure the infection are coming on the market this year but they are very expensive. What role should the state play in ensuring that residents are tested, linked to care, and have access to these new medications?
“Not unlike what happened with HIV, you have a situation where the cost can be prohibitive. What we need to do is work with some of the manufacturers to make sure that they can realize return for their work in their research and development. On the other hand, we should make treatment as affordable to as many people that need it as possible.”
“One solution might have to do with just extending patent life, so that these companies can recoup their R&D cost. They don’t have to do it in such an aggressive frontloaded way, just because they don’t have a long enough time on the patents. That’s something we need to think about. That’s a much bigger change than something we could do just at the state level.”
Question 6: There are multiple health care related ballot questions. What are your thoughts about them?
“We need to be very careful that we don’t get in the business of legislating the internal management practices or contracts between hospitals and their nurses. The nurses need to be at the table.”
“There’s a way that all of those players can work together without legislators believing that they know what’s in everyone’s best interest.”
Question 7: Your campaign platform mentions improving efficiencies and promoting preventive medicine. Are there specific steps you would take to achieve this?
“You have to get some of the larger providers at the table. There’s extraordinary evidence that primary care pays for itself many times over.”
“One area that we have to take to the next level is nutrition. We all know that there is rampant obesity in our country, which has massive downstream effects in diabetes. There are issues in cardiology, hypertension, et cetera. So we have to push in that direction.”
Question 8: Much of the emphasis in health care reform is on adult patients. Is there a need for a specific focus on children’s health?
“We don’t focus on children’s health as much as we should in certain areas like childhood obesity, which we know is absolutely going in the wrong direction and creates huge problems.”
“The child issues like asthma, overall health and fitness, they’re going to lead to higher cost. So we need to encourage healthy habits.”
“On the drug development side, it’s very common that there’s not even an arm for children in studies. We’re not compounding the way we should and there’s a lot of opportunity in that area for children’s health.”
Question 9: Is there anything you’d like to add?
“I do want to bring a new set of eyes to identify these problems and solutions and not do more of the same old, same old.”
“This a very complicated business and I do believe we all need to focus relentlessly lowering cost and driving outcomes to be better and better. I know that’s what I’ve done in my business. Some of it through technology, a lot of it through innovation of one sort or another.”