In this podcast interview, Mark Fisher, Republican/Tea Party candidate for Governor of Massachusetts discusses his views on healthcare with healthcare business consultant David E. Williams, president of the Health Business Group. This is the second in a series of nine in-depth interviews with the candidates. For a complete schedule and an explanation of the questions visit the intro post.
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?
“It is the wrong approach. It’s a huge costly government intrusion.”
“[Chapter 224] creates two huge new entities and seven different task forces and committees that employ a total 100 different people. It’s taking supposedly 50 million dollars from the casino licenses. I don’t look to the government for reducing the cost of anything.”
“I agree with the proposal to eliminate the number of physician assistants that can report to any one doctor. I think that’s a great thing.”
“I believe that a patient should be able to choose to have a physician’s assistant as their primary care provider. Chapter 224 does allow for that.”
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 problem is that we, as the buyers, the patients, have a middleman called the insurer. We all believe, as individuals, we can’t control the cost. It’s between the providers and insurers.”
“When we go for services, it’s the insurer who ends up paying the hospital or the doctor. If patients had more of the same selection, let’s say, of routine care, office visits and such and they had insurance only for more serious care, then we could start to address some of these problems.”
“We have to be the people who have to see those differences and make a decision accordingly. We can’t do that right now with the insurer paying for all those cost.”
Question 3: More than a dozen state agencies have a role in health care. Is there an opportunity to consolidate or rationalize them?
“When I think about government, I don’t think about reason. [State agencies] exist to employ political allies.”
“We have the highest premiums in the nation. We’ve been in this experiment with Romney Care for nine years now. It was supposed to reduce cost and we have the highest cost in the nation, and it’s going to happen with the Affordable Care Act throughout the country. We have an opportunity to consolidate or even eliminate many of these agencies.”
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 benefit of such technology should be plain for all to see. If it isn’t plain for all to see, there’s no way that the government is going to make it clearer. The government is just going to make it worse, they’re going to claim that they’ve made it better and then they’re going to send us the bill for their services.”
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?
“Hepatitis C has spread through the use of unsterile drug paraphernalia and needles, or through unlicensed facilities that are using such things.”
“The government has a role to play here, but its focus should be in the area of prevention.”
Question 6: There are multiple health care related ballot questions. What are your thoughts about them?
“If the patient and nurse ratio is made known to the public, they can decide for themselves which facility they would prefer to use or be treated in. I don’t think that making a new law is the best way, or the best approach, to achieve them.”
Question 7: How has your experience as a business owner prepared you to be Governor?
“As a small business owner, I’ve been a victim of big business insurers. What I learned is that they are more concerned about making big profits than they are in providing care for the patients that are paying the premiums.”
“In running a small business, we balance our checkbook, we live within our means, and have a healthy dose of common sense. Those are the things that make a big difference on this issue and all issues on Beacon Hill.”
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 do not have to provide equally amounts of dollars to each group to say that we’re treating them equally.”
“We do the best we can, and we know it’s not going to be perfect, and we provide the best available care with the means that we have.”
“I don’t like this divide-and-conquer mentality or pitting one group against the other. We’re a commonwealth. If we believe that and try to do the best we can, we would best serve all the different groups under our care.”
Question 9: Is there anything you’d like to add?
“Government intrusion into healthcare is bad.”
“With the Affordable Care Act, as well as statewide laws in Massachusetts, we have actually driven up cost.”
“I challenge insurers to expand these lower premium, catastrophic only, insurance plans.”
“Let’s open up the marketplace to all insurance plans across state borders.”
“We need to reject the Affordable Care Act in order to realize these cost savings.”
By health care business consultant David E. Williams, president of the Health Business Group.February 27, 2014