Thomas E. Price MD, US Secretary of Health and Human Services (HHS) came to talk to us at Athena Health’s MDP conference. It surprised me to see him in the agenda: not a large conference, in Maine, far enough from DC that the trip must have been a full day’s effort, to a group of maybe 300; seemed to me he has larger issues on his plate for a day’s work, but I very much appreciated the effort.
Format was a 45 min. couch to couch interview by Jonathan Bush, CEO of Athena, plus 15 min. fielding audience questions.
My takeaways were Dr. Price’s expressed main objectives as Secretary:
A. Instill trust in the HHS.
B. “Turn the tide on three major health problems going the wrong way”:
1. the opioid epidemic
2. behavioral health (particularly the population cycling between homelessness and prison)
3. childhood obesity
A., building trust is a tough job, given that his boss has campaigned on a lack of trust for politicians and career government administrators, yet Dr. Price is a politician as well and the HHS is staffed by career administrators. However, he did a good job, he showed himself to be seriously concerned. I for one was well convinced that he does have a passion for our common interests in improving health. His desire to instill trust was indeed expressed in his schlep to Maine to talk to us, a small group of people. We are in the trenches of health IT and the shift towards value based medicine, gaining our trust is indeed important.
On B., turning the tide on the health crisis, his choice of targets is well considered, no magic cure out there, but at least the variables of the problem are known, treatments do not need a major drug innovation, and these three problems need urgent tackling, no doubt. Dr. Price’s talk, however, was short on specific policy measures, which will help us turn the tide on any of the objectives, we hope to learn about them in the future.
When he fielded questions from the audience, nobody asked about specific policy measures, perhaps we should have. I tossed a standard question “What is your diagnosis and cure for the fact that US healthcare is per capita one of the most expensive, yet achieving inferior outcomes compared the rest of the developed world". His answer was interesting, first he disagreed with my premise, stating that if you filter out murder, accidents and drug overdose, life expectancy is just as high in the US as in other countries in the developed world. Interesting point. US healthcare at its best he saw as superior, and free peoples should be free to decide how much they want to spend in healthcare without a government to dictate it. He went on to discuss how the free market and deregulation would bring Adam Smith back to healthcare and reduce costs (reference to Adam Smith is mine, not Dr. Price’s).
US healthcare is certainly like some of the economies I have lived in: socialism without a plan and capitalism without a market. Whenever I have seen planned economies vs markets, time and time again markets have been more effective in both achieving efficiencies and more equitable distribution of resources. I am looking forward to seeing specific measures to achieve a market driven healthcare system.
He had a number of other good points, on the issue of health data interoperability he did see a government role in standardizing nomenclature, units, and such, what he called the language. “Imagine flight control without a common language or roads without standard road signs”. On value based medicine, where there is a definite consensus around the room, he suggested that doctors should be the people we trust in developing outcome measures and objectives.
Our hour was up, we were left with many questions, and hopefully, more trust.