Charlie Baker

This is Tom Finneran elicited the parents forum on AM 688 WR KO. A joint here in the studio by -- a -- a president and CEO -- right -- the title right president CEO of Cobb is no longer fill a room where health -- ago he and one of the -- just not the -- but one of the largest insurers in Massachusetts and you've been the president CEO of the challenge for our of seven years seven years wow that's and by the way as we would do in the intro from -- here's -- he he'd. He and I both agreed senator Bob havilland is a whack off an ice wackos are good whack Lebanese -- these a black actor will. It will have him on he had back in the studio at 8 O'Clock but for why we're going to talk to jolly about healthcare and we're going to take calls as well Charlie is in my opinion the most knowledgeable guy on healthcare in Massachusetts. Bring your ideas as well as you gripes to him he got solve every problem by the way. Hey you know what what you know what's interesting about this guy where to build wealth and I'm not just make an -- up Aziz. Sit here next to me -- at -- otherwise look at Caroline with. So one of this modest the nicest guys I ever met you know all of my time in public office. Ian recently just finished a term on the -- a select men in the town of swamps that way he and his wife -- raisins three fabulous beautiful children. And this is a guy who understands -- public services all about brings brains integrity. Energy in all that stuff to a and -- a plan that in health -- very very impressive. Tallied at a standoff without head of the general critique of healthcare in Massachusetts the United States of America is that one. We don't -- about everybody to who it's very very expensive in -- Massachusetts specifically but in the United States of America and people gripe about that and you see different people -- making policy proposals around those two gripes. Absence of universal coverage and cost costs moving up. Only in one direction and at a rapid rate as a guy who's right in the middle of the arena. What do you say to people who bring those similar complaints to you. And more importantly what do you do as president and CEO Papa pilgrim two trying to get a handle on those two issues.

The them the first -- coverage issue is. Sort of one of the great policy scandals of our time the fact that. The United States America hasn't been able -- a way to bring everybody in under coverage is is this terrible and it's and it's type of thing that's been kicking around in the in the policy worlds since Harry Truman was president. And most other countries have figured out a way to solve this one I'm on the coverage side there's really no excuse for the fact that we -- figure our. But most say that Massachusetts's engaged in what most people with -- Pretty interesting exercise in trying to cover everybody in Massachusetts over the course the next couple years and we're about. A year and a half and this in terms of legislation coming -- in the spring of 2006 this would be the run need to -- rightly be right initiative and we've covered we've enrolled the state -- room. The plans of enrolled the commonwealth is -- only the royal we on this emerald about a 160000 people who were covered before. And we already had one of the lowest on -- rates in the country to begin with and I think we're make -- progress on the island the cost question is a little more difficult for. A couple of reasons number one from medical technology continues to get more and more. Sophisticated and capable of doing more and more things the cheapest. The cheapest thing that can happen in health care is somebody can look you Encino if there's nothing we can do for that. Where there's nothing we should do for that the real money is is is -- things people care treatment -- treatment -- and and the system you know one of the things health -- doesn't get credit for is -- system actually gets more and more. Clinically sophisticated every year and they can do more things for more people and that's not an excuse it's just a fact and a -- if you look at our own data if you look at on anybody's data. On -- per person basis. People consume more health care today than they did. Yesterday skip the question about how much of particular procedure costs or anything like that we get to that later. But if you just say our people use in moralists of this and their use of last year on a per person basis every year for the past ten years. We've used more.

when -- let me ask your question is is what drives that wealth what I call the opportunities created by affluence or is it -- demographic situation I am now. 575 years ago I was 50 to five years ago I was healthy that I am today I mean I still look fabulous and I don't you think look I'm -- I -- buffet drag and all the rest of that. We we do have an aging populations -- what what drives the increase in consumption.

It's it's a combination of things warm room certainly wealthier countries spend more money on health care period there's you know there's credibly straight line correlation as people get older they spend more money in health care tuna population continues stage and that's especially true in Massachusetts because we have trouble. Primarily as a housing costs and much of attainable Elian -- a Tonys and their Euro but the other big issue is the technology the fact that the system can do more things if the system can't solve your problem. Then that doesn't help customers -- costs associated with that the big money is -- is in is an experimentation treatment.

You mentioned medical technology is one of the driving factors -- one of the driving concerns. I'm curious as as the president and CEO of Harvard pilgrim -- How do you handle it when in need shoe would come steel once that is you know to -- represent -- says I period of this procedure I heard of this technology -- of this equipment. And I think this this thing will be good full of -- Tom Finneran health care consumer you have my insurer let's say how do you folks. Handle that without running up you know without creating accusations of rationing but interference with the doctor does doctor patient relationship.

We have him we have the technology committee which jumped. Is made up of clinicians some of whom worked for us for a lot of homework for other folks and health care field and their we also was somewhat committee around pharmaceuticals which has some of the same issues. And and they typically help us develop policies around new technology and in many cases we rely and specialty societies that and other big societies have physicians that. Help the country figure out how to DO new technologies as they've become available their federal standards around as their state's standards around it and nominee at the end of the day if somebody has a beef with the decision that we make. Massachusetts has an external appeal process it's menaces the office of pace of patient protection at the department of public health and if you really think. What you're looking for something that the carrier whether -- adjustable Russia pay four. Well actually help people get in front of -- us. The appeal process that department of public health and then and have batted in and make a decision.

Shelly and my recollection is that not just how the pilgrims of blue cross blue shield and tops consistently ranked in the top ten. Of applause of plants all across the country every by every ranking quality of service especially on -- satisfaction as well as the quality of service provided by the by the provide -- I'm curious given that's actually zero without we're almost out of time but there's only only one that's been in the top one and that's not -- three years and so that's what you get the microphone and it's appropriate to brag they have the -- it when I was speaker once in awhile. So he is the question given those rankings particularly the patient satisfaction ranking. Once curious what your data tells you. How many people end up revealing themselves of that appeals process with the state where they feel that somehow or other. You while the others shortchanging them.

Not very often become you're talking about they're probably somewhere in the vicinity of four million. Plus or minus four or five million people depending upon hi Karen do the math people who are covered by private plans in Massachusetts there are. Tens of millions of health care and Connors and coverage decisions on our secure made every year and them. I can't remember the exact numbers that the PH but it's it's in the hundreds. -- actually end up over the course of the year before the department of public health and and the number of times in which have permanent public health things we've done the wrong thing is very.

Substances as if it's in -- They're going to ask you about the the do film released by -- Michael ball -- I have not seen Seko I don't know whether you have seems ago abscess this is great. We have I do we have we have at least one learned person here in the studio and we do. You've got to tell me about Michael ball up and sick go I have my own view of it but I don't want to just sort you know your a sense of the the movie and whether it's an accurate presentation the health care systems or whether it is.

It's a well I've seen all of his movies -- and I actually think she's even researching the enemy know he's just a pretty clever guy and I think the number it what I guess I would say Mexico is that I'm. There a lot of things about the health care system in this country that I don't like okay and and and I will I will defend the stuff I think is good but Iowa absolutely you know take the -- for the stuff that's not end. His case about coverage is undeniable mean we we should -- recovered from taxes. Disgrace that we haven't come there more things we can and should do about the cost of health care from my my one. The -- criticism was that it would be that I don't I happen you know after 8 years in government am here's a Harvard pilgrim and 30 years of work and throwing some. I sort of concluded that muffins -- black and white has anybody ever makes -- out to being in the most issues are pretty complicated and -- not as simple as people would like to make them and and health care is definitely one of those in my view and he. Basically says the health care systems and France Cuba England and Canada are great and healthcare system in the US is not -- stinks stinks and Tom you know that's certainly a point of view I think I think it's more complicated than that and and if one of the things that comes out of his movie is is a much more aggressive attack on dealing with the coverage problem I think that would be great thing. -- mentioned that you have a committee that work.

Oh by the way I dimensional a couple of minutes ago would would absolutely taken call also six point 72666868. I'm Tom Finneran talking to Charlie pick a president and CEO of Harvard pilgrim the highest ranked health plan in the United States on patient satisfaction as well let us as well as quality of service and two other plans Massachusetts plans are in the top ten that's tugs actually three. Felons out of that -- found somewhere in there somewhere around the top ten to so for the top ten I'll come from Massachusetts and -- this summit this so much griping about healthcare before we take some calls Charlie one last question. From a -- prices always comes in you know everybody talks about big bomber and it's breaking the bank of a cost of health -- In the health -- doll as it is spent today in Massachusetts in the United States of America how much is spent on pharmaceuticals he end. What is the what do you do another pilgrims to try to make sure that it doesn't distort the equation.

Pharmaceuticals is about 20% of the total number -- him in the way to think about it is you know 20% is impatient 20% is actually it's almost 25% as impatient 25% as a patient about 1520% is. Physicians and about 20% -- in the there's another 56% that's what I would call ancillary about them. Durable medical equipment stuff like that and and and pharmacies in 20% plus or minus for the past few years Adam. The pharmacies actual thing that the big driver of medical expense increases right now pharmacy trend is -- an expensive pharmacies going up above 45% a year. Which is not inflation but it's a heck of oh less than -- our money just -- was years ago. Couple things happened their number one -- formula -- you know this notion that if you do get a generic it's five barks if you get a a brand that's on the formula airing the preferred brand it's 15 marks imaging third tier drug for which there are clinical -- available on the second -- in generically as -- five bucks that's worked I mean there's been a tremendous movement. Toward generics over the course of the past 45 years generics now represent about 6065% of all prescribing they were sort of 40% of all prescribing for five years ago the third -- going for 15% down to about 56%. The trend overall has come down a lot and I think we've -- a fair amount of progress on the one thumb to big driver of the big driver of medical expense increased right now Massachusetts's the cost for service an inpatient and outpatient basis. What we pay for each unit of service. We're going to touch and we're going to talk a little that is.

Out that -- were going to take some calls right now want to get paktia rent for around transparency in comparison of costs at different providers but before we do that. Let's go right to a Ryan Ryan you are next on veterans forum with Charlie baker president and CEO pilot pilgrim. They -- they have.

I am on the -- we're doing great wrangling that your idea with jelly they -- the objects are deployed to give him my way to Iraq did you -- Bring up just you know auto insurance a quick -- you know what it you know what are we sure it's been you know you don't -- unit that. You don't get the best that operate -- the -- don't look now I think it should be -- and also are not object you'd think you know obviously hoping aren't that.

That's a really good point -- and one of the things that. The biggest difference between auto insurance and -- health insurance is auto insurance is individual coverage. Health insurance for the most parts group coverage typically most people and a -- and based on the experience of their employer so if you work for the come off Massey worked for Harvard pilgrim. From your coverage comes through your employer and the price of their coverage is a function of the cost of the services that are provided to everybody who works war Harvard pilgrim is covered by. Number who's covered by that plan and I think one of the big problems we all face in the space is trying to figure out a way to create the kind of individual. And senate to do the right thing you're talking about and a world in which. The coverage is being purchased at a group level by in most cases you know whoever it is you worked for. But that's a really mean that's a really good point missing mythic and observation the closest we've been able to get to that individual thing I would say right out of the gate is the is the -- form letters. If you did you buy the generic it's a while less expensive than I am to bring most expensive brand up.

Appreciate the call let's go to -- New Hampshire AJ Dion next on parents farm with jolly picked up from Harvard pilgrim.

a regular because they've bristle at Harvard's program -- for aid for its good insurance that he. You with OPEC carded at any darn -- like okay you know you're all. But -- I had a question.

What -- JLG as Dick did you just say that again just.

Okay if I don't know the girls they pulled out -- at -- with the current year. And that we were trying to document we have like five employees like often enough but. We don't have under like why so we can we want to say it's root as we don't it's like we're on the subject of not -- enough.

Yeah you don't have the scale of Raytheon that can employee that can go to -- in have a conversation about 14000 and -- had plenty to 25.

Certificates so I can imagine. In massive problem really get it up you know what.

Hot hot hot -- I'm glad he was sensitive to the FC CJ into my own personal standards the appreciate appreciate -- John what do you say do what I you know to -- like 2025 they shopped around to look at for the best bet he's clearly pleased with the experiences and we are.

Without the -- the jump up the of the small group market so called which is typically like one to 50 employees come small businesses. Is typically in most states including New Hampshire. There are banned smoking in them vest wearing -- ever been is to say there's a high and a low end with regard to what plan can charge. And you've become part of that big pool that's associated with your group and so and stay in New Hampshire all of the groups of the employers who were sort of between one and 15 in terms of employees. All get priced by Harvard pilgrim based on the experience of that group. Overall of the -- highest -- group of that entire group of small business -- Russia and so many of sought an individual rating for each small company drag its new individual areas need to be a bigger company I don't do that so when he says. He sort of get screwed he's partly right because he has a really healthy young. Workforce a dozen uses system -- all he's going to be paying for somebody it was a small businesses part of that same. Collection of people -- have a less healthy were asked and the the question there is always -- you -- equity you know is equity defined as everybody shares in the expense of those who are sick. Or is equity defined as every tub on their own bodily get price based on where you belong in most states. There's some attempt to try to put all the small groups together and creative a pool unified approach to move to pricing them. We've been talking a jolly pick a president and CEO of how the pilgrim.

Welcome back this is Tom Finneran -- listening to parents forum on AM 680 WR KO up already here is 6172666868 the email address is -- Finneran -- WR KO dot com -- here in the RKO studio by the one an only jolly baker. President and CEO I have a program in the most knowledgeable guy in Massachusetts on health yet -- with a target about tax deductibility. And under what circumstances is that payments healthcare premiums tax deductible for home who gets to take -- who denied the opportunity and why the heck with the of the difference

BM Tom the conversation that we have about with Brian about auto insurance which is individually based in health insurance group faced him in the main reason. Yeah health insurance or your employer -- cousin 1940s the federal government. Come decided to make. It tax deductible for company to purchase health benefits for its workers it wasn't tax deductible for an individual do it wasn't tax deductible for failing to do it just four. An employer and the employer based system we have in this country grew up around that because it's a pretty decent deal for an employer to purchase insurance for their workers and to be able to deduct the full cost of doing that. A bomb a lot of people have said that. We need at some point to make the tax deductibility of health insurance -- it's available not just to employers but also to individuals -- as they read back what about media what book that is the academy has become more and more like that or more and more people workers individuals sole proprietors like kind of stuff. That should have this should change and it's -- one of those things that the federal government's never be able to so you get its act together affects that's that's a disgrace that the federal --

Has yet to get its hands around that one that seems to -- to be not only just basic commonsense. But fundamental equity and Fiennes let's go to David watt without David they say had an idea Rainier with Charlie -- president and CEO about the pilgrim in Tom Finneran on veterans foreign

oh our child is most eligible and it helped catch the that the I think -- this out of my that the phrase but he really is so go ahead David art like out of the section increase our plan but are very what does it take -- complete a senate -- And I you know we're reporting requirements there.

The them. The in my I'm going to do two things on this one as I'm going to send it to two website okay the if you go to the state website. They're WW dot state dot MA -- US menu go to the connector which is the state entity that's overseeing a lot of the implementation of health care reform they have Paul section and more people need to do with regard to sexual -- point five plans in Massachusetts but the basic concept behind the sexual once when he five plan is for health insurance to be purchased on a pretax basis so that its federally tax deductible. An employer files sectional and 25 plan with the federal government that's the mechanism that actually makes it tax deductible under health care reform in Massachusetts if your employer that you work for sort of two or three employees employers and you don't meet. Basic number of our requirements that they have to -- them. You can get them to file a sexual one point five plan. On your behalf with the connector and in you can purchase insurance through the connector on a pretax basis. So that's a way that's the way the state tried divvy up work around the fact that the federal government doesn't make this available for for individuals and what's that -- website again jelly this WW every state -- image does US and you go to when you get to the main page -- the states -- you go to the connector which is part of health and human services and they have. You can actually download the -- torn -- forms -- whoever frequently asked questions section on what you have to do if you actually want to. Pursue getting your coverage federally tax deductible even if an individual David your that you need your employer again this all starts at the -- union the employer to actually do something --

David hopefully that's that that's a help deal let's go to Debbie in Cambridge Debbie are next on parents for a -- M 680 WR KO.

I can react company which if he had topic now we have a -- It is I don't want to know how I'd get their rates but I think is it it will -- opposite it is clear plastic claw and not pregnant going to.

The M -- above them a little bit ago experience when you're with us term is your kid is your employer headquartered in Virginia. Okay oh there's your problem right there mean their make him. There make him a corporate decision to purchase a single planned across the country and instead of purchasing a local plan for their local operation their purchase and the national planned. Out of Virginia and -- the reason. We would hesitate about. So to step in and stepping in at the local level is that if its decisions being made by you know some benefit officer and and private finally we would need them to to actually reach out to us to be able offer coverage you folks here is their make a McCall.

thank -- I think you should incurs in the do that I think that's a great thing for you don't.

a little goes that a little employ a peasant when -- peasant have a rising a lot of rising over there at the Cambridge office and let the Home Office know that you are very happy with that challenge an avid. Not that -- with blue cross but the experience obvious it was a positive one and you know this has a local flavor two for -- that's what I that's what I'd say let's go to two John on the -- sure hey John do you live next -- veterans for a AM 680 WR KO -- Harvard pilgrim.

But watch the morning again a question for. It hasn't everybody complains that health insurance so expensive and a possible cost assortment of the fight or all possible for procedure. It's it's a hundred bullets around mountains. And I want to pay cash and a articles. Yet when I get they were back my insurance company -- but it would be insurance but I don't know it's 60 dollars. Why can't I just made 60 most distribute didn't cost any more done. At like eight cash.

A great question so great question challenge volume purchasing -- area the end of the day what's going on here is. -- from by ensuring we are we are sort of a buyer's agent on behalf of the people who enroll in our plans and by virtue of having a million members and being able to commit to a standard way of doing business on behalf of those million members. With the providers that we do business with we get a discount off what would otherwise be suggested retail.

I got him. John here's a comparison that make if you and I walked into the local let's say Ford could use some business for Rodham automotive company. Let's say we barked at the local Ford dealership. And that we were -- by cops all let's say we walked in and we were going to buy 200 cows because -- purchasing for the local Police Department we need 200 new cruises. You know you know John what's going to happen when what I want got this one prize won by 200. There's another I think that's exactly which alleys just explained he has a -- insured he sits down what mass general and says. On -- be sending new volume I don't want to be trapped a hundred dollars the -- negotiate your point is very bad doesn't detract from your point it's that same service. Being provided he's just got volume and you don't there's an individual you know --

I'm their number of -- number of states have actually. Passed legislation and kicked around the idea of legislation that says that you can't charge an individual. Anymore then a certain amount more than what you. Charge because the companies you do business with and and I think in some ways that's one way of getting your question but I don't some I I don't start with the proposition that. Everybody should pay the same because in some cases it's number there is a legitimate benefit to two volume in there should be some kind of of a price break associated with.

Appreciate the call John let's go to David in lake in -- that you are next on veterans for a may M 680 WRK ago

they Charlie item. And a bit the bit different but I think related question I have a doctorate 18 years who I love look at them to a lot of -- I didn't need to go to anymore you know that the history. In my doctor market -- I am -- told me recently that it go to -- the concierge service yeah. And you know I it's going to turn out is reducing his fourth and you know -- based on what hundred. I definitely right probably -- guy I'm helping it really justified in -- 300 a month just to be a member but I love the doctor. Even a -- even -- truck violated way to -- at least don't you believe is -- for entry is is strictly your old. So I would -- big. Right now she's with.

Yeah yeah. I thought I'd hear a guy from Lincoln talked about -- the big but it just you know that's a lot of mobility in America.

Thanks so filled with the need to thread about how to open a second communicative but he can -- an island particularly healthy. I kind of thought that economic and cultural but I -- the doctor I don't want to -- what -- different trend. Do -- need to think about going to the doctor is going to happen industrywide are aware of peace talks that a little bit yeah.

Sure -- and concierge practices which are basically practices that -- the charge a fee. I was thought of as a theater -- can only kissed her better I'm the charge a fee for a at the charge a fee for for being able Texas their practice is. I don't know if I caught a trend it's certainly a significant development and it's really only started to happen in the last few years and and there are fees that range anywhere from 4500 or 5000 dollars a year down to a few hundred dollars a year and -- typically they're done by physicians -- reluctant to. Shrink the size of their practice see fewer people spend more time with the people they do see and at the end of the day have the math basically still work out mum for the practice overall and I would say that when this first started a lot of people thought that we would have tons of these in a very short period of time and we actually spent a lot of time talking to the docks thumb. In our who who we do business with about whether we they thought this is a good idea or bad idea whether we should do this and and we had a lot of members who call us up and said they were pests that they Garrett. Mum so removed from practices and then from long period of time because there were no longer able. To see their doctors when you go fourth 2000 patients down to 300 patients they're going to be 1700 patients who are going to have to go somewhere else unhappy they're happy and I'm. I think the answer David is that we will see more of these I don't believe. That we will I don't think it's ever going to be more than. 5105 or 10% of of practicing -- and I say that for three reasons number one. There's tremendous ambivalence in the physician community about whether it's a good idea or not to charge a fee to see patients and their just a lot of -- just uncomfortable with that is concept. Second is there a lot of people who are going to pay it we just basically say look you know I pay a lot of money for insurance. A bomb and they do and and that ought to be enough and and the and the third issue is going to be that they're going to be come. Limits to how many people are gonna wanna sort of jump into this and because it's that it does require dramatically altering the style an operation of your practice I would say. My advice you David would be that I'm sure you can find other docs who can't deliver very high quality experience for you in your family. Mum and I believe that most -- the vast majority of darts will not be in a concierge type motto gone forward but they will be 510% plus or minus of of practicing physicians is certainly in new in interest.

a new phenomenon and I'm fascinated by -- all hey let me do a quick reminder by the way about this nice charity auction item that we have going on with Tim Wakefield and Jason Varitek. The -- right now is at 1600 here's the deal. It's -- Available in the Tim Wakefield Jason Varitek pitching in to kids' golf tournament -- July theory it's right around the -- and beautiful black rock country club right down there and hang up. You and three friends not only play 18 holes with meat so it's four plus 15 would get lodged. Prepay hadn't presented by Fleming steak house. We tee off have a great round of golf at black rock we get a drive up the one an only in distracted out of golf club drive of the driver drive because. We'll have will make sure the registry of motor vehicles alert that after that. After a great -- in around a golf on awards dinner prepared by capital real is this outstanding -- Tim Wakefield Jason Ameritech a whole bunch of Red Sox play as local celebrities local comedians you me your buddy's great golf great who. This July duties black reckoning -- and it's all tax deductible the big right now is at 1600 this is to help Francisco hospital Steve Britain training camps pitching in for kids the Red Sox foundation it's good stop trust me this is fabulous and worth the effort so don't forget to call 617931168 the number against 61793116 -- bid right now is at 1600 we can and will do better than that will keep it going and will be back with your calls in jolly baker in a moment on AM 680 WR KO.

Give me any good doctor get out of bed this -- OBG I am unable to practice there their loved what women all across this country.

That's already been sick go home -- go God's idea I really only George Bush I -- and apparently but hot hot hot you know I didn't got a medical school -- be you know BG -- is no question about it have a great bedside manner.

And hey we're going to try to get a at least one book pollen with -- with so happy came in with us he's the president CEO of Java program in the most knowledgeable guy in America about -- yet. Al in -- Boston you why next on veterans foreign AM six EW cocktail.

Jurors' eyes wants unplanned trip that they 20% more based on your occupation looked at abroad and -- stops. I would put in like occasional remote drive a person's well being felt that there was billion dollars more months 960 year when -- do -- Shipley a common health common care for everybody -- discriminating on people's jobs you -- like.

The AM I can't speak specifically to whatever Thompson's -- and the what I can tell is that the way the post typically organizes -- top end on an about a man on in the state of Massachusetts the top and can't be any more than twice as expensive as the bottom and that the band is two to one. And but within that -- within those two bands there's a lot of stuff people. Mom can do I can't I don't know how to answer your particular question here but I can tell is that -- rating by groups is is is done sometimes but it's usually more in the larger markets from the smaller -- I'm surprised to hear that being the difference between being -- clothing and in a limo driver was that significant I don't know why that would have been -- you know.

And I and worker for example as opposed to somebody -- an administrative clerk and we concede. Pretty quick gas going to be a different a big difference -- and I think most people can accept that appreciate the -- show that you've shared with us that. The state has put limits on how much the differential can be a -- you go without asking you about political future for jolly picked off my democratic friends. My an enrolled -- keep saying you know that guy Kelly Banca. Tall handsome smack experienced wouldn't he be fabulous 82 what do you say to you it's just on the keep on things come -- time. How's that for a classic an audience of fraud and as yet unannounced candidate for something but whatever reruns -- he deserves to be elected to a I am grateful parties a friend he's a fabulous leader both in the public sector the private sector that's the one an only --