Category Archives: Policy and politics

Is Partners HealthCare charting a new course? I’m quoted

I’m quoted in today’s front page Boston Globe article (Partners HealthCare chief met a trail of resistance), which dissects the tenure of outgoing Partners CEO, Gary Gottlieb. It should be no surprise that the continued expansion of the biggest and strongest healthcare system in Massachusetts under Gottlieb has led to friction and controversy.

The reporter asked me about whether a new CEO would change the company’s strategy. Here’s what I said:

Partners executives have said bolstering their network of hospitals is critical to coordinating patient care and keeping costs in check through more efficient care. Gottlieb’s successor and Partners’ board will have to decide whether to stick with that approach.

“The broad expansion, it’s not obvious that they need to do that,” said David E. Williams, president of Health Business Group, a Boston consulting firm. “Partners doesn’t need to expand at all and it would still be the biggest and strongest in the state.”

I suggested that Partners could decide to go back to its roots as a world-renowned academic medical center with its Massachusetts General Hospital and Brigham and Women’s Hospital. There are other ways to coordinate care and control costs besides owning community hospitals and physician practices.

By healthcare business consultant David E. Williams of the Health Business Group

Trashing Charlie Baker on outsourcing –uncalled for

Charlie Baker (R), candidate for Governor of Massachusetts

Charlie Baker (R), candidate for Governor of Massachusetts

The mud-slinging continues in the campaign for Governor of Massachusetts. This time Democrat Martha Coakley is attacking Republican Charlie Baker for outsourcing jobs when he was CEO of Harvard Pilgrim Health Care back in 1999. This is on top of the previous accusations of “raising premiums, cutting coverage for seniors, and tripling his own salary to $1.7 million.”

It’s an unfair attack. Baker should be praised instead.

Harvard Pilgrim’s IT systems were a mess in the 90s. They couldn’t pay claims in an accurate or timely manner, and as a result the company couldn’t figure out if it was making or losing money. As it turned out they were losing, and on their way to bankruptcy. Baker stepped in and righted the ship.

Outsourcing to Perot was a good move. Perot hired the existing Harvard Pilgrim IT staff in Massachusetts. In 2006, Perot hired about 200 employees in India to serve the account. Apparently this is the basis for the Coakley attack, but it’s a pretty weak one.

It’s not Harvard Pilgrim’s job to boost employment in Massachusetts. Instead the primary goal should be to deliver excellent service and value to customers. They seem to have done a good job, since they consistently rate at or near the top of the best health plans in the US.

I assume the Coakley campaign knows that the allegations about raising premiums are not to be taken seriously. Health plans have been raising prices forever –there’s no reason to single Baker out for that. And Coakley would like us to believe that Baker cut benefits for the elderly, making him sound like Paul Ryan taking a knife to Medicare. The reality is much less exciting and newsworthy. And sure Baker got a big salary boost, which is a pretty modest reward for rescuing a major company. If it had been a for-profit company you can bet the rewards would have been a heck of a lot bigger.

Baker isn’t perfect. But attacks on his competence and wisdom as a healthcare leader deserve to backfire.

To read or listen to my interviews with all the candidates for Governor of Massachusetts, check out my coverage from earlier this year.

By healthcare business consultant David E. Williams of the Health Business Group

Falchuk, McCormick should be in the debate

Gubernatorial candidates Evan Falchuk and Jeff McCormick have been uninvited from the televised October 27 debate in Worcester. This despite the fact that Falchuk, and to a lesser extent McCormick, have been outperforming the Republican and Democratic candidates in recent debates and forums.

I’ve written to the organizers of the debates to share my views:

Here’s what I wrote:

Dear _________:

Earlier this year I interviewed all nine candidates for Governor about healthcare policy on the Health Business Blog. My objective was to encourage the candidates to address serious issues facing the Commonwealth, something that I feel was lacking in recent elections such as the Brown/Warren race. WBUR’s CommonHealth blog ran a story commending me for my efforts.

There are four serious candidates remaining in the race. (I don’t count Scott Lively.) Your upcoming debate in Worcester presents a great opportunity to showcase the different approaches to governing.

I understand that you have rescinded invitations to Evan Falchuk and Jeff McCormick, perhaps based on their low poll numbers. That’s a mistake and I urge you to reconsider. As you may have seen, Falchuk has jumped from 2% to 5.4% in the latest poll. His United Independent Party will qualify as an official party if he gets at least 3% —so his current level of support is meaningful and newsworthy. It’s also interesting to see how much he’s jumped now that more voters have seen him in action.

You’ll be doing the right thing for democracy by restoring your invitations to Falchuk and McCormick. Falchuk in particular has been eager to discuss important issues that Coakley and Baker ignore, such as the proposed Partners agreement.

Please let me know if you would like to discuss.


David E. Williams

E-cigarette makers warn consumers about their own products

Is there anything more alluring?

Is there anything more alluring?

In Dire Warnings by Big Tobacco on E-Smoking, the New York Times examines the perplexing case of tobacco companies makers like Marlboro’s manufacturer, Altria, voluntarily placing extensive warnings on their electronic cigarettes. The author and experts find themselves scratching their heads about tobacco company motivations. Their consensus is that the strategy is cynical and probably designed to protect the companies from future lawsuits. In any case, “many people don’t read the warnings anyway.”

There’s some truth to these interpretations, but I would go further and take an even more cynical view. Consider:

  • Before the 2000 stock market crash, financial analysts with clear conflicts of interest put out biased “buy” recommendations for companies they wanted to pump. Disclaimers within the reports cited the conflicts, but somehow people just read right past that or even considered it a positive. Surely if someone was disclosing a conflict of interest they wouldn’t be so brazen as to actually put out biased information! But the analysts were more cynical than that.
  • Mortgage documents are filled with so many protections these days that they have become simply too lengthy to read, and borrowers’ eyes glaze over as they apply their initials and signatures to page after page after page.
  • Plenty of anti-smoking ads (often paid for with tobacco settlement funds) inadvertently or intentionally glamorize cigarette smoking with their edgy, youthful appeal. I saw one recently while at the gym –called “Unpaid Tobacco Spokesperson”– that typified the genre. The ad itself seems to do everything it’s telling people not to. I think it’s absurd.

So basically my opinion is that the e-cigarette ads are intended to lull people into a false sense of safety about these products by warning against them in so much detail.

photo credit: alexanderferdinand via photopin cc

By healthcare business consultant David E. Williams of the Health Business Group

Big party candidates and Globe don’t get it on tech

Evan Falchuk (I), candidate for Governor of Massachusetts

Evan Falchuk (I), candidate for Governor of Massachusetts

Jeff McCormick (I), candidate for Governor of Massachusetts

Jeff McCormick (I), candidate for Governor of Massachusetts

The Boston Globe (No innovative sparks as Baker, Coakley address tech audience) has a harsh take on the performance of Martha Coakley and Charlie Baker at an innovation policy forum:

Baker and Coakley each often spoke in generalities, sidestepped questions about employee noncompete agreements — a major hot-button issue in the tech sector — and left attendees craving substance.

“It was terrible,” said Axel Scherer, a software architect at Cadence Design Systems in Chelmsford. “They said nothing. Just empty suits going, ‘blah, blah, blah.’ ”

Right from the start of the article, I was thinking, Why is this a surprise? And I bet the United Independent Party’s Evan Falchuk and independent candidate Jeff McCormick did a lot better. Sure enough, buried in the very final paragraph is the rest of the commentary from Scherer:

Most of the crowd left after Coakley and Baker’s remarks. But Scherer stayed to hear the two independents running for governor and came away impressed by both Jeff McCormick and Evan Falchuk’s ability to converse on the issues.

(In the comments section of the Globe story online you’ll see that Scherer was taken by Falchuk and wonders why McCormick and Falchuk had to go last.)

But the Globe reports exactly nothing of the actual substance of their remarks. Why not? They both gathered enough signatures to make it onto the ballot, and Falchuk needs just 3% of the vote in the general election to establish the new party, enabling it to place candidates up and down in the ballot in future elections.

The Globe partially redeems itself in an article about a debate later on in Springfield, which also included Baker and Coakley. It included this line:

Evan Falchuk pitched himself as a truth teller, willing to speak bluntly about everything from state finances to casino politics.

I honestly don’t understand why the Globe is focused only on the Democratic and Republican nominees.  The Globe and others blew it in the primary election by running story after story about Coakley’s huge lead in the polls. Remember that the Globe reported its final poll of Coakley 47%, Grossman 25%, Berwick 13%.

In the end, it was much closer: 42%, 36%, 21%. Or as the Globe reported, “far less than polls and party leaders had predicted.” And who knows, the Globe may have thrown the election to Coakley by making Grossman and Berwick voters think there was no chance for their candidates. As a voter in the Democratic primary, that’s how I felt.

Falchuk and McCormick are not fringe candidates. (Scott Lively is, which is why I ignore him.) The majority of Massachusetts voters are not enrolled in either major party. And as the innovation policy forum made clear, the “major” candidates, left to their own devices, will steer away from the tough issues.

At a minimum it’s good for democracy to cover all of the serious candidates so the voters can learn what they have to say. And even those voters who think that the independents don’t have a chance to win in November should consider voting for Falchuk in order to establish a permanent, moderate independent party in the Commonwealth.

By healthcare business consultant David E. Williams of the Health Business Group