By Richard Asinof
SMITHFIELD – It was the worst of economic times, according to the first panel, “Long-Run Economic Development in Rhode Island,” at The Rhode Island Business Environment: The Economy by the Numbers conference held March 13 at Bryant University. By traditional metrics, Rhode Island was operating in a poor business climate, with a heavy tax burden and huge gaps in its skilled, trained workforce.
In contrast, the second panel, “The Health Care Industry and Job Creation in Rhode Island,” had a very different view. If the state capitalizes on its nation-leading role in shaping a new, innovative landscape for health care delivery, it could lead toward much better economic times, the panel agreed.
Dr. Michael Fine, director of the R.I. Department of Health, put job growth metrics for Rhode Island in the health care sector in perspective, saying that the trend to move surgery to outpatient settings meant that jobs in community settings, not hospitals, would be growing. The multiplier effect could occur in the growth of multi-disciplined, primary care patient-centered medical homes, where 90 percent of patient services will be located within a few miles from home.
Fine said the best economic strategy for Rhode Island to pursue was to be able to “work smarter by leveraging the skills” being developed in training the medical teams that run patient-centered medical homes. “Rhode Island has the opportunity to develop and market the educational tools to the rest of the nation,” he said.
Fine also said that in terms of public health and reducing medical costs, there was no “business model” for tobacco cessation, yet it had played a major role in reducing medical costs and improving health outcomes in Rhode Island. “It’s not about patient care, it’s about pre-patient care, it’s about providing the care to prevent them from becoming a patient,” Fine said. Investments in treating and reducing the high rate of high blood pressure in adults in Rhode Island, often a precursor of diabetes, stroke and heart disease, would dramatically lower medical costs, improve health outcomes and increase productivity.
R.I Health Insurance Commissioner Christopher F. Koller cautioned against viewing the “meds and eds” sector as an economic engine, given the increasingly high cost of health insurance premiums paid out by businesses. From his perspective, new technology will not solve the problem; it’s not about new robotic surgery, he said, rather it’s about reducing duplication of services and over-utilization. “More MRIs will not get us better health care or lower the costs,” he said. What is needed, Koller continued, is “for someone to say no,” pointing to the way that Gov. Deval L. Patrick has been aggressively pursuing an agenda to bring down the cost of medical care in Massachusetts. The reality is that “20 percent of the economy [the health care sector] doesn’t respond to market rules.”