Peter Andruszkiewicz

Ahead of yesterday’s finance committee votes in both houses of the General Assembly approving RhodeWorks, the truck toll plan, a press conference was held at the Greater Providence Chamber of Commerce (GPCC) featuring some of Rhode Island’s most powerful political, business and labor leaders. They were there to present a unified message in support of the tolls, despite vocal opposition.

One prominent Rhode Island business owner, whose business has “been a member of the Chamber for almost as long as there’s been a Chamber” told me that contrary to GPCC President Laurie White‘s claims that this issue has been discussed with membership, he was never consulted about the plan, despite his business’s dependence on trucks for shipping. In fact, he said, “I didn’t even hear about this meeting until I heard about it on the radio this morning!”

As I said before, RhodeWorks is inevitable. The legislation has been fast tracked not because there is a sudden, urgent need to fix our roads and bridges; the need for this repair is decades old. The legislation is being fast tracked because the necessary arrangements between the various parties involved have been carefully worked out, but in an election year, meaning that the sooner elected officials put this issue in their rear view mirror the better. Several legislators are going to be challenged for their seats because of their votes on this.

Not that Republican challengers are offering anything better. As Sam Bell pointed out yesterday, the Republican plan seems to be privatization, which means private businesses will take over our roads and bridges and charge whatever tolls they want to for profit, or their plan is cutting the budget, denying important social services to families in need. (Not to worry, though: Senate President Paiva-Weed promises that she and Speaker Mattiello will continue to cut the budget, cut taxes and cut services. More on this in a future article.)

The cost of RhodeWorks will be passed onto consumers. Ocean State Job Lot raised a stink over the weekend when they put their expansion plans on hold, threatening as yet unrealized jobs, but after this all pans out, Job Lot will not lose out on any profits: They will simply raise the price of their goods. This means that we are not imposing a user fee on businesses as much as we are coming up with yet another regressive tax that will affect the poor and middle class more than the rich, which is just the way our political leaders like it.

The General Assembly is expected to pass RhodeWorks today, and Governor Raimondo will sign the legislation asap. In the meantime, you can watch the full press conference below.

Laurie White, Greater Providence Chamber of Commerce (GPCC) President

RI Governor Gina Raimondo

Providence Mayor Jorge Elorza

Peter Andruszkiewicz, Blue Cross & Blue Shield of Rhode Island CEO and President

Scott Wolf, Grow Smart Rhode Island Executive Director

Lloyd Albert, AAA of Southern New England Senior Vice President

Michael F. Sabitoni, Rhode Island Building and Construction Trades Council President

House Speaker Nicholas Mattiello

Senate President Teresa Paiva-Weed

Woonsocket Mayor Lisa Baldelli-Hunt,
Central Falls Mayor James Diossa and
Lt. Governor Dan McKee were in attendance but did not speak.

Imagine a plan sitting at the RI Department of Health (RIDOH) that would reduce health care spending in Rhode Island by 15 to 30 percent. A plan with the added benefit of improving health care outcomes “with a cutting edge technology that brings every Rhode Islander into world class care – as they need it, where they need it, when they need it, in a way that builds community instead of building profit for others.”

Neighborhood Health Stations, developed by the RIDOH under the leadership of Dr. Michael Fine, is that plan.

Neighborhood Health Stations are “basically community hospitals without walls,” says Dr. Fine in conversation with Richard Asinof of ConvergenceRI. Dr. Fine planned to build one station for every 12,000 Rhode Islanders, between 75 and 100 such stations in all. The first one was to be built in Central Falls.

Neighborhood Health Stations would locate pediatricians, internists, family physicians, dentists, nurse practitioners, licensed and registered nurses, advanced practice nurses, physician assistants, mental health and social workers, physical therapists and occupational therapists, pharmacists, emergency medical technicians and paramedics, registered dietitians, home health workers, promotoras, health coaches, navigators and other healthcare workers under one roof, in a facility that would also offer programs such as “nutrition courses, Zumba classes, or group counseling sessions.”

According to Dr. Fine, if we implemented this plan, we could shrink the hospital system in our state. “When you build out the full delivery system of one neighborhood health station for every community of 12,000 people,” says Dr. Fine, “it is very likely that we can reduce the total number of hospital beds by 40 to 45 percent. That means dropping [the number of hospital beds in Rhode Island] by about 900 beds.”

Governor Gina Raimondo’s budget proposes cutting $88 million from Medicaid’s $2.7 billion in spending, a 3 to 6 percent reduction. Since “Reinventing Medicaid” is being presented as an answer to an imminent disaster, improving the quality of health care or paying adequate wages to health care workers is taking a back seat to saving money.

That’s a shame, because a fully realized health care system of the kind imagined by Dr. Fine would attract business and investment to Rhode Island, while draconian cuts in services to our most vulnerable will have the opposite effect. If we could build Neighborhood Health Stations and make them work, “then health care spending becomes a business magnet. People come and locate businesses here, just because of our health care,” says Dr. Fine.

It’s a great idea, but not one that’s likely to happen. Since Dr. Fine’s departure, Neighborhood Health Stations seem in jeopardy. The new head of the RIDOH, Dr. Nicole Alexander-Scott, has yet to comment on the plan. But a more immediate reason for the plan’s quiet demise can be intuited.

“…if I have had one failure [while serving as director of the R.I. Department of Health],” said Dr. Fine, “if I want to be self-critical, [it’s] that I haven’t made it clear enough to people that we don’t have a problem with insurance, the problem is insurance. That thinking, that insurance, as a financial mechanism, can impact health, is a fundamental, categorical mistake.”

Dr. Fine saw his Neighborhood Health Stations as saving money by cutting out for profit insurance companies, and actually reducing the size of hospitals. The Reinventing Medicaid working group is comprised of a diverse group of people, but for-profit insurers and health-care providers have a prominent seat at the table. Timothy Babineau, MD, president and CEO of Lifespan, Peter Andruszkiewicz, president and CEO of Blue Cross Blue Shield of RI and Helena Foulkes, executive vice president of CVS Health and president of CVS/pharmacy will ensure that their corporate, for-profit interests are protected.

To Dr. Fine, Neighborhood Health Stations are the future of health care. “…if we don’t do it, all we’re doing is perpetuating a costly infrastructure that doesn’t work.” An infrastructure that will remain immeasurably profitable to those sitting at the top of certain health care empires.

The “artwork was created by Roger Williams University students, in consultation with students at Rhode Island College School of Nursing, to illustrate how Neighborhood Health Stations could enhance well-being in Rhode Island communities.”

Tag: Peter Andruszkiewicz

Fast tracking RhodeWorks: Passing unpopular legislation in an election year

Neighborhood Health Stations are better than cutting Medicaid