California solution | Duane Dauner | Topical Agenda

The role of California as an independent health policy actor is coming into sharper focus, with both new assets and liabilities getting clarity. We’re tracking some of those items below in 5 Things We’re Watching in California health care for February.

1.  Replacing Duane Dauner at CHA

Duane Dauner’s public announcement that he’s leaving CHA is now a few months old, and Sacramento leaders are starting to realize what a loss his departure will be.  Duane is well respected for having the institutional knowledge, credibility, and respect of his peers that create uncommonly large shoes to fill for the next CEO.

Some insiders tell me they like Anne McLeod for the position though I’m told that the CHA board won’t consider internal candidates. Names like Diana Dooley, Cindy Ehnes, Bill Barcelona, and Dimitrious Alexiou have also been bandied about. Whoever takes the position will face some immediate headwind as a result of the transition from the ACA.

2.  NorCal Topical Agenda out next week

We are looking ahead to our April 27th event in Sacramento, the 2017 Northern California State of Reform Health Policy Conference.  Next week, we release our Topical Agenda for the event with a scope of topics drawn directly from our Convening Panel and stakeholder conversations.

We build our agendas through a process heavily reliant on input from market and policy leaders. It’s iterative, and relies on the engagement of folks interested connecting the conversations taking place in health policy with those in the health care market.

When we release the Topical Agenda next week, let me know what you think. Are we missing topics? Is the framing quite right? Have a speaker you’d like to suggest?  Send me an email to let me know.

3.  Is a single payer model the CA solution?

Here’s a dirty secret: hardly anyone likes the ACA enough to implement it in their own state. In other words, if California were to raise the billions of dollars needed to implement the Exchange and Medicaid expansion on its own, my guess is progressive advocates otherwise supportive of the ACA would likely rather direct those hypothetical new state funds to something like Sen. Lara’s Healthy California Act, a single payer model introduced this week.

The ACA might have been a federal solution, but it might not be a future California solution.  The ACA was borne from compromise with then-Democratic US Senators from places like Nebraska and Alaska. Now, Congressional Republicans want to roll back Medi-Cal FMAP funding well beyond simple ACA repeal.

Perhaps Sen. Lara’s bill gains currency in this context:  Trump and the Republicans don’t get to pick the health care winners and losers, and we’ll never get to 100% health care in California unless we lead.”

4.  Video:  Sameer Awsare on drug pricing

Dr. Sameer Awsare is the Associate Medical Director at The Permanente Medical Group.  He’s become an important thought leader, both in California and in Washington DC, on the challenges of managing drug costs in the health system.  He joins us for this episode of “What They’re Watching.”

From his comments:  “The drug pricing model in this country is really broken and it needs to be redone. I think it needs to have three components in it… to figure out how the heck do they come up with these drug prices.”  It’s a sentiment of exasperation, and one likely to continue to garner attention until it’s resolved.

5. Providence coverage drives resignation

The Seattle Times just printed two of the most powerfully damning stories I’ve ever read about the health care system with Providence Health and Services and its affiliate Swedish as central figures in the stories.  You should read them both (one, two).  This is part of a series by the Times on how the financial incentives in health care can corrupt a system – from care delivery to administration.

This week, Swedish’s CEO Tony Armada resigned as a result of the investigation, but not before saying the stories were based on “rumor and misinformation.” Legislators in Washington state are now calling for a new investigation into Providence’s practices, as well as a review of any harm done to Medicaid beneficiaries by Providence.

Meanwhile, a neurosurgeon in Texas just received life in prison for practices similar to those employed by Prov neurosurgeons, as detailed by the Times.