>>> JOINING US NOW, PRACTICING
PHYSICIAN, SCIENTIST, AND HEALTH
CARE ADMINISTRATOR, DR. VIVIAN
LE.
PRESIDENT AT HEALTH PLATFORMS SP
SENIOR LECTURER AT HARVARD
MEDICAL SCHOOL.
SHE’S ALSO THE AUTHOR OF THE NEW
BOOK, "THE LONG FIX, SOLVING
AMERICA’S HEALTH CARE CRISIS
WITH STRATEGIES THAT WORK FOR
EVERYONE."
IT’S VERY GOOD TO HAVE YOU ON
THE SHOW.
THANKS FOR BEING ON.
A LOT TO WANT
TO GET TO YOUR PLANS AND
CONCEPTS TO TRY TO WORK THROUGH
THIS.
BUT JUST LOOKING AT THE NUMBERS
HERE IN TERMS OF HEALTH CARE,
LOSING 1.4 MILLION WORKERS IN
APRIL, THE IMPACT ON THE HEALTH
CARE SECTOR AND ALSO WHAT HAS
BECOME OF THESE PEOPLE.
>> SUCH A GREAT QUESTION AND
IT’S SO GREAT TO BE WITH YOU
THIS MORNING.
THANK YOU FOR HAVING ME.
ONE OF THE THINGS THAT THE COVID
CRISIS IS REALLY TEACHING US
THAT WE HAVE TO BUILD A MUCH
MORE ROBUST AND RESILIENT HEALTH
CARE SYSTEM.
THE FACT THAT OUR HEALTH CARE
SYSTEM RIGHT NOW IS DESIGNED TO
BE FEE FOR SERVICE MEANS THAT WE
HAVE INVESTED IN THINGS THAT
GENERATE FEES, LIKE OPERATING
ROOMS AND IMAGING CENTERS AND
CANCER CENTERS.
AND AS SOON AS WE STOP HAVING
THE ABILITY TO JEBGENERATE THOSE
FEES LIKE IN A COVID CRISIS,
WE’RE LAYING OFF OVER 1.4
MILLION DOCTORS AND NURSES.
WE HAVE A CRITICAL SHORTAGE OF
DOCTORS AND NURSES BECAUSE OF
OUR AGEING POPULATION.
AS WE WERE JUST HEARING ABOUT,
WE’RE ALL CONCERNED ABOUT ALL
THE PEOPLE WHO DIDN’T RECEIVE
CARE OVER THESE LAST FEW MONTHS
WHO NEED CARE PLUS THE CONCERNS
ABOUT A RESURGENCE OF COVID IN
THE NEXT FEW MONTHS, CLEARLY WE
NEED TO THINK ABOUT HOW COULD WE
BUILD A MORE RESILIENT SYSTEM.
ONE OF THE THINGS THAT I WRITE
ABOUT IN THIS BOOK "THE LONG
FIX" IS ABOUT HOW WE CAN DO
THAT, HOW WE CAN CHANGE THE WAY
IN WHICH WE PAY OUR HOSPITALS,
PAY OUR PHYSICIANS SO THAT WE
CAN CREATE A SYSTEM THAT’S NOT
ONLY MORE RESILIENT BUT ALSO
MORE READY IN THE FACE OF THESE
KINDS OF CRISES.
>> DR. LEE, IT’S WILLIE GEIST,
GOOD TO HAVE YOU ON THIS
MORNING.
YOU DO LOOK AT THE BIG PICTURE
OF OUR HEALTH CARE SYSTEM VERY
WELL.
YOU DO IT IN OUR BOOK AND PART
OF YOUR PROFESSION.
WHAT WOULD YOU SAY WE’RE
CERTAINLY NOT AN AFTERACTION
REPORT TIME YET, WHAT WOULD YOU
SAY WE NEED TO BE PREPARED FOR
FOR THE NEXT TIME THIS KIND OF
THING COMES UP, IF GOD FORBID IT
DOES, HOW CAN WE DO BETTER THAN
WE’VE DONE THIS TIME?
>> WELL, YOU KNOW, THERE ARE
ALREADY PLANS THAT HAVE BEEN PUT
INTO PLACE.
THIS IS NOT THE FIRST PANDEMIC
OR EPIDEMIC THAT OUR COUNTRY HAS
FACED.
WE KNOW THAT UNDER PRESIDENT
BUSH, FOR EXAMPLE, WHO WAS VERY
CONCERNED ABOUT A REPEAT OF THE
1918 INFLUENZA EPIDEMIC AND SET
INTO MOTION A WHOLE PLANNING
PROCESS, WE KNOW THE OBAMA
ADMINISTRATION HAD TO DEAL WITH
EBOLA AND ZIKA, DUSTED OFF SOME
OLD PLANS, ALSO STARTED TO PUT
THOSE INTO PLACE.
THOSE PLANS TALK ABOUT PPE.
THEY TALK ABOUT SOCIAL
DISTANCING.
IT’S NOT LIKE THESE IDEAS ARE
NECESSARILY NEW.
WE JUST DIDN’T HAVE THE
POLITICAL WILL TO FOLLOW THEM
THROUGH AND TO FUND THEM.
SO WE ABSOLUTELY NEED TO INVEST
IN PUBLIC HEALTH AND PREVENTION.
WE ALSO NEED TO COMPLETELY
RETHINK HOW WE’RE PAYING FOR
HEALTH CARE.
THIS FEE FOR SERVICE MODEL MEANS
THAT HOSPITALS AND DOCTORS ARE
LIVING HAND TO MOUTH.
WE’RE ONLY INVESTING IN THINGS
THAT GENERATE FEES AND NOT
THINGS THAT CAN ACTUALLY HELP
PREVENT PANDEMICS AND HELP US
REALLY RESPOND.
YOU KNOW, THERE ARE SOME REALLY
FANTASTIC EXAMPLES OF WHERE WE
ARE DOING IT RIGHT.
SO, IN MEDICARE, THERE’S A
PROGRAM CALLED MEDICARE
ADVANTAGE, ABOUT A THIRD OF ALL
SENIORS ARE IN MEDICARE
ADVANTAGE.
AND MANY OF THE CLINICS THAT I
WHERE ABOUT ACTUALLY IN THE
BOOK, MANY OF THESE GROUPS NOW
ARE PAID IN A COMPLETELY
DIFFERENT WAY.
THEY GET PAID A FIXED AMOUNT OF
MONEY EVERY YEAR TO CARE FOR
PEOPLE AND THEY CAN TAKE THOSE
DOLLARS NOW WITH THE SECURITY OF
KNOWING THEY HAVE THEM UP FRONT
AND INVEST IN MUCH BETTER CARE.
THEY ACTUALLY INVEST IN ON SITE
PHARMACIES AND SHUTTLES FOR
THEIR PATIENTS TO COME IN, BE
BROUGHT INTO CLINIC AND BACK.
THEY ACTUALLY DURING THIS COVID
CRISIS BECAUSE THEY WEREN’T
WORRIED ABOUT FURLOUGHING THEIR
EMPLOYEES LIKE MOST HOSPITALS
THEY ACTUALLY SET UPPER URGENT C
IN THEIR CLINICS.
THEY CAN GO TO THE CLINIC AND BE
CARED FOR SAFELY THERE.
AND AS A RESULT, THEY’RE KEPT
HEALTHY, THEY’RE KEPT OUT OF THE
HOSPITAL AND IN THE LONG RUN
THEY ACTUALLY SAVE US MONEY.
SO I THINK THERE ARE MANY WAYS
IN WHICH WE CAN ACTUALLY PREPARE
OURSELVES.
THERE JUST NEEDS TO BE THE WILL
TO GET US THERE, THE POLITICAL
WILL TO GET US THERE.
>> THE NEW BOOK IS "THE LONG
FIX" SOLVING AMERICA’S HEALTH
CARE CRISIS WITH STRATEGIES THAT
WORK FOR EVERYONE.
HARVARD MEDICAL SCHOOL’S DR.
VIVIAN LEE, THANK YOU VERY MUCH.
>>> AND COMING UP, IT WAS A TALE
OF TWO VERY DIFFERENT STYLES OF
LEADERSHIP.
PRESIDENT TRUMP AND JOE BIDEN
BOTH MADE PUBLIC APPEARANCES
THIS MEMORIAL DAY.
ONE WITH A MASK AND ONE WITHOUT.
AND GENE ROBINSON SAYS THE
PRESIDENT GAVE THE PANDEMIC AN
INDELIBLE, VISUAL IMAGE THIS
WEEKEND.
TRUMP DECLARED IT WAS ESSENTIAL
THAT AMERICANS BE ABLE TO SPEND
SUNDAY AT CHURCH SERVICES. BUT HE CHOSE TO HEAD FOR THE