Before Howard Dean was a Democratic candidate for president in 2004, he was the governor of Vermont for 12 years. And, before that, he worked as full-time practicing physician. And, long before that, he was a high-school student at the St. George’s School in Middletown, and a big fan of Second Beach.
On Feb. 4, Dean returned to Rhode Island to be the keynote speaker at the kickoff event of Shape Up RI’s at the Providence Public Library, sharing his insights into the need to shift the focus of health care delivery system to wellness instead of illness. In advance of the event, Providence Business News had a chance to catch up with Dean, as he discussed his views on the future of health care.
PBN: What attracted you to speak at the Shape Up RI kick-off event? What do you see as the best strategies to move the nation from illness to wellness?
DEAN: Anything that emphasizes wellness and weight loss is a good thing. One of the reasons I’ll be at the [Shape Up RI] event is that the director, who has asked me for two years in a row, is a good friend of my daughter.
In terms of strategies, we need to pay for wellness. We should pay doctors a single, comprehensive payment to keep people well. Right now, the health care delivery system rewards illness; it should reward wellness.
PBN: What concerns, if any, do you have about for-profit hospital systems owned by private equity firms buying up non-profit community hospitals, many of which are in financially fragile condition?
DEAN: If they can evolve into an ACO, into an accountable care organization, and they can [create a system of] capitated payments, moving away from fee for service, this may work very well.
PBN: Vermont, your home state, has signed into a law a plan to create a single-payer plan under health reform, beginning in 2014. Do you support this? Do you think it can be replicated in other states?
DEAN: I am not that familiar with the plan; I don’t do much of my work in Vermont these days. But, in general, I’m very supportive for efforts to change the health care system and reform the payment system. It’s getting worse each year, and more expensive each year.
PBN: What kind of exercise program do you and your family follow?
DEAN: Well, my children are adults now, all grown up. My wife [who is also a physician] bike rides, and I bike ride when I can. I walk a lot. I never take an elevator, if I can help it; I use the stairs. I walk when I’m in the city, instead of taking other forms of transportation. And, I’m very careful about what I eat, most of the time.
PBN: Do you think there should be a coordinated national effort, similar to what happened with efforts to stop smoking, to create a tax on sugary drinks to pay for the long-term health impacts?
DEAN: It’s already happening; it’s a big fight right now. And, it’s going to take time. I prefer an educational approach. I would like to believe that better education can help to make such changes work.