Obesity key cost driver

Gov. Gina M. Raimondo has stepped up to the plate with two initiatives designed to address the challenges facing Rhode Island’s health care system. The governor’s first executive order created the Working Group to Reinvent Medicaid and the second created a Working Group for Healthcare Innovation.

We are used to hearing about health care challenges as a national issue since there has been so much rancorous debate about the Affordable Care Act. In creating these working groups, the governor has signaled her recognition that there’s a compelling need for Rhode Island to strategically attack problems on a local level. We simply cannot wait for some silver bullet to come from Washington.

While I applaud the governor’s efforts, I’m less enthusiastic about the Working Group for Healthcare Innovation. It has 34 presidents and CEOs from health care, community and business organizations; the top leaders who are, to use the jargon, our biggest stakeholders in health care.

While it’s an impressive group of concerned, well-intentioned people, it’s not one I would assemble to find innovative solutions to health care challenges.

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First, innovation seldom comes from the corner office. It’s the top leader’s job to create the culture and environment to facilitate innovation. Only in rare cases are they in the thick of the work.

Second, innovation does not often come from the work of big groups. Innovation comes out of garages, small companies, small groups and individuals.

Most of the members of the working group have jobs that demand 99.9 percent of their attention. The reality is that their participation is a show support for the governor’s sincere effort.

Finally, perhaps the greatest obstacle to fixing health care is a number of players with entrenched interests in the status quo; stakeholders that don’t want certain changes.

Take a look at a major health problem in Rhode Island and the country that is not being addressed. Obesity is the root cause driving up health care costs. It’s the cause of the deadliest chronic diseases in our society. Yet, our health care system does not pay for the treatment of obesity. It pays for bariatric surgery for the morbidly obese but nothing for treatment of the vast majority of overweight and obese people.

If you doubt that it’s possible for a community or government to have an impact on obesity, take a look at what Somerville, Mass., has accomplished since 2002 when they took on the problem. Or how grocery giant Safeway lowered its health care costs by 25 percent with their companywide wellness program.

I would suggest that in our efforts to create positive change on a local level, Rhode Island, because of its size, has an advantage. •

Chris Westerkamp is a principal with Noll & Associates Management Services.

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