Innovation Ecosystem/Opinion

Disturbances in the force

What is worth saving from a lifetime of reporting?

Photo courtesy of U.S. National Park Service

The view from the Sliding Sands Trail into the dormant volcanic crater, Haleakala, on the island of Maui. The destruction of Lahaina on Maui from a fast-moving wildfire, caused by the climate urgency, is a reminder how vulnerable the planet has become.

By Richard Asinof
Posted 8/14/23
In a time of climate urgency, in a time of health care crisis, in a time of heightened political reporting, here is ConvergenceRI’s primer for understanding where we are – and where we need to go.
How will leaders in the General Assembly respond to the urgent need to raise Medicaid rates for providers of behavioral health and mental health services? How can the research and clinical trials being conducted by Women & Infants’ Dr. Jill Maron on rapid genomic sequencing of saliva analysis of newborns serve as a driver for creating a new research hub for Rhode Island? What is the status on the construction of the new state public health laboratory, which held an alleged groundbreaking ceremony in October of 2022? When will Rhode Island create an annual database, an “Index of the Rhode Island Innovation Economy,” to develop benchmarks for efforts to develop a life sciences and biotech hub in the state? Why are some major health care corporations, such as UnitedHealthcare, unwilling to answer questions about their investments in community agencies?
The legal controversy around the future of Roger Williams Medical Center and our Lady of Fatima Hospital, run by CharterCARE but owned by Prospect Medical Holdings, a for-profit private equity firm based in California, continue to grind on. For the second time, an application by The Centurion Foundation to purchase the hospitals has been rejected by the Attorney General’s office and the R.I. Department of Health as being “incomplete,” citing deficiencies.
Under Rhode Island state law, under the Hospital Conversions Act, transacting parties – Prospect Medical Holdings and The Centurion Foundation – are required to file an initial application to begin the process of transferring the ownership. Once again, the application has been deemed incomplete, lacking sufficient information for the state regulators to begin to conduct their review.
The applying parties have been given until Sept. 26, 2023, 30 working days, to correct the deficiencies. Stay tuned.

PROVIDENCE – Moving is one of those traumatic events in everyone’s lives that involve confronting the future and letting go of the past.

For a published journalist of more than 50 years – my first story in a national publication was in Seventeen Magazine in September of 1972, “Notes on My First Convention” – the question is always what to keep and what to throw away.

I had reported on the Democratic National Convention held in a sweltering Miami Beach in July of 1972, which had nominated Sen. George McGovern for President. He was vanquished in a landslide, succumbing to President Richard M. Nixon.

[In the tick and tock of history, two years after his landslide re-election, President Nixon would announce his resignation on Aug. 8, 1974, beset by corruption, lies and deceit. Last week marked the 49th anniversary of Nixon’s demise, during a time now when former President Donald Trump is facing trial on charges of corruption, lies, and an attempt to overthrow the duly elected government of the U.S. Separated at birth?]

I was a member of the college press, an editor of my college newspaper. That was the first year that 18 year olds could vote – and representatives from college newspapers were given, as a token of tokenism, an entire separate and unequal section in the stands of the Convention Center. We had the privilege of paying for a week’s housing in the southern tier of Miami Beach, in former hotels that once catered to an urban Jewish northern clientele; my room had a painted-over mezuzah on the door.

But the real story occurring underneath the generational change was the transformation of Miami Beach into an enclave of Hispanic culture – I had included a graph about this observation in my original story on the convention, but it was cut out of the final edition that appeared in Seventeen.

That is the strange thing about reporting on politics: There is so much focus on the inverted pyramid – the “who, what, why, when, and where” – that the bigger, more important stories tend to get lost in the shuffle.

My priority this week has been to focus on my own life – to survive the overwhelming stress of the moving process and to take care of my own health – and to make sure that my computer is up and running so that ConvergenceRI does not miss a beat.

The last several issues of ConvergenceRI have been chockfull of important stories:

• My interview with State Rep. June Speakman, chair of the legislative study commission on housing, talking about future housing issues that Rhode Island needed to wrestled with, was sent by House Speaker Joseph Shekarchi to the entire House membership. [See link below to ConvergenceRI story, “When Rep. June Speakman speaks, people listen.”]

• My story about the return of Anya Rader Wallack, Ph.D., to the research enterprise in Rhode Island, made the digital health rounds at Brown. [See link below to ConvergenceRI story, “The return of Anya Rader Wallack.”

• The two-part interview with Save The Bay’s Topher Hamblett captured the need to redefine what “save the Bay” means in a time of urgent climate change. [See links below to ConvergenceRI stories, “Why the sea is boiling hot?” and “Keeping our eyes on the prize: Saving Narraganset Bay.”]

How do we talk about climate urgency? The images of the horrific wildfires sweeping the island of Maui and destroying Lahaina are hard for me to fathom. In my early 30s I spent several weeks on Maui, visiting my friend, Sandy; she was a park ranger at Haleakala National Park, a dormant volcanic crater.

I stayed at the ranger cabin at Paliku, deep in the middle of the crater. Walking from the top ridge at 10,000 feet elevation down into crater, through an evolutionary journey that passed through volcanic sands to sparse wildflowers to rainforest, always appearing to be heading toward sparkling rainbows at the horizon’s edge, where the blue of the ocean met the blue of the sky, peering through the Kaupo Gap where the last volcanic eruption had torn a large gap in the crater’s walls, was one of the most spiritual explorations I have ever undertaken in my life.

Snorkeling in the ocean off Lahaina, when I had put my head under water, I could hear the sounds of the migrating whales, moms and their keikis [child in Hawaiian], singing to each other.

Imagine if the traumatic scene from Lahaina was transposed to Newport, with wildfires raging from Middletown sweeping through the city, people jumping into Narragansett Bay to save their own lives from the flames. What a billboard on Route 95 that would make. [In pain? Call...] The question is: How many political reporters are asking questions about the climate urgency to the Congressional candidates?

Health care tsunami
Another big question that keeps being avoided by the political inquisitors to the Congressional candidates is about the future of health care in Rhode Island. We are, if I can slip into my teenage Jersey vernacular, cruising for a bruising.

What I am most proud about in the content in the recent issues of ConvergenceRI is my consistent, in-depth reporting on how Rhode Island is quickly reaching an inflection point in the crisis in the delivery of health care in Rhode Island:

• The interview with investigative reporter Maureen ‘Mo’ Tkacik detailing how alleged “criminal” syndicates of private equity financiers have taken control of health care in the U.S. – and how they now may control the future of Roger Williams and Fatima hospitals. [See link below to ConvergenceRI story, “Has health care fallen under the sway of organized crime syndicates?”]

• The one-one-one interview with R.I. Attorney General Peter Neronha about his efforts to forge a solution to the health care crisis in Rhode Island. [See link below blow to ConvergenceRI story, “AG Neronha to offer a bold prescription to solve RI health care crisis.”]

That particular story caught the attention of the former president and CEO of the Rhode Island Foundation, who then sent it on to a former executive vice president at Lifespan to read – providing the answer to the questions: “What is the value of Convergence?” and “How do you create an engaged community of readers?”

• The story of how a millennial family physician, Stephanie Arnold, MD, had decided to become a direct primary care provider in response to corporate medicine. [See link below to ConvergenceRI story, “My life in corporate medicine.”]

• The launch of the first sobriety column in Rhode Island by Katherine Linwood. [See link below to ConvergenceRI story, “The bright side of sobriety.”]

Willful ignorance?
Last week, taking a break from unpacking boxes,  I read with interest the Boston Globe story about the decision by the Attorney General to oppose the proposed rate hikes by the commercial insurers serving Rhode Island.

On the platform formerly known as Twitter, AG Neronha summed up the challenge: “Year after year health insurance rate increases are approved – and yet our health care system remains weak financially. So an obvious question is: is the money we’re paying going back into the system to [the] extent that it should be? And if not, what’s the answer?”

However, I laughed out loud when the reporter, Alexa Gagosz, claimed that the current OHIC Commissioner was Patrick Tigue – given that Tigue had left his job in November of 2022 to work for the Boston Consulting Group and had been replaced by acting Commissioner Cory King. To quote the always intrepid WPRO reporter Steve Klamkin, “Really?”

[Editor’s Note: Gagosz is an terrific reporter. I have frequently praised her reporting in ConvergenceRI. But her “mistake” in this story is endemic to a much bigger problem, reflective of the Boston Globe’s priorities: They have no dedicated health care reporter covering Rhode Island and its $8 billion a year medical industry.]

To make that kind of mistake [which was corrected in later editions of the story] is an indication of the disadvantage the public is in – they are besieged by a health care system that does not meet their needs and, at the same time, corrupted by reporting on health care in Rhode Island that is woefully – and perhaps willfully – inadequate.

Worse, perhaps, the “mistake” points out the ignorance about OHIC Commissioner King’s ongoing work as convener of the Cost Trends Steering  Committee, analyzing how the $8 billion medical industry is spending its money, having tabulated and publicly released the results of the analysis for 2021. [See link below to ConvergenceRI story, “Measuring annual spending in an $8 billion industry.”]

In addition, Commissioner King is a key member of the new Care Transformation Collaborative task force on Primary Care. [See link below to ConvergenceRI, “When a strategy of convergence works.”]

The story begins with long excerpts from interviews that ConvergenceRI conducted with Attorney General Neronha, Dr. Jeff Borkan, MD, and yes, Commissioner Cory King, framing the problems around primary care facing Rhode Island, setting the stage for the context of the work to be done by the new Task Force. The story then concluded with an interview with Debra Hurwitz, executive director of the Care Transformation Collaborative.

Gagosz, however, is not alone among reporters afflicted by an apparent unwillingness to read ConvergenceRI. The Public Radio’s Ian Donnis recently conducted interviews with Dr. Michael Fine and Christopher Koller, president of the Milbank Memorial Fund, who served as Rhode Island’s first OHIC Commissioner. Both Dr. Fine and Koller are original thinkers when it comes to pushing the envelope to change the current health care system – although Dr. Fine is insistent that health care behaves more like a market, not a system, one that is practiced in extracting wealth from patients.

Donnis is one of Rhode Island’s top political reporters, someone who ConvergenceRI has often praised in ConvergenceRI and on the platform formerly known as Twitter.

But the dialogue on the Aug. 4 “Political Roundtable” between Donnis, Koller and Fine seemed to be missing the boat, stuck in the past, oblivious to what was actually occurring on the ground here in Rhode Island, in ConvergenceRI's opinion. There was:

• No mention of the Attorney General’s plans to propose solutions to the health care crisis. [Koller had actually met with Attorney General Neronha.]

• No mention of the newly formed Task Force on primary care by the CTC.

• No mention of the looming threat of private equity to the future of Rhode Island hospitals.

• No mention of the ongoing leadership changes occurring at hospitals such as Lifespan and at community health centers.

• While there was some discussion about the problems with how hospitals were dependent on financing care, through Medicare and Medicaid insurance plans, there was no mention of the critical need to increase the rates for providers for behavioral health care and mental health services.

Translated, all they had to do was to be active readers of ConvergenceRI; one of the three is even a subscriber. All they had to do was read the damn stories.

The one substantive idea that was brought to the table during the Roundtable was the idea that Rhode Island should launch its own public health medical school as a away to re-invigorate health care in the state. Wow, talk about dancing in the dark.

The School of Public Health at Brown University is still struggling financially, by all reports.

Please, please, please: Ian Donnis, Dr. Michael Fine, and Chris Koller [and Alexa Gagosz]: Read “My life in corporate medicine,” by Dr. Stephanie Arnold, MD, in the Aug. 7 edition of ConvergenceRI. It is not what happens in med school; it is about the corporate takeover of health care by private equity financiers. [See link below to ConvergenceRI story.]

A hot tip for health care, political reporters
In two weeks, on Friday, Sept. 1, four days before the primary voting day for Congressional candidates running to replace former U.S. Rep. David Cicilline, OHIC Commissioner Cory King will release the results of the study commissioned by the General Assembly in 2022. The tasks assigned to OHIC included:

• An assessment and detailed reporting on social and human services program rates, including rates currently being paid, and the date of the last increase.

• An assessment and report on utilization trends from Jan. 1, 2017, through Dec. 31, 2021, for social and human services programs.

• An assessment and reporting of national and regional Medicaid rates in comparison to Rhode Island social and human service provider rates.

Translated, the Sept. 1 report being published by OHIC Commissioner King will create a comprehensive, inclusive database of Medicaid rates, trends, and comparisons with regional and national markets.

That’s incredibly important data for OHIC Commissioner King to be releasing, with profound reverberations across the political and health landscapes for Rhode Island, because it will make the case – by the numbers – for dramatic increases in Medicaid rates to be legislated by the General Assembly. The question is: What does it mean when a reporter didn’t know his name?

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