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What’s Dr. Michael Fine thinking?

March 21, 2011

Kudos to my colleague  Richard Asinof over at PBN for chatting with interim Health Director Dr. Michael Fine about his priorities for a very short term (about two months) over at the Department of Health.

Dr. Fine has always been an ambitious advocate for reforming the health care system, so it’s not surprising that he has some clear goals for his tenure during a time when other folks would just be twiddling their thumbs.

Asinof lists these highlights among Dr. Fine’s ideas for improving health care in RI-

  1. A statewide primary care system, making sure that everyone has access to affordable primary care in their own community.
  2. Creation of a single statewide public hospital system to achieve lower costs and higher quality, in parallel to the private system. It contrasts with the current system, in which, he said, “private boards are using public money to accomplish a public end.”
  3. Establishment of a public primary care medical school in Rhode Island to train primary care physicians.

Asinof reports that Fine is also in favor of Governor Chafee’s plan to eliminate the Health Services Council.  The council’s main job is issuing  “certificates of need.”  The certificates give hospitals permission to make major investments in their buildings- new wings, extra beds, fancy expensive equipment.  They basically say, yes, there is a medical  “need” for these new things in the state, it’s not just another thing that will make health care more expensive.

Fine tells Asinof he approves of getting rid of the certificate of need process.

There is no statewide plan to reference, there is no context for a decision, and the Health Department has no real enforcement power, once the certificate of need is applied, if conditions are not met.

But controlling hospital spending on these items is one item in the tool kit for managing the expense of our health care system, as disjointed as it is.  I wonder if Fine really believes the certificate of need process is worthless or just currently ineffective/lacking teeth?

In other Director of the Department of Health news- Friday was the deadline for applicants for the permanent position.  This is all the Governor’s office would say on the matter-

There are several applicants being considered, but we will not be releasing specific numbers at this time. The Administration’s goal is to have a selection made by the third week of April.

Stay tuned!



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