There's a huge delta between the best-case and worst-case scenarios for Rhode Island's health care landscape. If a big out-of-state firm swallowed a major Rhode Island hospital group, more care would likely migrate elsewhere, with negative implications
There’s a huge delta between the best-case and worst-case scenarios for Rhode Island’s health care landscape.
If a big out-of-state firm swallowed a major Rhode Island hospital group, more care would likely migrate elsewhere, with negative implications for Rhode Island’s economy.
On the other hand, the academic health system envisioned by Lifespan and Care New England, with Brown University, could bolster economic growth and have other benefits.
Still, there are a lot of unanswered questions, including whether this unified entity would cause higher health care costs for average Rhode Islanders. Brown University President Christina Paxson doesn’t believe that will happen, in part, she said, since Rhode Island is so small and since greater scale is needed to generate efficiency.
“You can’t provide effective low-cost care with this sub-scale health care system – it doesn’t work,” Paxson said on Political Roundtable at The Public’s Radio last week. “So I’m excited about this, because I think we're going to be able to provide better care to patients. I think it can be, bend that cost curve, keep costs from going up.”
The agreement announced in February between Brown, Lifespan and CNE still faces a series of regulatory hurdles. And there’s the matter of how Rhode Island’s two biggest hospital groups will resolve questions of governance and overcome the institutional politics that have scuttled this kind of amalgam for years.
Asked to outline the process for working this out, Paxson sidestepped the question, saying, “My sense now is that the two health care systems, and again I don’t sit in those boardrooms. But my sense is that they are in a very, very different place than they’ve ever been before. And the coronavirus, the COVID pandemic, taught them, really underscored how they can work together well. They can collaborate, and that coming together, you know, put the governance battles aside … And I really hope it works.”
On her way out of Rhode Island, Gina Raimondo released a 34-page report on her six years as governor. She claimed credit for making the Ocean State more equitable and strengthening its economy.
Rhode Island did make some gains on its business tax climate during Raimondo’s time in office, climbing in the Tax Foundation’s survey from 45 to 37. But Rhode Island still faces many of the same familiar economic challenges that existed before Raimondo became governor, including under-performing schools, the absence of a more diverse job base, and projected deficits of more than $300 million for each of the next four fiscal years.
As I reported last week, Raimondo put considerable focus on trying to foster high-wage jobs, although Rhode Island was one of just two Northeast states to lose so-called advanced sector jobs from 2015 to 2019.
Gov. Dan McKee signed the Act on Climate, billed by supporters as the most important environmental bill to emerge from the General Assembly in years, in Newport on Saturday. The legislation requires Rhode Island to get to net zero climate emissions by 2050.
Supporters, such as Sen. Dawn Euer (D-Newport), say it will boost the economy and help to create green jobs. Opponents say they still fear that the climate bill will spark big retrofit costs for consumers and give too much power to unelected state bureaucrats.
Meanwhile, the legislation got an assist from Attorney General Peter Neronha, who moved quickly to dismiss McKee’s concern that the bill could cause excessive litigation.
A 2017 study that examined 38 universities, including Brown, found that they were more likely to admit students from the top 1 percent of income strata than the bottom 60 percent. So, are colleges like Brown perpetuating the power elite by not taking more aggressive steps to counter this imbalance? I put that question to Christina Paxson on Political Roundtable.
Here’s her response: “College access in America is a major issue. And we need to get more students from lower- and middle-income backgrounds into higher education. And when I say that, I’m not talking about privates, like Brown. I’m talking about the vast majority of students in America – college students are at public institutions. And I’m a big advocate for public education, too – that needs to be supported as well. So you know, what are we doing? We are need-blind; there are not many universities in the country that accept students regardless of their financial need. When we admit students, we meet their full need, which means you know, we don’t say, great, we’d love to have you, but we can’t afford to give you the scholarship that you need to come. Three years ago, we eliminated loans from financial aid packages. So those were all converted to grants. We’ve seen steady improvement in the breadth of students who are coming to the university. It’s in the high 40 percent received financial aid. And we’ll continue to make progress on that. It’s a really important issue.”
The decennial process of redrawing legislative and congressional districts is getting under way, with House Speaker Joe Shekarchi’s introduction of a bill last week to create an 18-member special commission. Two-thirds of the slots are reserved for lawmakers, reflecting the controlling stake that legislative leaders have over a process that has traditionally rewarded friends and punished enemies.
During the White House briefing last week, Commerce Secretary Raimondo – whose agency includes the Census Bureau – said redistricting data is expected no later than Sept. 30. John Marion from Common Cause of RI parsed the RI House bill; he reports that lawmakers are optimistic that the Ocean State will be able to maintain two congressional seats (!). Time will tell.
With the Biden infrastructure plan offering a potential windfall for states to use in reimagining their transit systems, I asked Scott Wolf of Grow Smart RI to share thoughts on what he would like to see happen. Wolf said the state is well positioned to compete for discretionary federal grants and infrastructure stimulus thanks to the completion of the long-range Transit Master Plan. (“The controversial RIDOT-led multi-hub proposal for downtown Providence was neither conceived nor vetted as part of the RIPTA-led transit master planning process,” he added. “Advocates continue to call on the governor to withdraw that proposal and explore transit-friendly alternatives.”)
Here’s Wolf’s wish-list for the potential use of transit in RI: “Today, 77 percent of Rhode Islanders live within a 10-minute walk of a transit stop, yet less than 3 percent commute by transit. Building a system that gets more people where they’re going more quickly and efficiently holds great potential to reduce transportation emissions while saving Rhode Islanders money. Among the transit initiatives we hope the state will consider prioritizing with new federal transit funding are additional Bus Rapid Transit routes like the popular one currently in operation along Broad and North Main streets, a general increase in the frequency of RIPTA service, development of an in-state light rail line between Central Falls and Green Airport, improved, speedier commuter rail service between Providence and Boston, additional funding for bike and pedestrian infrastructure that is in greater demand than ever as a result of the public heightened appreciation for outdoor activity associated with the pandemic, and funding for more ‘Complete Streets’ projects that ensure new and repaved streets are safer and more user friendly for all users, including pedestrians, bicyclists, children, the elderly and the disabled.”
In assessing former Gov. Raimondo’s economic record, state Sen. Sam Bell (D-Providence) – a critic of tax incentives – said more focus should have been put on place-making and infrastructure designed to spur growth and attract people.
“It’s why we moved the highway, it’s why we reopened the rivers and created WaterPlace Park,” he said. “Those real investment approaches to economic development continue to drive growth in Providence today. Yet the Raimondo administration vetoed and stopped the main effort to do a similar vision that would have unlocked an enormous amount of jobs and growth when they blocked a proposal to remove the 6/10 and unlock enormous areas of Providence for economic development.”
URI alum John King, who cut his teeth in the Providence and Boston bureaus of The Associated Press, is set to open the inaugural lecture series honoring the late WJAR-TV investigative reporter Jim Taricani. It’s on for 5 p.m. on Wednesday, April 21.
Via URI: “As a URI junior and Associated Press intern, King met Taricani in 1984, the same year New England organized crime boss Raymond L.S. Patriarca died and Providence Mayor Vincent ‘Buddy’ Cianci was forced to resign from office. ‘So much has changed in the nearly four decades since,’ said King. ‘We live, learn and work now in the Age of Disruption: breathtaking technological innovation and equally breathtaking assaults on truth, science, and common sense. But a lesson learned then is just as relevant now, perhaps more so: The First Amendment and the freedoms it protects, and the fairness and responsibilities it demands, remain a best friend and best compass in challenging times.’”
Ian Donnis can be reached at email@example.com. For a longer version of this column, visit www.thepublicsradio.org