Five questions with Bob Laszewski

For the audio assignment of Medill’s New Media Storytelling course, I spoke with Bob Laszewski, who is president of the Health Policy & Strategy Associates consulting firm in Washington, D.C. Laszewski also writes a blog relating to health-care issues, the Health Care Policy and Marketplace Review.

Two ways to access the interview:

  • Listen to the audio
  • Read the transcript (below)

Five questions with Bob Laszewski:
(Please note: One of the questions does have a short answer, but the others have long enough answers – even after editing – to compensate for it, and one of them is a compound question; that is, two questions at once. Also, at 4:41, the audio is too long to add any other questions from the original interview and still remain under five minutes.)

HEALTH CARE 2008: We’re here talking with – Bob Laszewski, who is the president of Health Policy and Strategy Associates in Washington, DC. Can you tell me a little bit about your company?

BOB LASZEWSKI: Well, Health Policy and Strategy Associates was founded in 1992, and we work with people who are in the health-care financing business; that would be primarily people who pay for health care or provide health care. So that is, more often than not, health insurance and HMOs, insurance consultants and brokers, pharmaceutical companies, provider organizations, doctor or hospital organizations, that sort of thing. We do not lobby.

HC08: And you also have the Health Care Policy and Marketplace Review blog, on which you kind of do the same thing, right?

LASZEWSKI: That’s right.

HC08: OK, so, you know, I follow your blog quite a bit, actually, as far as just things that are happening in the market. How do you find out about all of this stuff?

LASZEWSKI: Well, first of all, we spend a lot of time in the marketplace and we’re talking to people about what’s going on. We’re very careful, as a consulting firm, not to – not to repeat information that’s of a confidential nature, obviously, but we form impressions about what’s happening in the marketplace as we work in the marketplace. We also have a lot of contacts on Capitol Hill – again, we do not lobby – but we maintain a lot of contacts inside the policy community – inside the Beltway, if you will. [We] attend a lot of meetings, read a lot of periodicals, look at a lot of [articles]… In the Internet age, the amount of information that changes hands every day, compared to say, 1992, when we began, is just incredible. In ’92, all of our information probably came from, you know, face-to-face meetings and phone calls with contacts and associates, and now, it’s about half that, and half information that just flows freely in the public domain.

HC08: What’s your basic impression of the health-care marketplace right now? Is it really in dire straits, as everybody seems to think so?

LASZEWSKI: Well, the health-care marketplace has been in dire straits in the United States, I think, probably since about 1951. And – when I was starting out in the business in the 1970s, we actually thought that when – most of us in health insurance; I worked for a health-insurance company in the mid ‘70s – we actually thought in 1976, when Jimmy Carter was elected president, when he beat, uh, Gerry Ford for the presidency, he ran on a platform where he said that he and the Democratic Congress would implement a Canadian-style health-insurance plan. And in ’76, the beginning of ’77, when he was inaugurated, the Democrats of the White House had complete, dominant control of the Congress. The new president had just been elected to take a private health-care system, at least the insurance portion of it, into the government – to socialize insurance, health insurance, if you will, very much like the Canadian-style system. And he was elected on that platform because there were a lot of people who were uninsured at that time, and health-care costs had been soaring. We were probably seeing – I don’t remember the exact numbers going back 30 years now – but we were seeing something like double-digit increases in the cost of health care. So when people talk about how bad the health-care system is today, my perspective is, it’s been this bad as long as I’ve been around, and for some reason I can’t completely explain, we kind of bump along and survive year to year. It’s not sustainable. I’m not trying to argue that, gee whiz, because we’ve had these problems for 30 years, we’ll have exactly the same kind of system for the next 30 years. It is not sustainable, but it has been absolutely incredible to me that it’s lasted this long.

HC08: Do you think anything’s actually going to happen this time around?

LASZEWSKI: Well, I hope so. I mean, we can’t keep going on the way we have been, that’s for sure. No one should underestimate the forces that oppose any kind of fundamental health reform; some of those forces for self-serving reasons, some of those forces for ideological reasons, believing that intervention on the part of the government is not the way to go. So, you know, we’re going to have one heck of a debate – there’s no doubt about that. One would have to believe that finally, with health costs as high as they are (with 47 million uninsured and so forth), that there are still plenty of reasons for it to get done.

HC08: Well, thank you very much, Mr. Laszewski. I appreciate it.

LASZEWSKI: All right. Good luck.

HC08: OK. Thanks.


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