REACHING OUT Fine.
It's no easy task to schedule an interview with Dr. Michael Fine. The man has a lot on his plate. Since assuming duties as Director of the Rhode Island Department of Health in July 2011, he's been on a mission to get all Rhode Islanders tested for HIV over the next four years, to mitigate teen pregnancies, to reduce the number of smokers, and to curb prescription drug abuse. In addition to these overarching goals, the Department of Health has recently rolled out its vision for the Rhode Island Primary Care Trust, a dramatic revision of the health care care system for the Ocean State.
In essence, the Primary Care Trust will create and fund "Neighborhood Health Stations" across the state offering a myriad of services including primary care, dental care, and mental health care. The model is based on a concept of a "patient-centered medical home," which employs a team of family physicians, social workers, pharmacists, and physician assistants working together to care for the collective health of a community and its inhabitants. The department projects that Neighborhood Health Stations will offer care to 75 neighborhoods of approximately 10,000 individuals each.
Recognizing the need to explain this vision, Fine recently teamed up with AS220 and the Roots Cultural Center in Providence for three free health care forums on the changing nature of health care in the state: "The Current State of Health Care in Rhode Island" (held on April 24); "'OBAMACARE': What it Means for Rhode Island" (held on May 1); and "Michael Fine's Ideal Vision: What Health Care Could Be in Rhode Island," on May 8, which will focus specifically on the Primary Care Trust.
Receiving an impromptu call from Fine's office, I was told he had 20 minutes to speak about the forums and his vision for the future of the state's health care system. Our conversation has been edited and condensed.
HOW DID THE IDEA OF THE HEALTH CARE FORUMS COME ABOUT? I was having dinner at AS220 and discussing health care for artists. The idea for the three forums came from that discussion to educate the artistic community, looking particularly at artists, writers, and musicians who haven't always been well served by the health care system. [By developing the forums with AS220 and the Roots Cultural Center,] we broadened out the audience to be sure we included people working in the hospitality industry who often don't have health insurance. Because, from an outsider's perspective, the health care world is pretty opaque. [Our goal] is to spend some time discussing how the moving parts work and what changes are coming.
WHAT WAS THE RESPONSE TO THE FIRST FORUM? The response was phenomenal. I expected the event to last an hour but it lasted two hours and stimulated a fair amount of discussion. I confirmed and learned how confused people are about the difference between health insurance and health care. There was a woman — a small business owner who [had] just come from a divorce — who is still on her husband's insurance and was worried about what happens when she's no longer on her husband's insurance. She was looking at paying $7000-$8000 a year for a single person health insurance [policy]. From her perspective, health care costs $7000 or $8000 a year. What she hadn't realized is primary care [can cost well under that rate] and was something she could very easily afford.