Day 6

Name: Bob

Profession: Retired, former healthcare administrator

Location: Starbucks, Huntington Ave.

Question: What are you doing here today?

Answer: I’m here for the love of music

365Debuts (3D): What are you doing here today?

Bob (B): I’m going to the symphony tonight.

3D: What’s going on at the symphony?

B: The Boston Symphony Orchestra, the regular season.

3D: Do you usually go to the orchestra?

B: I go a dozen times a year.

3D: What do you do for a living?

B: I’m retired now.

3D: What did you do?

B: Healthcare.

3D: Did you vote today [in the special election for Massachusetts senator]?

B: I did vote today.

3D: Did you keep healthcare in mind? Was that a major factor in who you voted for today?

B: That’s a hard question. It certainly was there, but it didn’t override other factors.

3D: You’ve lived in Boston for…?

B: Forty years. Nearly forty.

3D: And where did you live before that?

B: North Carolina.

3D: Why did you move? Because of your job?

B: Yeah, yeah.

3D: Are you going to the symphony with anyone tonight?

B: Nope. Just me. My wife does not share my enthusiasm for classical music, so she’s at home watching 24, I think. [Laughs]

3D: Have you ever played any instrument?

B: Oh, in high school. I played like kids do. I love music but I don’t have any real talent.

3D: Besides classical music, what other type of genres are you interested in?

B: Oh, a lot of things. I don’t really understand jazz. I’ve never really tried jazz to a great degree, but pop and rock and real country, not the, you know—…. Country today is more pop than, you know—…. Folk. That’s also a genre that’s really hard to define. I like folk music in the old style. The kind that tells stories. I got a lot of that.

3D: Do you go to a lot of other concerts that aren’t associated with classical?

B: Yeah, yeah.

3D: What was the last one that you went to?

B: I went to see a woman called Marta Gomez, which is someone you should go see if you haven’t heard of her.

3D: I haven’t.

B: She’s a Colombian lady. Probably thirty. Twenty or thirty. She was actually at the Berklee School. She used to perform as a street performer in Cambridge, outside of the subway station. That’s how I got to know her. She’s a remarkable writer. She’s got a full time job, but she doesn’t travel every week like performers who do twenty, thirty concerts a year. But she assembles a band which is a couple of people from the Berklee School , and then a couple of people from the South America—I forget where this fella’s from. But he’s a fiftyish-year-old guy who is so skilled in all of the South American instruments: the acoustic guitars and the high-strung stuff like that. Anyway, she’s uh, she sings only in Spanish. Her audiences are always three quarters non-Spanish-speaking, which makes it remarkable. She has a lot of causes she supports; causes involving the status of women in Latin America. She does a lot of benefits for that. She’s a wonderful musician. I recommend you go see it. You’d like it. If you’ve never heard of her, really, she’s just remarkable.

3D: Do you speak Spanish at all?

B: Nope.

3D: How do you know all this stuff about her? Did you get to know her personally?

B: I knew her there in Cambridge. Since she’s been at Berklee, I went to go see her. Her website’s really descriptive. That’s more than you wanted to know about that! [Laughs]

3D: No! Not at all! What would you say was one of the most memorable shows you’ve ever been to?

B: Going back classical, which is probably about—probably the music I enjoy the most—the Berlin Philharmonic is probably my favorite orchestra in the world. Most people would place them in the top two or three. Any time someone like that performs, that’s a notable occasion. The orchestra was fantastic. If you ever get a chance to go, it’s a wonderful concert. I like to go to things I’m not often familiar with. Uh, pop music? I think, Springsteen. That would be 1975. Paul Simon in the seventies, which was, I’ll always remember, a great gig.

3D: But what you did with healthcare has nothing to do with music, right?

B: No, no. I worked in administrative positions. I ran several medical group practices. I was an administrator. A CEO.

3D: Did you enjoy doing that?

B: Yes. Yes! Yes. I absolutely did.

3D: Is there anything you wish you would have done differently when it comes to your career?

B: Not really, no. [Smiles] It was a career that allowed me to give. In healthcare, if your involved with direct service, you know, you’re sort of servicing people’s needs. I worked for organizations that were serving the population, so I feel good about that. I wouldn’t have changed anything.

3D: And the big healthcare debate right now—was that something that was a big issue when you were working?

B: No, not so great as today. Thought a lot more about it over the last five or six years. I was working for a think tank organization in Cambridge the last five years of my career. There’s another website you should go to, which is www.IHI.org, and it promotes improve healthcare globally by improving the processes by which healthcare is delivered. Not, ‘How do we do cardiac surgery,’ but ‘how do we stop killing people in hospitals caused by cross-infections?’ Ninety thousand people here die in hospitals from something that was not what they went to the hospital for. Bet you didn’t know that. It’s true! And so I got engaged thinking about healthcare over the last forty years of my career. And as a citizen now, a Medicare person, I’m interested in the Medicare situation, which is desperate because Medicare’s going to run out of money in seven years, and the population is aging. This country is not facing up to it, and it’s going to be terrible. Your generation’s going to bear the brunt of it.

3D: Do you think that the overhaul is a good idea?

B: No, I don’t. Again, nobody knows what we’re going to do because nobody can read it. None of the members of Congress have read it. It’s too broad. What I want to see happen—what we need to do—is to create a mechanism by which whatever number you want to choose, thirty million, forty million, Americans and legal immigrants have access to healthcare that don’t have it now. Almost everybody would agree that a fundamental right in this country is to healthcare. Needed healthcare. But the bill went too far and then got bound up with all the special interests, so at the end of the day, even if this passes, it’s so broad and so unworkable that it’s actually going to make matters worse. And it’s going to cost us, it’s going to add, a trillion dollars to the deficit. I think the Massachusetts plan is actually much closer to the world we should—… And I’m not convinced that we shouldn’t break this up into segments. Maybe a national healthcare scheme is not practical. The healthcare needs of Hawaii, Mississippi, North Dakota, and Boston are not the same. Nor are the social and medical communities the same. This might be something that’ll better be taken on regionally. State by state or regionally. So I’m pessimistic about this bill if it passes. It speaks to healthcare reform but it doesn’t reform anything. There’s nothing in it about reform. There’s lip service to plenty of things: improving quality, providing a greater access, lowering costs. But there’s nothing in there that’s actually going to do any of those things. Saving is supposedly going to be found in certain government programs, but if the savings were there they would have already been found. And when the special interests are on all sides of the equation, they dominate the ultimate way in which this gets completed. I don’t think the payoff is going to be nearly worth the cost.

3D: Do you think we can get there in the near future? To have a system similar to Massachusetts’?

B: I am very pessimistic.

3D: Do you know where a student, or anybody, could get more information on what’s going on with the healthcare bill? Very reliable, unbiased information?

B: If you write down IHI—it’s the Institute for Healthcare Improvement—IHI.org, go in there and look at the website, which will give you more information than you could imagine. IHI is an organization that was started by a doctor who worked in my organization twenty years ago. It’s grown from a small demonstration to the leading organization promoting healthcare equality in the world. When I left, and it’s even broader now, in addition to other projects in this country, it has an active program in the United Kingdom, working with the National Health Service, in Sweden, in Africa. The problems in all these places are not all that different. Different systems, but the problems, they’re more alike than they are different. If you go there, and click on what interests you, you’ll find something that will give you more information. Don Berwick is the founder and he’s widely recognized as one of the ten or twenty most influential people in healthcare, and one of the greatest individuals I’ve ever known. Quiet, unassuming. Terrific human being. He’s dedicated, and he’s connected to everybody. He advised the Obama administration. He advised the Bush administration! He has certain social points of views, but he is not an ideologue of any kind. So if you really want to learn something, that’s a great place to start.