There’s a lot of hand wringing right now about healthcare affordability, but not enough action. Paul Markovich, the CEO of Blue Shield of California, is on a mission to bring down health costs by reducing administrative overhead and negotiating lower drug prices. In this episode we dive deep into Paul’s call to action for healthcare leaders to tackle the affordability crisis head-on.

Paul and I discuss:

• How Blue Shield slashed the cost of arthritis drug Humira, by offering a biosimilar at 25% of the cost
• Why reducing healthcare costs is critical to averting a national economic crisis
• Whether we need a new national mandate for health data sharing
• Paul’s advice on tackling fear and being a brave leader

Paul says healthcare affordability isn't just a pocketbook issues for patients, it’s also a huge economic issue for the nation:

“The reality is we are facing a huge affordability crisis, a fiscal crisis right now. Even though our economy is running pretty much at or near full employment, we have record fiscal deficits… We cannot keep spending on this program the way that we are. We need to bring the spending down... Even our dysfunctional political system is going to have to deal with that.”

Relevant Links

California’s new data sharing law

Announcement of new Humira biosimilar

Investment in nonprodit Civica for lower cost generics

New prior authorization platform with Salesforce

About Our Guest

Paul Markovich is Chief Executive Officer of Blue Shield of California, a nonprofit health plan with $25 billion in annual revenue serving 4.8 million members in the state's commercial, individual, and government markets. Markovich has launched and led numerous initiatives to drive innovation and help reimagine healthcare, including funding support for a statewide provider directory to make it easier for Californians to find physicians and facilities in their plan; supporting development of a statewide health information network for patients’ records, enabling more seamless and holistic care; and investing in a partnership with the California Medical Association to help physicians pilot new care delivery models and leverage technology.

Markovich is a North Dakota native and Rhodes Scholar with a master’s in Philosophy, Politics and Economics from Oxford University. He is a graduate of Colorado College, where he earned a Bachelor of Arts in International Political Economy and played Division I hockey.

Source: https://www.blueshieldca.com/en/home/about-blue-shield/corporate-information/leadership/paul-markovich

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On so many issues, Congress has not been willing or able to act. But when faced with horrifying stories of death and mismanagement, Congress finally passed legislation to reform the US organ transplant system. They did so because people like Donna Cryer, a transplant recipient and patient advocate, demanded a better system for Americans who need lifesaving organ transplants. Now, as the new law moves into implementation, the work continues.

In this episode, Donna and I discuss:

• The new legislation that is breaking up the deadly organ transplant monopoly
• How ignoring the expertise and insights of patients dooms us to slow progress making healthcare safer and better
• Her advice for young people: “take your shot”

Donna says we all need to start listening more closely to patients with lived experience:

“I often think if you... had many people with great deals of experience and intelligence who were highly motivated to help you achieve your goal. Why would you not want to use them? Why would you not want to partner with them? Why would you work really, really hard to keep them away from solving the problem? And that's how people treat patients and patient advocates.”

Relevant Links

Donna Cryer’s testimony to the Senate Finance Committee on organ transplant system failures (just past the 48:00 mark)

Summary of the new law to break up the organ transplantation monopoly

More about the Global Liver Institute

See more details about the Advanced Advocacy Academy Donna's organization launched

Visit UNOS’ website

About Our Guest

Donna R. Cryer, JD is the Founder and former Chief Executive Officer of Global Liver Institute, the only patient-driven liver health nonprofit operating across the US, EU, and UK. GLI convenes the NASH, Liver Cancer and Pediatric and Rare Liver Disease Councils, as well as the Liver Action Network, collectively more than 200 organizations.

Mrs. Cryer has channeled her personal experience as a patient with inflammatory bowel disease and a 29-year liver transplant recipient into professional advocacy across a career in law, policy, consulting, public relations, clinical trial recruitment, and nonprofit management.

At GLI, Mrs. Cryer has raised more than $10 million for liver health initiatives. She is a frequent speaker on the topic of patient-centeredness and patient engagement in healthcare transformation and created a unique model for advocacy that mobilizes patients, influences policy, and coalesces clinicians to improve patient outcomes.

Mrs. Cryer serves on the Boards of Directors for the Council of Medical Specialty Societies, Sibley Memorial Hospital/Johns Hopkins Medicine, the Innovation and Value Initiative (IVI), and the Clinical Trials Transformation Initiative. She was the first patient to serve on the ABIM Gastroenterology Specialty Board, was one of the founding members of the AASLD Patient Advisory Committee and is the Community Representative on the AASLD NASH Task Force. She has been named one of the Top Blacks in Healthcare by the Milken Institute at GW School of Public Health and BlackDoctors.org, one of the Top 10 Patients Who Make An Impact by Health 2.0 and one of PharmaVoice’s 100 Most...

Dr. Theresa “Terry” Cullen is on a mission to make Pima County, Arizona one of the healthiest counties in the nation. It’s a challenging goal, and one that will take dedication and a willingness to fight for what’s right. But, Terry is a self-described, life-long pugilist – with an approach to healthcare that goes beyond policies and programs. Everything she does is rooted in her deep belief in accompaniment; that her role is to walk alongside her patients and community offering empathy, dignity and respect.

We discuss:

• Her work as a rural doctor with the Indian Health Service
• Deploying to West Africa in 2014 for the Ebola crisis
• Why the VA and DOD could not agree on electronic health records
• Her commitment to make Pima county one of the healthiest in the nation

Terry reminds us that sometimes we need to step back and look at the work we do through a new lens:

“My husband's an artist, and he challenges me all the time to look at something and look at the light. Look at the composition. Look at where it is. What's the pattern there? You know, and a lot of medicine is based on pattern, but think of a disruptive pattern. Think of a puzzle where the piece doesn't fit and what do you need to do to make that piece fit? Because if it falls into place, maybe the whole thing will heal.”

Relevant Links

Definition of pugilist

Resolve to save lives - 717 alliance

Healthy Pima Indicators

About Our Guest

Theresa Cullen is currently the Public Health Director of Pima County, Arizona. She has developed a strategic approach to transformational health status change with a goal of health equity through supporting a learning public health system model based on data and action. She continues to work closely with Tribal, federal, state and local partners to ensure that community needs are integrated into planning with a goal of health justice. Dr. Cullen, RADM (retired) USPHS, began her family medicine clinical career with Indian Health Service (IHS) and worked in leadership positions for 25 years with American Indian/Alaska Native communities with a goal of improving health status through innovation and data informatics. Dr. Cullen worked as the Chief Medical Information Officer for the Veterans Health Administration from 2012-2015 and Associate Director of Global Health Informatics at the Regenstrief Institute. She has been honored with multiple local, state and national awards including the USPHS Distinguished Service Medal, the University of Arizona Medical College Alumni Award, and the AMIA Don Detmer Award for informatics health policy contributions.

Source: https://academyhealth.org/about/people/theresa-cullen-md-ms

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For more information on The Other 80 please visit our website - www.theother80.com. To connect with our team, please email claudia@theother80.com and