Toby Cosgrove, MD, discusses his concerns about the regulatory burdens on healthcare providers ahead of serving on the president-elect's "strategic and policy forum."
This is the first in of a series covering the Shaping of Healthcare's Future in the Trump era. As the new administration prepares to take office, HealthLeaders Media will continue to talk with healthcare leaders about the challenges and opportunities for the industry that lie ahead.
The single voice representing healthcare on President-elect Donald Trump's "strategic and policy" forum belongs to Delos "Toby" Cosgrove, MD, president and CEO of the Cleveland Clinic.
Although details about what the group will discuss in its monthly in-person meetings are not yet known, Cosgrove says he's honored by the selection and humbled that he will be able to represent healthcare to the president.
Forum members are charged with offering insights on how government policy impacts economic growth, job creation and productivity. The 19-member group will bring together leaders from business, finance, and technology and is scheduled to start its meetings in February, after the inauguration.
Following is a lightly edited transcript of a conversation between Cosgrove and HealthLeaders Media on his thoughts about the group and its purpose.
HLM: You said you had heard from other healthcare leaders. I won't ask you who, but talk generally about some of their concerns with respect to the ACA and value-based care?
Cosgrove: They haven't been that specific, the ones who have reached out about the group.
Occasionally people have come to me and asked me to talk to them about this or that, but so far they haven't been major healthcare leaders.
First of all, there's a recognition by this group that if you're going to talk about strategy and the economy, you have to talk about the biggest employer and biggest industry in the U.S., which is healthcare. So that certainly is part of the agenda for the group.
The second thing that cannot be avoided is that we have to begin to think about the ACA and what the ramifications of that are not only for the healthcare industry, but also for the U.S. in terms of jobs, employment, the economy, and the health of patients.
Essentially, when healthcare sneezes, the U.S. gets a cold. I care deeply about its future as it affects 100% of the population.
HLM: Given its large share of the economy, why was only one person from healthcare named to the committee?
Cosgrove: I don't really know what the thinking was about putting the committee together. Trump vetted [a list of] individuals, some of whom he did not want, and some of whom he added. I don't know if I was on the list to begin with or whether I was added.
HLM: The president-elect promises to cut red tape. What are healthcare leaders telling you about regulations they'd like to see done away with or modified?
Cosgrove: Well, we've got a tremendous number of quality metrics that we're held to on a regular basis. I think we report something like 120 quality metrics to the federal government on an annual basis, and we have somebody inspecting our organization every day of the year. It's a real burden.
It seems like one side of Washington wants to improve efficiency, and the way most industries have done it is through consolidation.
The Justice Department seems to be taking the opposite tack, certainly for providers. [It] has been trying to derail increasing efficiency by being worried about competition.
I won't speak about insurers because I think that remains to be seen.
HLM: Have you met President-elect Trump? If so, what were the circumstances?
Cosgrove: Yes. I first met the family when I operated on his brother [Robert] a number of years ago. I've also met him on other occasions, such as when we [Cleveland Clinic] were doing a fundraiser at Mar-a-Lago.
HLM: Were you surprised to get this call?
Cosgrove: Totally. The day before Thanksgiving I got an email from Steve Schwarzman [CEO of Blackstone, a global investment firm, and chair of the policy forum], telling me what he was doing and asking me to call him.
I called him the day after Thanksgiving and we had about a 30- to 45-minute conversation about it and then I talked with people here at Cleveland Clinic and got their approval.
HLM: Do you know any of the others on the forum personally?
Cosgrove: I've known or met most of them previously. Some of them are acquaintances and some are friends. I have spoken about healthcare with several of the members. I met some through meetings, through mutual friends or introductions, from business interactions, and even from vacation.
Three of the leaders have spoken at Cleveland Clinic for our Ideas for Tomorrow speakers' series. I'm truly looking forward to working with the members of this group.
HLM: Do you know if President-elect Trump plans to attend these sessions?
Cosgrove: Well, supposedly these are meetings with him on a monthly basis. Whether that ends up being monthly or less frequently, I don't think we know at this time. We meet first in February.
HLM: What are some of the most important healthcare policy areas you feel the administration should address quickly?
Cosgrove: It's important to address the rising cost of healthcare, high drug prices, and wellness to reduce the burden of chronic diseases. The health of our nation is only as good as the health of its citizens. We need to move from sick care to healthcare.
HealthLeaders: What's your top piece of advice to healthcare CEOs worried about big changes from a Trump administration?
Cosgrove: As I told [Cleveland Clinic leaders], there are two things we have to do on the continuing march we've been on.
One, we have to improve quality. And two, we have to make healthcare more affordable. Those are no-regret moves regardless of what kind of policy we have. I'd be happy to talk more about this once I know exactly what it's going to be about.
Trump "Strategic and Policy Forum" Members
- Stephen A. Schwarzman (Forum Chairman), Chairman, CEO, and co-Founder of Blackstone Group
- Paul Atkins, CEO, Patomak Global Partners, LLC, and former commissioner of the Securities and Exchange Commission
- Mary Barra, Chairman and CEO, General Motors
- Toby Cosgrove, CEO, Cleveland Clinic
- Jamie Dimon, Chairman and CEO, JPMorgan Chase & Co
- Larry Fink, Chairman and CEO, BlackRock
- Travis Kalanick, CEO and Co-founder, Uber Technologies
- Bob Iger, Chairman and CEO, The Walt Disney Company
- Rich Lesser, President and CEO, Boston Consulting Group
- Doug McMillon, President and CEO, Wal-Mart Stores Inc.
- Jim McNerney, Former Chairman, President, and CEO, Boeing
- Elon Musk, Chairman and CEO, SpaceX and Tesla Motors
- Indra Nooyi, Chairman and CEO, PepsiCo
- Adebayo Ogunlesi, Chairman and Managing Partner, Global Infrastructure Partners
- Ginni Rometty, Chairman, President, and CEO, IBM
- Kevin Warsh, Shepard Family Distinguished Visiting Fellow in Economics, Hoover Institute, and former member of the Board of Governors of the Federal Reserve System
- Mark Weinberger, Global Chairman and CEO, Ernst & Young
- Jack Welch, former Chairman and CEO, General Electric
- Daniel Yergin, Pulitzer Prize-winner, Vice Chairman of IHS Markit
Philip Betbeze is the senior leadership editor at HealthLeaders.