January 17, 2024
Welcome to Perspectives, Leerink Partners’ signature podcast, where we share our insights and interview leaders across the industry to get their perspective on how they’re driving innovation. We’ll also be digging into the backstory to learn more about what has most influenced their success. Be sure to check out all episodes by Leerink Partners.
Thad Davis: Hey, Sue. My name’s Thad Davis. I’m a senior managing director at Leerink Partners. You’re actually a unique guest actually, you’re the first policy and governmental player that we’ve had on the podcast, so thank you for taking the time to join.
Sue Birch: Well, thank you so much Thad. It’s an honor and we do really important work, so I look forward to talking to you today.
Thad Davis: You’re the Washington State HCA Director right now. Before I get into the rest of your resume, just a walk through what you’re doing out there.
Sue Birch: You bet. So, I’m really fortunate to lead an agency of about 1,800 folks that oversee coverage for about 3 million people that live in the state of Washington, and we are a governmental agency. We’re one of the six biggest in Washington. We not only purchase health insurance for all those three million folks, but we are a major policy force. Roles very seriously about aligning transformative policies that are evidence based. And we align that with our purchasing power. We also come alongside other jumbo purchasers. But truly, we are one of the largest in the nation. And we don’t just buy for Medicaid, we buy commercial for our public employees and our school employees, and we also have the public option, and we’re soon to do another expansion where we are bringing on all undocumenteds in the state. So, Washington’s goal of having all people covered with access to value-based services is what we’re all about.
Thad Davis: I think your role is somewhat unique because you actually are doing coordination and purchasing across multiple portfolios of pay. Correct me if I’m wrong, but I think that’s actually a pretty unique seat to see a lot of different aspects of like, especially as you noted, value-based care across, you know, different verticals, et cetera.
Sue Birch: Yeah, you’re absolutely right, Thad. And we do this also with a life course approach. So, cradle to grave, we cover services. The other unique thing in Washington is we are one of the pioneers now trying to push out the correct kind of medical to social spend ratio for these three million lives. We are trying to work with kind of a one healthcare authority mindset of what is good for some populations is good for all populations. For example, right now in Washington, we know that the behavioral health services provided under Medicaid are actually more robust than some of our commercial offerings. We’re trying to level these things out and try to create more uniformity around, policies and that service provision. It truly is a big chunk of work to undertake, but we’re really excited to be pioneers and pushing kind of the transformations forward.
Thad Davis: The core of our podcast here is to understand sort of how you came to this role. You’ve had a, a number of interesting and illustrious roles. You’ve spent time at the Colorado Department of Healthcare Policy and Financing, you’re under Governor Inslee in Washington State, then Governor Hickenlooper in Colorado, but you started out from UC Denver getting a bachelor’s of science in nursing, right? So, you’re a trained nurse.
Sue Birch: Yeah, that’s right. I am really proud to call myself an executive nurse. We have a unique skill set to combine some kind of broad clinical service perspective understand kind of the policy drivers and implications about operationalizing policy. But then I also have my master’s in business, and so with that, I’ve been able to learn from really the private industry and to put this public private piece together. So, as I participated over the years in bringing up two different health benefit exchanges sitting on those boards, have been able to kind of blend both that clinical quality perspective and also the financial business side of things. And that, that is a really sweet spot. We need more, executive nurses in the nation sitting in these roles so we can blend not just, cost, but quality into…
Thad Davis: You mean practitioners that, people that have delivered care, you know, implementing care? That’s crazy. That’s crazy, Sue.
Sue Birch: What a thought, huh? What a thought. You know, there are times I have to get my clinical side of my house to calm down and say, “no, this is real, you know, it’s real about the cost. It’s real about the implementation efforts.” So, it again is a really practical place to sit. I’m so humbled as I’ve been able to travel to other international countries and learn about what they’ve done. I will say their kind of nursing and multidisciplinary perspective is part of their successes. And we need to drive more of that into our American health transformation models. And so, what better place to have nurse executives sit in the C suite.
Thad Davis: Remind me, you’re from Colorado originally.
Sue Birch: Don’t stop the interview, but I was actually born in the Washington, DC area and spent the first two decades of my life there.
Thad Davis: Born and dipped in the policy market. Yeah.
Sue Birch: Yeah, I don’t know, somehow I have a lot of respect for how the federal state local alignment has to be brought into this whole reality. And that is another structural flaw in the US is right now we have enormous distance between federal and state policy. The states are actually the labs of innovation. But our federal partners are really coming along and trying to understand how each region, each state is so different and some of the unique challenges. That trifecta of policy alignment is critically, critically important because you and I both know, all health should be local. It should be between that provider, that physician, or nurse practitioner, or PA, and the client. And then we should be having the other extensive services wrap around that.
Thad Davis: Yeah, it’s pushed down to the state to implement it. It’s like, the closer you get to the actual implementation of it, I mean, and in terms of distance, I mean, there couldn’t be any, I mean, Washington state couldn’t be any more physically distant state. Then going from Washington to Washington State literally in terms of where national policies being worked on and then Washington State where you are, where you’re actually have to deliver it on the ground and solve, even at scale large problems at the state level. You were doing a lot of rural coordination, if I recall, around Northwest Colorado, and then through your nonprofit work, how did you make the transition into the administration? Can you just walk us through how that transition occurred? Because I think a lot of people think like, “oh, I’m going to go into policy” and like you’ve actually done that.
Sue Birch: Yeah, there was never any plan. There’s a lot of good fortune and luck in life. And I was so honored to be selected for a Robert Wood Johnson executive nurse fellowship experience where they scouted across the nation, executive nurses and said, “you are really getting a lot of attention, getting a lot of money, you’re moving the needle. Who are you?” And it opened all sorts of doors or assignments, like, “Hey, we need you to go to the White House”, or, “Hey, we need you to be, you know, on this panel of experts”, or, and there was a lot of coaching and helping kind of really open the breadth of thinking about how you scale and continue to be part of the transformation of the US healthcare system. And they have many foundations do this kind of work. I was again so honored to be selected by Robert Wood Johnson Foundation and then that continued on through another Colorado based foundation years later, who said, “keep going.” And during that time, I had elected officials reach out to me saying, “wait, wait, we need you inside government” and to which I generally said, “yeah know, I’m not doing that.”
Thad Davis: Them the governor calls, you know, like, “okay, I got, I got the call.”
Sue Birch: Governor Hickenlooper and Governor Inslee have been amazing leaders to work with who have said “help us fix it from inside.” That is how I landed in what I’m doing, but I will tell you, I mentor all sorts of folks that want to go into this area and I do think it’s really important for us important for those of we leaders that are already kind of at this place in our careers to keep bringing up and building capacity of the leaders that need to come after us.
Thad Davis: Bringing folks like yourself into government service. Which is a high, a very important role, but having that prior executive background, like you’ve noted, I think that’s a great union and definitely difficult to cultivate.
Sue Birch: You know, Thomas Friedman put it best in his book, Thanks for Being Late, I think was the title, about how really government and healthcare have been late to the game on data and informatics and computing, and we really need to keep optimizing in this space this work has to be done in true public private partnership.
Thad Davis: So coming forward, I’d like to do is start at Washington State and kind of begin to burrow out from Washington State into kind of broader transformation, now that you have all the perspective that you have looking backwards, what are some things that you’re like, “listen, here have been the challenges in the state, here is what we’ve done to address them, and here’s where, either state or broadly, here’s what we think we should go with what we need to do in Washington State” and maybe splice that into sort of maybe, generalize that to what, you know, other states are tackling or what you’re seeing out there broadly.
Sue Birch: What a great question. Much of what I’m going to talk about is publicly available in our budget requests and our legislative agenda for this last session as we go into. Unfortunately, we still have nine or ten states that haven’t expanded Medicaid, so my comments are really more for the states that have gone for full coverage, but I always offer to help any state that wants to expand Medicaid, uh, to how to get that done, because, lived through that. Our future going forward, and the things, to me, that America really needs to back up on, and then alter are things like the investments in data and infrastructure. So, for example, Washington has made the decision, I believe, will be the first in the nation to offer up an electronic health record as a service. Now, you might be wondering, like, “Sue, that’s pretty blasé. We got all that done during our high-tech years where that funding came forth from the federal government”, but that was only the digitization of doctors. And some hospitals, the big health systems could afford to put in the functional electronic health records and other smaller systems don’t have that. And so, we have huge implications for how that is a real disservice as a health inequity driver. And so, the state will offer up some improved analytics. We’re also doing this in partnership around some of our cost transparency work that is being fueled by several private foundations, the Peterson Center, Gates Ventures, and Milbank, have been really supportive of helping us get stealth kind of data analytics teams into greater alignment. We’ll be doing work with the Institute for Health Metrics out of the University of Washington. And we need to, quite frankly, just continue to modernize, as Thomas Friedman warned everybody, like, “hey, government and healthcare, get your heads in this game around IT and data.” And so that is one of the backbone areas that needs to be strengthened. Really proud that not only are we going to be a first mover on electronic health records as a service, we’re not just doing this for the medical enterprise. We’re pushing further and we’re bringing on behavioral health data systems. We’re bringing up systems for tribes. Washington has 29 tribes, and this drives huge disparity. People of color really suffer disproportionately. And so, we just quite simply have to attack health equity in a different way. We also are bringing up our aging services. Washington is rated number two in the country for a social model of aging in place. And so, we need to create these linkages. In essence, we need to digitize the community efforts that support good health and well-being and drive costs in a better direction. Our cost containment in the US just has to accelerate and we can work so much smarter and more efficiently once we have an aligned IT platforms with our private sector partners. So, we are doing that in Washington. I’m really proud that our legislature is getting behind us. I’m also proud that our federal government has heard us out and is saying, “yep, inch forward.” This area of case management and care coordination is one of the big things that trips us up in the US healthcare system, and so this infrastructure, this kind of nerve system to the US healthcare system is critical for not just your overall health and medical well-being, but your social well-being. We know, there’s not many people that have come out of this COVID and all of our kind of global instability without a little anxiety and depression and that’s a huge driver right now to somebody’s health and well-being.
Thad Davis: You’re talking to like a lot of that is enabled you talked about like it’s backbone that’s enabling the characterization that it kind of came to mind as you were reviewing that Was it, you know, a lot more social determinants of health, a lot more analytics about true fundamental problems. How do we get down and identify or align value to that? I mean, that’s all that that infrastructure work should, you know, promote, continue to promote that. That’s the whole idea, right?
Sue Birch: Absolutely, and you know, I can point to countless examples, if a young woman doesn’t, isn’t picking up their birth control or getting on the right kind of birth controls and it leads to an unwanted pregnancy. I can point to neurocognitive dysfunction in elderly. If that doesn’t get diagnosed and moved on, it costs us a ton more money in society. We need to be on the care coordination and case management in a crisper, more efficient manner. Those are pretty old examples. But there are so many more that are emerging where we know we got to get on this health issue more quickly. And we’re not so known for that. And as we see more movement into genomics and precision medicine, we’re going to need that fast, nimble, responsive communications. We saw it during COVID. I mean, we simply had to get to populations that were kind of bigger areas of disease spread or were more vulnerable. And so, in order to drive towards some of the health inequities that are costing us just enormous sums of money, we need, this system that will help us monitor and pivot, move on a dime to respond more quickly and effectively.
Thad Davis: Where do you think this goes for, like, what, what is the, what is the transformation that you needed over the next five years? What is the most pressing issue? I mean, the infrastructure is obviously the enablement, but what is the core, what are the sort of two to three large, large-scale issues? I think you labeled behavioral health, which you and I have spoken about offline around tackling the behavior, the continuing evolution of behavior as a healthcare matter. But it has to be one, I guess, what are some of the other sort of macro things that you’re trying to attack at the state level?
Sue Birch: Well, we also know, for example, that those neurocognitive diseases are tripling. So, when, you know, we were all worked up about COVID and the pandemic, we need to get ready for the next pandemic type things that are already coming our way. And the neurocognitive diseases, the onset of Alzheimer’s and all of the, the related illnesses that are kind of impairing us, but not necessarily killing us, but costing us a ton while we live out our lives. It is part of why we want to see so much more movement into investments in primary care. If we can spend so much more time getting upstream and doing early identification and detection and then tight, tight case management. We also know there’s a suite of drugs that are millions of dollars that will be blowing out all our budgets, both on the commercial side and the public side. And that’s not to say we shouldn’t be doing it, but we need to know exactly what’s the evidence behind it? How are we going to get the best deals? Who’s going to get the meds? And so, we’re going to need to use the data infrastructure to help combat some of the ongoing challenging pharmacy costs. And not just pharmacy costs. We’re going to see this with all sorts of other innovations that people are going to want to scale and have us pay for it. And again, I think we’re going to have to respond and do that, but we’re going to have to do that judiciously and efficiently because as you and I both have talked, we cannot continue to see the health, total health expenditures continuing to increase out of control. It just simply will gobble up all of our resources. And we know that between our environmental and our economic needs that we’ve got to get kind of this health and social realm under control.
Thad Davis: The things you hit on are long term spend trends. Effectively, the way you identified, you’re like, “listen, here’s, here’s the areas of spend expansion that needs to be way more efficient.” In order to get, you know, this cost angle under control because it’s not an infinite. It’s not an infinite pay There’s not an infinite amount of I guess in this case tax dollars or commercial dollars to spend there has to be some limit and how do we address policy to get to that? How does that work across the government pay line and the commercial pay line? Like how much this is actually an interesting area that we spent some time earlier this year, you and I talking about, about like, there’s actually people think about these programs is, you know, the type of pay corridors, shall we call it, very different from each other. And they’re trying to tackle things. But actually, I think from, from my discussions with you, you’re actually looking across the pay corridors and you know, seeing a lot of opportunity either in, you know, transport innovations across those lines or frankly, just merge them together. Where are you at on that thinking?
Sue Birch: Well, you know, it’s, it’s really interesting. You know, who was it that said, you know, “America will get there. It’s just that we’ll spend a lot of money getting there.” I think we’re increasingly realizing that our health and wellbeing is impacting each other, no matter who’s paying for our insurance, you know, gun violence, our social unrest, our inability for our kids to learn more effectively, not to be total doom and gloom, but we just simply have to decide in America if we are going to have more of a social good construct in healthcare. I don’t think that’s going to come quickly. So, Washington is continuing to use our prowess in the public side and the commercial side to experiment and transform, to try to create that alignment in evidence-based services, to really try to drive the transparency, to create greater cost containment, to try to align with our private purchaser, other private purchasers. especially the jumbos and, the investments that have been made in the traditional kind of carrier insurance, uh, health systems models to try to look at how we can do this work more uniformly and more in alignment. So, we’re reducing kind of the waste. We are also being much more open to how we get government to reign in some of the over-engineered administrative processes that have, through that federal and state misalignment evolved. And quite frankly, government’s really gonna have to step up its game there and really both federal and state to make sure that we are tightly aligning. And I’m proud of Washington because as we, for example, have lifted on the public option, as we, for example, most recently, put up a benefit to cover all Medicaid children from 0 to 6, we’re also talking, again, on the commercial book of business looking at, okay, are there gains if we’re going to build a maternity bundle or a pediatric bundle, or as we are moving into a focus on hospital costs, can’t we do this in alignment to see why is commercial paying sometimes, you know, at 250 and 300 percent of Medicare, and we are also leaning on our federal partners for the rural and frontier areas of the state, where many of our international purchasing partners have factories or operators. How do we get their healthcare into alignment and cost control? How do we work on that together so that we are creating the same sort of contractual packages that we are both investing in workforce alignment that IT data alignment so that we’re really understanding the spend across the different sectors and trying to make certain that there’s justification and reason and what should be kind of the cost allocation. so we’re trying to look at these things in a little bit more of a utility model. I’m very concerned right now with the attitude of health professionals, rightfully so, that are really burnt out with the, again, over engineered or the complexity of kind of the business arrangements that are going on. And I think that it will not bode well for the health sector if we can’t continue to build up the appropriate workforce and get them to work together. many of them will say to me, “Sue, the systems are non-navigable and or we just simply have gotten so far away from the mission of what we signed on to. And we are seeing tremendous workforce shortages.” And so, we, we have to really take this seriously to get the right kind of provider mix going so that we can again move towards more of the value-based arrangements that need to play out to get higher quality, lower cost services. And again, we’ve seen it done in those OECD nations. We need to follow suit with some of their best practices and implement.
Thad Davis: How difficult has it been to actually affect change? I mean you’re required to advocate for policy get funding for policy implement policy watch rinse repeat. How difficult has that been in your seat, both in Colorado and in Washington? I mean, how, how empowered have you been and how, I guess in general, how empowered is a position of yours to actually implement this level of change?
Sue Birch: It is doable. You have to have tremendous patience. You have to have tremendous tenacity. I think systems at the federal and the state level oftentimes need a more runway. They need more time. Although we have seen, during the pandemic, obviously, where things turned pretty quickly with telehealth and whatnot. Telehealth is a great example. It was fabulous to be in a state where we aligned, the transformations with our legislature who were eager to make certain some of these changes stuck and that they have become lasting. You definitely need double proportions of tenacity and patience, but you have to really be on top of also being a driver. I know I was recently in D. C. spending time with some of our partners there, our national elected officials trying to help them understand like this moment in transformation, the crossroads that we’re at, especially with workforce and helping them understand that this is so far beyond licensing and credentialing. We have to really retool the workforce. So, there’s a lot of just, stakeholdering and networking that has to happen to keep bringing people into alignment about these transformation efforts. Cause I, I still run into all sorts of providers that say, “what exactly is, you know, are these alternative payments and value based?” And so, it takes, it takes a fair amount of time for elected and non-elected folks and clinical and business folks to really speak that same language and understand why we have to move in this direction.
Thad Davis: I think you have you found that when you’re moving through the halls of the halls of government, do you feel that that this has been, everybody’s receptive to the message? Have they been supportive? Like, how would you characterize is it? I can’t imagine anybody’s actually like, “no, no, no, we need to stick with the old way of doing things.” Nobody says that. But I guess it’s more of a matter of being tenacious around, you know, ensuring that competing priorities don’t get, don’t overwhelm the I guess the medium to long term urgency of what you’re what we’ve been talking about around transformation. How has it been with the other side of that, the folks you’ve had to interface with?
Sue Davis: I’ve had the good fortune to be able to stay very independent and work both sides of the aisle and help people better understand the importance of things that we need to forestall teen pregnancies and to have healthier functioning able bodied people because we know that people that are healthy and well cost us a lot less and are productive and we have been very, very successful in providing the data and lining up the efforts with the political leadership that I’ve been involved with. That said, I’ve chosen two very progressive states to work in.
Thad Davis: That’s true, but I wouldn’t characterize all of Washington. I mean, they’re progressive because they have large core cities. But the urban to rural ratio in both of those states is quite tremendous. I mean, actually getting real, it’s easy to set policy to a city, but actually getting rural effects at the same time. That requires a lot of buy in by people that are not necessarily, you know, a pro progressive administration, I think that’s pretty unique actually.
Sue Birch: Really good point, really good point, and there are ways, I think that we’ve had to learn to speak, less medical and more kind of, um, social implications. I learned early on from some very savvy economists about, you know, the real three secrets about healthcare spending are to try to assure that people are forestalling pregnancies till 21, to be productive citizens and working at something near full time, somewhere in that 30 to 40 hours a week, and to have, um, the ability to function with a basic level of education. We’re slipping in this country on two of those three measures and we’re slumping more dramatically in certain states on all three. And so, I’ve been able to kind of create that crosswalk in the conversations to link it back to why, you know, electronic health records will help us do tighter case management and why purchasing in the way we do with alternatives.
Thad Davis: It’s translating a core need of the stakeholder you’re facing into the meta objective that you’re like, “listen, you’re absolutely correct about X, that weaves into this policy Y, and this is what we should be doing as a state that will help you, help me help you, help me help you.” Effectively.
Sue Birch: I am also probably a little bit more alone in this effort around public private partnership, but government is not going to work our way out of this problem. The public private alignment will. And so, we quite frankly have to keep beating that drum to help people see that this has got to be an ongoing public private partnership and commitment towards getting that right together going in the healthcare industry. And I think that’s where we have just some fabulous opportunities with the partners that are making kind of investments in private equity. But we’ve got to do that with more of a mindset and attention towards quality and what’s absolutely critically necessary in the US and we have several centers for evidence-based health policy. What we need to see start happening is more robust investments in evidence based social policy. And so that way we’ll have more best practices and facts to look at how we create successes in we’re seeing,
Thad Davis: That goes back to the data architecture you’re talking about. Like just having medical records and accessibility, information to study these things in a macro scale. I mean, I, I spent a little bit of time in the, the health policy schools around. And I mean, they would love to get their hands on more data to, you know, begin to see like evidence based social policies. And I think a lot of experimentation is going on, but I mean, it’s good to hear that what you’re trying to implement is actually trying to accelerate that in terms of, you know, studying health as a social dynamic and social dynamics as a health dynamic at the same time.
Sue Birch: The other thing I think America has really got to wake up to is not only did the pandemic exacerbate some of the challenges, but the opioid, fentanyl crisis that’s occurring across all socioeconomic groups will continue to lead lasting impacts and costs. And so we simply have to do tighter integration on that primary care and behavioral healthcare work and figure out how housing and residential living has to shift to support folks that are in recovery that can go on to lead very productive and healthy lives because this is such a scourge on America and, you know, we will continue to be able to quantify just like we have now with the pandemic to look at the number of lives we could have avoided losing. We’re going to continue to be able to have crisper data as time goes on. And I worry that those costs are inordinately huge for what has to happen in a functioning society.
Thad Davis: So why didn’t you ever cross over to pure politics? Why not go for an elected seat? Has that been on the, been in the mind, on the radar, anything like that, over time?
Sue Birch: Oh, heck no, man. I’m one of those. I think maybe when I was younger, but I’m one of those nurses. You know, we’re in that most trusted profession. And I, I will say, you know, there are times where sitting on the sidelines of some of this politics that it’s just a little too ugly for me. And while I’m fine kind of helping shape from the side wings, I’m not sure I want to be right there in the spotlight. But, boy, what a time now. So maybe I have too much honor and integrity. And I actually, I think that where I’ve been able to sit at state level is where we’ve been able to move faster. And when you look at, again, you know, the Commonwealth Fund’s ranking of Washington, I’m really proud of both Colorado and Washington that continue to stay right up top in the foundational work that we’ve laid.
Thad Davis: More, uh, healthcare focused and more personally impactful is probably a, a way to, a way to kind of summarize the not going down the politics route. I mean, there’s good union for that, but that’s a broader scope outcome than what you’re, you’re getting done right now.
Sue Birch: And I would be lying. I do get asked frequently. They’re saying, “no, no, it’s time still,” but I, I gotta tell you. I probably enjoy more of working with the, the teams of policy walks that are trying to align and work. And for those that are saying, “yeah, yeah, this happens inside government.” No, no, no. I’m very proud to be part of the purchasers business group on health. You know, I see this, I, the Boeing team, the Microsoft team has some extraordinary health policy launch. So they’re just right up there in their human resources department.
Thad Davis: That’s actually an interesting point that you’ve surfaced this before, and when we’re talking, is it, when you get into a state, when you get into Washington state and you’re looking at is sort of the care you’re providing at the state level and then you look at like you look at an employer like Boeing which for those who don’t understand Boeing is a massive employer in the state of Washington and then there’s actually a lot of actual thinking and discussion to go on across lines where Boeing actually wants to interface with the state around your care policy decisions about that actually affect their population and vice versa. Is that accurate?
Sue Birch: Absolutely. And, you know, huge shout out to Boeing. Greg and Linda and his team, but also when you think about it, you know, Walmart, they are right at the table. Microsoft, Costco, you know, these entities are very, very concerned, not just from what they’re paying for health insurance. They’re concerned for the types of employees that they have to find to work for them. And so, I am so proud that as I have again, spanned this public private partnership to see the investments that these folks are making to try to drive this aligned policy, we simply need more of that. We need healthy, educated folks to be part of our productive, capitalistic society. And we need to do that with a fair amount of benevolence and intelligence and stop wasting money because there will come a time, and I believe we are at that crossroads, given the comparisons to those OECD nations where we got, we got to knock it off, we got to stop some of the egregious pricing and financing schemes that aren’t, they’re not helping us improve health outcomes.
Thad Davis: Right. Agreed. So, the administration’s winding down, or I guess it’s not like, not like right here, but it’s coming, coming down to an end, you’re pushing through priorities in a, in a budgetary move here. But after all this is done and behind you, what’s next in terms of where are you going to be? You’re going to hang out in Washington. You’re going to head back to Colorado. What’s, what’s next for you in that one?
Sue Birch: Wow, you’re going to have to wait for the next podcast on that one, but I am fortunate, um, you know, I’ve got kids in both states and so I want to be around for them.
Thad Davis: Oh, that’s really good. Actually. That’s that, that’s pretty great actually. You’re like, “oh, I don’t know. I can be in both states and I have kids in both states.” It’s great.
Sue Birch: Yeah, and I’ll probably be like Alice Rivlin and those, those that know Alice know she pretty much worked up until, she passed on and I, I have health policy in my genetics, so I’ll be doing this work for the rest of my life but stay tuned and I, I really hope that other states will continue to join in the pursuit of understanding better cost data transparency. I hope they will continue to be open to aligning with the private side differently. I hope that they will lead like Washington has on creating accountable communities of health because they are the ones trying to try to create more uniform capacity on community-based organizations. I mean, just close your eyes and think back to what we saw during the pandemic and how those food banks were blown away with miles of cars lined up. Yes, those were extraordinary times, but we have to be ready with environmental, climactic changes coming our way to deal with more of this instability in the environmental, economic, and social sector. And I just hope we can really keep aligned and moving forward as we really keep improving the US healthcare system
Thad Davis: One last question before we wrap up here. What’s the best piece of advice you were ever given?
Sue Birch: Oh, go bold, go big, keep moving, be persistent. But always focus on how we get this work done. You know, we got amazing innovations, in the US But, you know, as I spend time with those that are closing out their last hours and days of their lives. How we all work together is really, really important. And so, I hope that we can create more respectful civil discourse where we agree to disagree. And I hope we can keep really showcasing that we’re all in this together. This is really ultimately going to be a global issue of how, you know, emerging diseases and infections and how limited resources affect all of us, so it’s going to drive a lot of need for collaboration and, uh, tenacity to keep after this.
Thad Davis: Well, I appreciate the conversation today. It’s been great. I really appreciate the insights and it’s always good to speak with you Sue.
Sue Birch: Thanks so much. We look forward to talking to you in the future.
Thank you for listening to this episode of our Perspectives podcast. If you are interested in participating in future podcasts or would like to learn more about Leerink Partners, please email us at info@leerink.com.
