HJBR Nov/Dec 2023

HEALTHCARE JOURNAL OF BATON ROUGE I  NOV / DEC 2023 17 that there’s an epidemic of loneliness in America. What’s your take on that? Secretary Russo Yes, I agree with the Sur- geon General, and I think it’s, once again, just the lack of folks getting over the stigma and coming to the conclusion that it’s okay to get some help. Basically, you become a prisoner of your own mind, so to speak. So yeah, you’re not reaching out to folks, you’re not talking through things. I would agree without a doubt. Editor I think this 988 number’s going to be interesting to see implemented. I’m glad, just on a personal note, to see it. I’m really holding out hope that it’s going to be a step in the right direction where peo- ple call 988, it’s confidential, they hang up, and they feel better. Instant gratification, you’re feeling better, and then start going, “Well, wait a minute, that wasn’t too bad. I didn’t have to give my name, didn’t have to give where I live, where I work, and I’m feeling a whole lot better now.” Boom, that’s the first step. Switching to the opioid fentanyl situa- tion in Louisiana, I heard a grieving par- ent the other day say, “My son did not overdose. He was poisoned.” How can LDH help address this crisis? Secretary Russo Well, one step in the right direction, of course, was the legislature last year allowed for fentanyl test strips. Because that is the frontline defense, folks can test to see whether fentanyl is present. The overall challenge of it is we have prioritized trying to expand access to medication for opioid use. I mean, we’ve got 27 additional office- based opioid treatment facilities through- out the state. I know we’ve increased our opioid treatment programs from 10 to 11. That’s probably still not enough. I know we’re looking to increase our peer support specialists and our resource coordinators. Just the outreach and some of the things that have really been telling on me is when I drive down the interstate and I see these bulletin boards. It’s really profound when you think about it. It’s like, “Man, one pill, one mistake could really cost you your life.” I think the outreach at that level, but then also increasing mental health services, because a lot of folks turn to that because they need some mental health help. They may not need long-termmental health help. They may just need that simple call to 988 … something like that. Hopefully, as we talked about earlier, that’s going to help us put a good dent and try to help us solve that prob- lem. Or, at least, make some headway. Do I think, realistically, all of a sudden, we’re going to wave a magic wand, and there’s not going to be any more fentanyl or other opioid use? No, we have to be realists; but I think it’s something that we can make a significant dent in, for sure. Editor Many in public health believe that violence is a contagious disease and should be addressed as such. If that’s the case, how can we eradicate it? Secretary Russo Well, once again, men- tal health; get treatment. I mentioned this when we talked about 988. There is bullying at school. Folks, when they get home, start feeling anger, and then end up potentially lashing out and doing violent acts. That is some people’s way, unfortunately, of deal- ing with the mental health struggles they have. And it’s incumbent upon us, I believe at least, as a society, to meet that problem where it’s at, and that is in the community. That is letting people know that you’re not alone, a prisoner of yourself, for instance. You’re not alone. People care about you. You’re part of a grander thing. You’re part of a community. Once people, realize that, then I’m hoping they don’t need to resort then to violence because they feel we’re all part of one community.” Editor Blue Cross and Blue Shield of Lou- isiana recently announced that it has entered into a definitive agreement to be acquired by Elevance Health. Now, that merger has been taken off the table, we’re told, until after the upcoming elections because of an outcry from citizens, offi- cials, and organizations who have exam- ined the acquisition. Is it in the best inter- est of the citizens of Louisiana to have the largest private insurer switch from a not- for-profit to a for-profit provider? Secretary Russo Let me put it this way. To me, competition is, in a lot of instances, what drives quality. Now, that’s not to say if you have one large provider and they have something that is close potentially to a monopoly, that they’re going to necessarily be a poor-quality provider, or not focused on quality. Because I think folks inherently, even if you’re a for-profit business under- stand, the healthier your folks are, it should follow that potentially the more profit you make. Nobody wants unhealthy people and to treat unhealthy people. But still, I stand by my statement, and it is generalizing, but I do believe that competition, in large part, breeds better quality, and I’ll just leave it at that. Editor Okay. If you had a magic wand and could apply it, what would your vision of healthcare look like for our citizens? Secretary Russo Vision of healthcare to me would be that all folks, whether you are on Medicaid, Medicare, you’re a member of a commercial plan, have ready access to healthcare. That’s high-quality healthcare, it’s affordable, and it is equal. That is really about as succinct as I can put it; and we get there, I think, by having rate equity — physi- cians, providers, get paid a fair rate for the services they provide. Kind of where CMS is trying to pushMedicaid, to a large extent, you are paid potentially a supplemental, or a kicker payment for the quality and/or the value of the service that you provide. Editor Thank you for your time, Secretary Russo. Secretary Russo Thank you. n