Top of Mind: Charlie Baker

Harvard Pilgrim CEO, healthcare reform pot-stirrer, Great Massachusetts Republican Hope, 52, Swampscott.

charlie baker

Baker in the Quincy offices of Harvard. (photograph by corey hendrickson)

Will he or won’t he? We’ve been here with Charlie Baker before: when Baker, at the time a highly regarded Weld aide, mighta-shoulda-wasn’t Paul Cellucci’s running mate in 1998; when he flirted with a gubernatorial bid in 2006. Now Baker is again weighing a campaign for governor, and it looks as if it could be a go—unless he opts to pass, again. Meanwhile, he’s contending with the crossfire from the state’s warring hospitals, as well as the simmering federal healthcare debate, which could dramatically shift the terrain for insurance companies like his. It’s all a lot to mull, and Baker says he’ll reveal his 2010 plans soon. (But not so soon as this month.)

Here are some of the best quotes pulled from his interview with Boston editor James Burnett:

Since you have this on (gestures at recorder], I’m going to give you a long answer.

I said from the beginning that I thought the test for our state’s healthcare reform over the long term would not be whether we could get people enrolled. It would be whether we could sustain the costs. That’s the $64,000 question, probably more like the $64 million question, and on that one we still have our work cut out for us, bigtime.

I think we insurers for the most part are always going to have a certain amount of negativity attached to us. We’re the ones who are told to fit 50 pounds of stuff into a 20-pound bag. We’re the ones who are supposed to make sense of patient demand, new technologies, new capabilities, government underfunding, and employer expectations. You put that all together and it’s a big, hairy ball of twine. Being the “bad guy,” if you want to put it like that, is almost unavoidable.

I get enough positivity from our customers that I don’t have any trouble getting out of bed in the morning. There are a lot of people who depend on us, and I think we deliver on that, day in and day out. I feel okay about our place.

The big problem with healthcare reform has always been—and this is true whether you come at it from the right or the left—that your preferred alternative to getting what you want is the status quo. So unless you’re getting exactly what you’re looking for out of reform, most people fall back on the status quo, the devil they know, as their second choice. That’s made it really hard.

There’s a growing consensus in Washington that doing nothing is simply not financially sustainable. And so the devil they don’t know, warts and all, is finally looking like a more viable alternative than the devil they do. That’s going to lead to a much more intense and meaningful conversation than the ones we’ve had previously.

Now, that’s kind of the optimistic view. The pessimist in me thinks we’ll do a whole lot of things that just sort of push the problem off, and actually make it worse down the road. And, you know, it’s anybody’s guess as to which we end up with.

My wife and I have been Harvard Vanguard patients since we were first married. My doctor is at the Kenmore center and hers is at Post Office Square. That’s not an impertinent thing to ask.

This may disappoint you, but I tend not to read everything in the news exactly as it gets printed, because you just never know the context of a lot of these conversations.

I just finished reading A Prayer for the City, which is this unbelievably cool book about Ed Rendell’s first term as mayor of Philadelphia. This guy was viewed as basically done in electoral politics when he decided to get into the mayoral race back in the late ’80s. Honest to God, it’s one of those books, if you pick it up and start it, don’t plan to put it down, because it’s beautifully written.

Is it now or never for me? I don’t think so. Let’s put it this way: I cannot think of an industry in which more people have been down, out, gone, and then come back and succeeded than politics.

The question I’ve always struggled with is, Can I bring something to the table? Before you even get to could you actually win, you gotta start with whether you think you could actually get anything done. And in some ways, that’s a hard question to answer. Because it’s not obvious. It’s not clear.

I’m a talk-to-a-lot-of-people-and-then-go-with-my-gut person.