Q&A: Farzad Mostashari
The past 90 days have been good to Farzad Mostashari, who says he is working reasonable hours again after leaving his position as the national coordinator for health information technology at the Department of Health & Human Services. Now, Dr. Mostashari is a visiting fellow at the Brookings Institution, a think tank in Washington, D.C.
Earlier this month, Mostashari came through Nashville to speak at the Nashville Health Care Council program “Leadership Health Care,” which aims to educate future industry leaders. While in town, Mostashari took a minute to talk to TheTennessean about watching the West Nile virus come to this hemisphere and why Nashvillian health care execs seem singularly mellow.
I saw that you went to the Bluebird Cafe while you were in town.
That was fun. I had no idea what to expect. Later on, I figured out that’s an iconic Nashville place. I really loved it. I mean, I’m not a country music fan, I must admit that to you, but the storytelling is pretty special.
Nashville music is great. Did you notice anything special about our health care industry?
Here’s what I like about Nashville: People seem to be less in a frenzy here. One reason is that there’s pretty good information-sharing within the health care sector. Once someone learns something, they have other people to turn to and they have other people to teach. I think part of that is because everyone has either worked with someone before, or worked with their brother or will work with them in the future.
You can’t really burn bridges here.
Yeah. The other thing is – and I appreciate this – there’s a healthy profit motive. It’s not ideological as much as it is practical, as in, “Let me understand the situation so I can make money.” That mentality is paired with the ability to mobilize capital and resources to get it done. That’s what we need. There’s nothing wrong with a profit motive that gets people clear-sighted and hard-nosed about what needs to happen.
What needs to happen?
One of the problems that we’ve had with health care has been short-term thinking. And health care’s problems are not short-term problems. Health care does not move like Facebook, you don’t get a new economy all of a sudden – it’s really region by region, doctor’s office by doctor’s office, and change is really hard. And it’s not about technology, really, it’s about bringing data and science to how we practice medicine.
I’ve heard from some people that certain Affordable Care Act policies don’t take into account what it’s like to run a health care business day-to-day, for example, or to be a nurse on the floor. Is that true?
No, I don’t think it’s true at all. I’m no longer in government, but I wish people appreciated that making regulations is an exhaustive process. There’s this sense of that it’s arbitrary or naïve. But if anything, it’s overly careful.
And no one is perfect – sometimes you may make the wrong decisions, but it’s never because enough points of view weren’t considered, or that the knowledge wasn’t there.
Do you think that 20 years from now, people will look back at the rollout of the Affordable Care Act as a success?
I don’t think the rollout will ever be viewed as having been successful. But I think once people have something, it’s really hard to take it away from them. So once people really understand that the insurance company can’t stop covering them because of a pre-existing condition, that’s going to be seen as a real turning point in how the country cares for its most vulnerable people during the most vulnerable times of their lives.
On the other hand, I do hope that there will not be lasting damage done to the idea that government can accomplish big things. Sometimes we need to do big things as a country, and the government is our expression of shared interest.
What did you do before you worked for the government?
I’m a medical epidemiologist. I look at patterns of disease and society and try to understand what causes some groups to have better outcomes or more disease than others. I was at the Harvard School of Public Health, Yale Medical School, and then back at Massachusetts General at Harvard for internal medicine. Then I did a CDC Fellowship in New York City called the Epidemic Intelligence Service.
I’ve never heard of the Epidemic Intelligence Service. What is it?
It’s about finding outbreaks. It was actually started after World War II to potentially help identify biologic terrorism out of the CDC.
It sounds like a team of superheroes.
That’s what I thought it was going to be like, but it turns out it’s much more about service – effacing yourself, not striding in there.
So you didn’t bust through doors yelling, “Code Red! We found the virus!”
No. But we did find West Nile Virus. During my time there, it came over to the Western hemisphere, which was fascinating.
That must have been cool. Awful, but interesting.
It was amazing.
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