Rhode Island faces a growing shortage of primary care doctors. Medical specialists make more money than primary care doctors, and the economic conditions for physicians are better in Massachusetts and Connecticut. This is why a legislative panel is studying whether it would help to create a state medical school at the University of Rhode Island. There are a host of other healthcare-related challenges in the state, including the difficult fiscal outlook for some hospitals and Rhode Island’s heavy reliance on public payers like Medicare and Medicaid. State Senator Pamela Lauria, a Barrington Democrat, has a front-row seat on these issues since she’s a nurse practitioner for Coastal Medical, a primary care practice serving more than 100,000 patients. Lauria is also co-chair of the legislative commission studying the potential of a possible state med school at URI. So what is the freshman senator’s prescription for improving healthcare in Rhode Island? As an East Bay resident, how does Lauria assess Governor McKee’s performance on the Washington Bridge issue? And as a Democrat and longtime gun safety activist, what is her explanation for why Donald Trump remains a competitive presidential candidate? This week on Political Roundtable, I’m going in-depth with state Senator Pamela Lauria.
Ian Donnis: Welcome to The Public’s Radio.
Sen. Pamela Lauria: Thanks for having me.
Donnis: Rhode Island faces a shortage of primary care doctors. What do you think should be done to address this?
Sen. Lauria: So I think we need to do a lot of things to address this. It’s not a one problem kind of situation. But one of the things I think that we need to do is look at our primary care workforce and what we can do to bolster that. One of the things that I think that we need to look at is why Rhode Islanders aren’t staying in Rhode Island to practice primary care. So one of the reasons for that is our rate of reimbursement. We know that. We are very small and it’s very easy to cross the borders to Massachusetts and Connecticut. You don’t even have to uproot your family and you know, you can make 20 to 25 percent more by doing that. So we need to look at reimbursement rates for sure and most thought leaders think that that’s the biggest problem. But also we have an aging workforce and we’re not training enough primary care providers to come and stay in Rhode Island or incentivizing them to come and stay in Rhode Island.
So one of the things that we have been looking at in the Senate is to have a commission to look at whether or not a public medical school at URI is a feasible option to help with that workforce issue. We’re one of only two states that don’t have a public medical school and it is very costly to go out of state or to a private institution to seek medical education, particularly for primary care, where you’re not going to make as much.
Donnis: I believe that panel is due to make its report in December of next year. Is that correct? And if so, do you have any, have you come to any conclusion on your own about whether a state based medical school at URI is a good direction to go in?
Sen. Lauria: No, we’ve really just started our work and we’re going to have to continue with that work and get some thought leaders in to discuss that with us. But we also need to have a feasibility study and how much it would cost, what it would need at the university to do that. So it’s much too premature to have an opinion yet on whether that would be a good idea.
Donnis: One member of the panel that you co-chair is former state health director, Dr. Michael Fine. He is of the belief that Rhode Island has too many hospitals and that the state could save money and offer better care by raising the emphasis on primary care. Do you agree?
Sen. Lauria: I think that that’s a great optimistic goal. I think that right now, unfortunately, because we don’t have enough primary care, we have ERs that are overly busy with work that could be done outside of those institutions. But I think that it’s an interesting thought. We know that more and more surgeries are being done outside of the hospital setting and hopefully if we do our job well, we’ll need less ICU beds, but I think it’s too soon now to say that we could let hospitals fail or close without a deleterious effect on Rhode Islanders.
Donnis: One more health care question before we move on to other topics. Health care is obviously a huge topic, complicated, defies easy solutions. But beyond the issue of primary care, what do you see as two or three other top challenges and how to address them in Rhode Island on health care?
Sen. Lauria: I think one of the biggest is cost. And that’s a very big problem. And I don’t know that we have any magic bullet to fix that right now. I think that we need to look at the way that our insurance is and how many people are on Medicare, and I’m sorry, Medicaid, and how the rates for that are very low in the state, and we need to improve that, but we also need to improve our payer mix, and that means bringing more industry and good paying jobs in the state so that we have more private insurance. I think that the workforce, not just as far as primary care physicians, but our nursing workforce and our nursing assistant workforce, so we need to look at that as well.
Donnis: Speaking of good jobs, we’re all concerned about the possible move out of Rhode Island by Hasbro. The state was taken by surprise by the news that the company is looking elsewhere. Do you think this shows that Governor McKee was not doing enough to stay in touch with the company?
Sen. Lauria: So, I don’t know enough about the situation to address Governor McKee’s role in that. I do think that Hasbro is an important corporate citizen in this state, has deep roots in Rhode Island, and it’s important that we do what we can to keep them here, if that’s feasible. But I certainly don’t think that we know enough now why they chose not to speak with us before they looked into Boston. But hopefully they’re speaking with us now and we can get to the bottom of what they need.
Donnis: You represent an East Bay District in Barrington and East Providence, so I’m sure you and your constituents have been very affected by the Washington Bridge issue. Are you satisfied with how Governor McKee and RIDOT Director Peter Alviti have managed this issue?
Sen. Lauria: So I’m definitely affected by the bridge. I live in Barrington and I work in East Greenwich, so I travel that bridge all the time. It has had an enormous impact on all of the East Bay residents, which is my entire district. So I think that right now we need to make sure that we’re doing everything we can to get that situation fixed as fast as we can. As far as whether I’m satisfied, I’m satisfied with the communication that we’ve had. And the East Bay legislators have had almost weekly Zoom meetings with Director Alviiti since the bridge is closed. We’re going to have another one on Monday to discuss again where we’re at with everything. And we demanded the reports, the monthly snapshot reports, and I think that’s been very helpful. I’m very disappointed that we don’t have a company yet to build the bridge. But I don’t know, you know, it’s too early. We don’t have the reports about what happened prior to the bridge closing and I look forward to having those and I think my role here now is to do everything I can to advocate for the citizens of the East Bay. I’m very pleased that we were able to get double what the governor had asked for as far as money for our small businesses, and we’re just going to keep pressing for how fast can we get this bridge built because East Bay needs it done as soon as possible.
Donnis: The state seems to be emphasizing trying to recover money from companies that worked on the bridge over many years. And this could be potentially tens of millions of dollars might sound like a lot, but not a lot in the context of the state’s annual budget. Do you think there should be a more emphasis on the public’s right to know how this entire situation happened?
Sen. Lauria: I hope that we can do both, right? So it’s more than $80 million that the state’s looking at hoping to recover. And I don’t think that that’s small money, but I also think that there’s a public interest in knowing exactly what happened. I trust, the Attorney General that we’re going to get that information, as much as we can when we can, and I will continue to push for that.
Donnis: You serve in the Rhode Island Senate where the President Dominic Ruggiero is considered likely, perhaps, to hand off the leadership in the next session starting in January. If that happens, who would you like to see as the next President of the Senate?
Sen. Lauria: So nobody has told me that the president plans to step away. He certainly hasn’t said that to me. I look forward to getting back in January and the president being there to lead the Senate as he has for many years. So right now we’re looking at the election. I have many colleagues that have elections coming up in November, so I’m looking to help. You know where I can in those elections and then we’ll see what happens come January.
Donnis: When the Senate organizes its new leadership in January do you support the incumbent majority leader Ryan Pearson or would you like to see someone else as the number two leader in the Senate?
Sen. Lauria: I think, again, we’re going to have to wait until after the election when a caucus is called to see who is interested in that position, but I wouldn’t be making any promises to anybody right now.
Donnis: You are a Democrat, so I think it’s probably safe to assume that you support Kamala Harris for president. If I’m correct there, why do you think so many Americans, more than 40 percent of voters, support Donald Trump if he’s as bad as Democrats say?
Sen. Lauria: So I don’t know why people support Donald Trump. I am a staunch supporter of Kamala Harris. I was lucky to be in Chicago at the DNC in October, in August rather, and I saw people that were excited, were ready to move forward, were ready to support the candidate that they saw as the future of our country. I don’t agree with many of the things that Donald Trump has done, and I am concerned what a future would look like if we went back to a Donald Trump administration, but I’m looking forward to working as hard as I can for Kamala Harris, and I think that many of my Democratic colleagues are doing the same.
Donnis: You have been a volunteer and advocate with Moms Demand Gun Sense for America. Critics on the other side of the issue say that criminals inherently do not follow the law and therefore law-abiding gun owners are likely to bear the brunt of new restrictions on guns. How do you respond to that argument?
Sen. Lauria: So I think that the laws that we have passed, and I’m very grateful for some of the legislation that we have gotten through in the last several years, I’m very happy to have been able to shepherd the safe storage bill. I think that none of these are terribly onerous on current gun owners. I don’t think that anybody needs a high capacity magazine. I think that safe storage is important for everybody. When people fought against wearing seat belts for years, but once they started to do it, it became second nature to them. We know, right now, we are in Suicide Prevention Month, and we know that guns are the most effective form of suicide, and that keeping those safely away, particularly from children that shouldn’t have access to them, is a life saving measure. So, I think that we need to balance the Second Amendment rights, which I absolutely do support with the safety and concern for life and having common sense on legislation is the way to do that.
Donnis: Although you’re a freshman lawmaker, Pamela Lauria, you’re part of a movement in which we’ve seen a lot more policy-oriented women become part of the General Assembly over the last 10 years. What difference do you think that has made?
Sen. Lauria: So, you know, this is my first term, so I can’t speak to the whole, over this last several years, although, you know, I was an advocate there before I became a legislator. And I think that you hit the nail on the head, that they are, we have lots of policy-oriented women that are doing great work at the legislature. I think that it’s a responsibility to have a legislature that looks like the people that we represent, which means we actually have more work to do because we’re not quite at the 51 percent that women occupy in this state. So I’d like to see that happen. But I’m very fortunate to be in the company of women who have all kinds of backgrounds and expertise and life experiences that they bring to the legislature. And, I count them as mentors
Donnis: with about 25 seconds. What are your top priorities for the new legislative session starting in January?
Sen. Lauria: I’d like to keep working on our health care issues. I’d like to work on an assault weapons ban for sure. I’d like to work on affordable housing. I think, I like to work on some of the social determinants of health. We need more housing. We need to make sure that people aren’t hungry and that they can take care of their families so that they can look forward to the health things that I’m asking them to do, like eat healthy, exercise more, take care of their health.
Donnis: We’ve got to leave it there. State Senator Pamela Loria, Democrat of Barrington. Thank you so much for joining us.
Lauria: Thanks for having me.
– – – – –
The indictment of New York City Mayor Eric Adams is drawing some wisecracks on social media about how this kind of thing is more common in Providence and Fall River. In fact, it was 10 years ago when the rascal king of Providence, Buddy Cianci, made his last comeback attempt. Cianci fell short, but he got a lot of votes, showing how he had many fans even after a few years in federal prison. You can read more about that in my TGIF column, posting around 4 this afternoon at the publics radio-dot-org and on what used to be known as Twitter at IanDon.
That’s it for our show. Political Roundtable is a production of The Public’s Radio. Our producer is James Baumgartner. I’m Ian Donnis, and I’ll see you on the radio.
