Leaders gather for an authentic, lively conversation about health care policy in Rhode Island

Richardson noted that while medical school graduates tend to attend residency training programs across the country, data shows residents tend to stay where they train. She said that 90% of people who go through family medicine residency end up practicing primary care, and that the family medicine residency program at the Warren Alpert Medical School has trained many of the primary care doctors in Rhode Island. But there needs to be many more spots made available, she said - and that relies on federal funding.

Richardson shared that even when the state and federal government approved a plan for a new family medicine residency program at Thundermist Health Center in Woonsocket, R.I., which would have provided more much-needed training spots, a lack of federal funding meant the entire plan fell through.

"Federal investment in family medicine residency programs is important for the state," she said.

In another example of panelists good-naturedly challenging each other, moderator Andrew Ryan, director of the Center for Advancing Health Policy through Research, noted that health care premiums have increased roughly 20%. He turned to Rhode Island Health Insurance Commissioner Cory King and asked, "Is this your fault?"

King, a master's in public policy graduate of Brown, gave a detailed explanation of how his office conducts a rate review. Echoing Shekarchi's earlier point about being mindful of different constituencies, he talked about how he needs to balance the needs of insurance companies, health care providers, consumers and employers.

"It's complicated," King said. "I'm absolutely open to constructive criticism that perhaps my decisions don't meet the appropriate balance of those three constituencies, but that's what we encountered."

Brown President Christina H. Paxson, an economist and public health expert, had offered introductory remarks at the event that set the tone.

"These are really complicated issues, and some of the policy solutions are more immediate, and some of them are much longer-term," she said. "My hope is that this discussion can clarify the answers to some questions and get us all thinking about them so that we can make really good decisions for the future of the state."

The conversation at Brown, as Beaudoin had noted, was the starting point, and now the work will continue on campus, in the community, with insurance providers and in the legislature.