Gettin' Wonky w/ Universal Healthcare


Economies run on healthy people. Healthy people are handcuffed to their employers. Entrepreneurs can only innovate if they can take those handcuffs off without the risk of losing their healthcare. How do we create a more healthy workforce and society?


All hard questions that The Chad & Cheese can ask, but no way in HELL have the answer.


Enter healthcare expert founder and chairman of Nightingale Partners and former appointee by President Bill Clinton, John Gorman. John is a healthcare rockstar and at 25 years of age he was appointed as Assistant to the Director of Health Care Financing Administration’s (HCFA, now CMS) Office of Managed Care during the Clinton administration where was handling a $79 billion portfolio.... That's BILLION with a B kids.


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PODCAST TRANSCRIPTION sponsored by:

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Sovren (26s):

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Chad (29s):

How old were you at this point?


John Gorman (31s):

I was 25 years old and had a $79 billion portfolio. That shit only happens in DC.


INTRO (52s):

Hide your kids! Lock the doors! You're listening to HRS most dangerous podcast. Chad Sowash and Joel Cheesman are here to punch the recruiting industry, right where it hurts! Complete with breaking news, brash opinion and loads of snark, buckle up boys and girls, it's time for the Chad and Cheese podcast.


Chad (-):

Welcome to the Chad and Cheese Podcast everybody! I am Chad Sowash here with my work wife, Joel Cheesman,


Joel Cheeseman (-):

What up?


Chad (1m 13s):

and today, Joel, we're going to have somewhat of a cerebral discussion. Are you ready for that?


Joel Cheeseman (-):

Getting our brain on today.


Chad (1m 19s):

Getting our brain on. So on today's show, we have a real rock star. We're going to talk about how we can build a stronger, better, more healthy and innovative workforce. On Chad and Cheese we always talk about and debate quite frankly, about how we need to change government regulations, programs, obviously staff to drive innovation, wages, and many other opportunities zones. Well today we're going to do just that with our friend John Gorman.


Applause (1m 46s):

Clapping


Chad (1m 50s):

Now John is the founder and chairman of Nightingale partners, and John's did a bunch of other stuff, but John, I can't wait, dude, I gotta, I gotta jump in. I want to hear the story about how you landed in the Clinton administration. Was that an appointed position? How did that all happen?


John Gorman (2m 8s):

Yeah, sir, it's a, it's a long, strange trip. And one, thanks for having me on guys. It's a great pleasure to be here. So how did I land in the Clinton administration? So my career in DC started about 30 years ago. I was hired straight out of Oberlin College to come be the press secretary for my hometown Congressman John Conyers, Jr. from Detroit, where I grew up. A year later, I was his chief of staff. And then a year later I was helping to run then governor Clinton's campaign in Michigan, which he won handily in 1992.


John Gorman (2m 48s):

And I was an appointee to the, what was then called the healthcare financing administration, which runs Medicare and Medicaid, and is now known as the center for Medicare and Medicaid services. My job was to be the founding deputy for what was a new office of managed care. So for the first time we had set up an office that would be the hub for all the Medicare and Medicaid HMO programs back in the early nineties.


Chad (3m 23s):

How old were you at this point?


John Gorman (3m 24s):

I was 25 years old and had a $79 billion portfolio! That shit only happens in DC.


Joel Cheeseman (3m 37s):

So that's a glimpse in the past, let's talk about present real quick Nightingale Partners, what do you guys do?


John Gorman (3m 43s):

We are kind of a weird beast. We are one of these opportunities zone funds, that came out of Trump's big tax giveaway bill, but this was actually Cory Booker's program designed to spur investment in real estate, in disadvantaged communities. And then a really strange thing happened. Last year the IRS loosened up the regs to allow opportunities, zone capital to be used for not just purchasing real estate, but for leases, more importantly for working capital and for meeting the business requirements of a new company in one of the roughly 9,000 opportunity zones around the US.


Chad (4m 27s):

And that was Mnuchin wasn't it?


John Gorman (4m 30s):

Well, yeah, technically IRS is part of Treasury. I doubt that minutia had anything to do with that loosening.


Chad (4m 38s):

I don't know, man, any way to be able to perspectively launder. I think he might've had something to do with it.


John Gorman (4m 48s):

Well, what happened was basically the way the program works is if you invest capital in one of these 9,000 disadvantaged communities, not only is the initial investment tax free, but all of the proceeds you make on that investment are completely tax free. So as you can imagine, that was like catnip for Republican billionaires. And it opened up about $6 trillion in available capital of which about 30 billion has been invested in these opportunities zones in the 18 months of the program, that has been operating.


John Gorman (5m 24s):

So it's brand new, but it suits our purposes very well. We are the only opportunity zone fund that makes investments in healthcare and specifically our focus is on social determinants of health. So these are basically four fancy words for poverty. So basically we invest in large scale antipoverty interventions with large health insurers.


Joel Cheeseman (5m 50s):

Give our listeners who don't live this every day, what is an opportunity zone?


John Gorman (5m 55s):

So an opportunity zone is one about 9,000 census tracks across the U S that were selected by governors as being really economically disadvantaged and they're all medically underserved. Which is a designation by the feds that means they have really terrible access to healthcare, not nearly enough healthcare providers to go around to the population. So for instance, the West Baton Rouge opportunity zone in Louisiana is one of the worst medically underserved communities in the U.S.


John Gorman (6m 35s):

and it has about a one to 7,000 primary care physician to patient ratio. So that's where we focus our investments in partnership with health insurance companies. So we'll stand up things like meal delivery programs if food security is a challenge for their members. We do a lot of non-emergent transportation to doctor's appointments, to pharmacies, so people can pick up their meds. We do a lot of housing security and so we are involved in lots of low income housing developments with onsite health and social services because all of these types of investments have been shown to yield about a three to eight X return on investment.


John Gorman (7m 23s):

And so as investors in partnering with health plans on these things, these are really impactful investments that improve the quality of care and dramatically reduce its cost.


Chad (7m 32s):

This actually helps drive the economy. Did you have anything that actually ties to economic growth as well?


John Gorman (7m 40s):

Oh, that's in our DNA as opportunities zone investors, you know, there's always a huge priority on economic development and making underserved communities, disadvantaged communities, more resilient, especially during this pandemic, to really foster job growth. One of the consistent themes that we see in our roughly 50 projects that we've got in development right now, and why I was so excited to join your show today, guys is the common thread in all of our projects include community health workers or Promatores as we call them in Puerto Rico.


John Gorman (8m 24s):

And the community health worker is basically just a social worker without the license, but who's from the community in which we're intervening and can help serve as a navigator and a coordinator of care and services for a really vulnerable and expensive patients within their neighborhoods. So in every single project we do community health workers are a fixture. But you know, the very nature of the stuff that we get into in social determinants even really speaks to physician, nurse and extender burnout.