Early efforts
A Boston native, Fisher, 59, glides through Washington like a veteran of the district, well-acquainted with the halls of Congress and innermost workings of federal health agencies from her work with the Food and Drug Administration on regulation of human tissue in the mid-1990s. Twenty-some years later, distinguishing the roads to dead ends from the roads to Notices of Proposed Rulemaking comes naturally.
Within 18 months of founding Patient Rights Advocate Inc., a nonprofit with the mission of supporting price-transparent models, Fisher found herself across the table from several top officials in the Trump administration — and soon enough, President Donald Trump — pitching the central thesis of what she now considers her life’s work: putting patients in the driver’s seat, and letting them shop for care in a free, transparent market.
Less than two years later, three transparency efforts championed by Fisher were underway in Washington: the now-finalized interoperability rules, transparency rules for insurers under White House review and a rule mandating hospitals post prices, which is currently tangled in the courts. With amicus briefs, committee assignments and close relationships with top administration officials, Fisher has staked out ground in the trajectory of each -- even as the COVID-19 pandemic rages.
“This is David and Goliath kind of stuff,” said Don Rucker, HHS’ National Coordinator for Health Information Technology. “We see a lot of people in D.C. who are lobbying to, quote unquote, help the public, that are really marginally disguised ways to line their own pockets. What she’s doing is straightforward, and in the public interest.”
In early March, Rucker’s office was widely praised for the interoperability initiative by technology companies ranging from Apple Inc. to small startups and app developers eager for a point of entry into the $3.5 trillion U.S. health care economy.
If implemented in tandem with the initiatives pushing hospitals and insurers to disclose prices and negotiated rates, the rules would fundamentally reshape the way Americans navigate the health care landscape. It’s part-and-parcel of the vision Fisher presents to the administration: “Uber-ize” health care by retooling an antiquated, opaque system to make it fit for the 21st century.
“At first, I thought the answer was in Congress,” Fisher said. But the “health care cartel,” as she calls the companies that together comprise the $1.3 trillion U.S. economy, has thousands of lawyers and lobbyists working on a coordinated effort to protect their interests. “I’m one woman.”
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