Issue link: https://tmcpulse.uberflip.com/i/1048847
T M C ยป P U L S E | N O V E M B E R 2 0 1 8 26 Q | Can you elaborate on how too much consolidation in the health care industry is detrimental to consumers? A | How many different health care systems do we now have in this city? There's Methodist, there's CHI St. Luke's, Memorial Hermann. ... It's a few major systems selling most of the health care, with four or five major insurers. Every time you have that few competitors, we call it an oligopoly. We need multiple competitors who are then going to be forced to bargain with each other to give more competitive prices. We don't have that on the insurance side; we don't have that on the pro- vider side. Physician practices are consolidating. All of this is driving up prices. Q | You aren't the first person in your family to go to Boston. A | My dad went there to get his undergraduate degree, then his master's degree in engineering from MIT. My mom's family did the typical Chinese thing: They ran a laundromat. The laundromat apparently was the place for young people to go and socialize, so they were there one night and my dad came with a friend. That's how my mom and dad met. The laundromat is still there [in Massachusetts]. They kept that laundromat in the family for generations. Q | Did your mother also attend school in the U.S.? A | She did not go to school here in the United States. Her family left China because of the Communist Revolution. She was not able to enroll in high school or college once she got here. It was just a challenge enough for her to learn English. When she first came, she contracted tuberculosis. She was in a sanatorium for several months until she recovered. It amazes you that your parents go through this whole experience. Q | After Boston, you moved back home to California to earn your Ph.D. in economics from Stanford University. You also returned to Canada to work at McGill University, then moved to St. Louis for a position at Washington University and relocated again to work for The University of Alabama at Birmingham. How has living in different cities across North America informed your work as a health economist? A | I think that's been one of the biggest gifts. It was just not planned, but to be able to learn about people, about different communities and their outlooks on life has definitely shaped my understanding of what people are looking for in terms of health care. Q | How does Houston compare to the other cities you've called home? A | This place is fantastic. I love it here. Some people complain about it, but there's so much growth and activity that it's this multicultural melting pot. At the Texas Medical Center, you get doctors who are tops in their field and they're happy to talk about the health care system. I've written a lot of papers with ter- rific co-authors across the street. The Baker Institute and the relationship it has with the Texas Medical Center has been such a boon for me. We're really lucky to have this general policy institute that is so well connected with so many talented doctors. That's something that does distinguish us. Other think tanks don't have that advantage and I think that shapes the type of work that we do. Vivian Ho, Ph.D., was interviewed by Pulse columnist and news writer Shanley Pierce. The conversation was edited for clarity and length. Spotlight