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Q&A: Andy Slavitt and Mark Addicks

Can Minnesota play a key role in health care's future? The Medicare chief for Obama and the retired General Mills executive sure think so.

Q&A: Andy Slavitt and Mark Addicks
Mark Addicks (left) and Andy Slavitt discuss the big challenges and opportunities in health care today. (Photo by Hanna Voxland)

Andy Slavitt and Mark Addicks are meeting in person for the first time, at the request of Twin Cities Business. Both are influential former execs of prominent Minnesota companies—Slavitt for UnitedHealth Group, Addicks for General Mills—so it’s surprising they’ve never crossed paths in person.

But then, they’ve been busy. Both have been working at the intersection of health care challenges and opportunities, and they want to see Minnesota drive change.

Slavitt spent much of the past few years in Washington, D.C., where he was called in 2014 to repair healthcare.gov following the Affordable Care Act’s problematic rollout. Then, President Obama appointed him acting administrator of the centers for Medicare and Medicaid Services. He’s back in Minneapolis now, working on two new national health care initiatives—a nonprofit called United States of Care, and an investment firm, Town Hall Ventures. Both are headquartered in an office building on University Avenue, built as the Pillsbury branch of the Minneapolis library. The ceilings are high, the rooms are grand, but Slavitt’s shelves are still empty, save for a few family photos and one of the Obamas.

Addicks is best known for ushering legacy brands like Cheerios into the 21st century. A 30-year veteran of General Mills, he retired as chief marketing officer in 2016, and since then, hasn’t been one for big public statements (unlike Slavitt, whose 213,000 Twitter followers look to him for blunt, daily commentary on health care policy). But behind the scenes, Addicks has been applying his brand-building expertise to his home state. He was part of the effort to bring the 2023 World’s Fair to the Twin Cities; when that didn’t pan out, he focused on health care as the issue that could propel Minnesota forward. He formed 2023 Partners with Kathy Tunheim, founder and president of the Tunheim communications firm, and Arick Wierson, an entrepreneur who was senior media advisor to Michael Bloomberg when he was mayor of New York. The trio set about creating Manova Global Summit (manovasummit.com), a new health conference with the Medical Alley Association.

The conference is Oct. 8-11 in Minneapolis. Slavitt is one of the keynote speakers, along with a roster that includes Arianna Huffington, Mary Matalin and James Carville, and Mayo Clinic’s new CEO, Dr. Gianrico Farrugia. The goals for Manova are lofty—Addicks describes it as South by Southwest meets the World Economic Forum annual meeting in Davos.

On a sunny summer day, Addicks climbs the stairs to Slavitt’s office and waits to be buzzed in. The two greet each other with a warm handshake. Slavitt, in a black T-shirt with a Superman tattoo on his forearm, and Addicks, in a dress shirt and sport coat, may look like they come from different worlds, but the two are game for any conversation that could lead to health care innovation, particularly if it’s close to home.

TCB  You’re both very accomplished in your own right, but not necessarily a pair we might have thought of working together. How did it happen?

Addicks: I’ve always known who Andy was, and we know some people in common. As we started this effort, from a national standpoint, his name kept popping up. When you think about what we’re trying to do, it’s start a national conversation about health.

Q  Seems there are a lot of conversations happening on health care. What makes this conference different?

Addicks: We’re reaching a phase where we can actually improve the health of every person on the planet. So we didn’t want it to just be a U.S. conversation. We want to look at topics like extreme affordability—places where people are really innovating, like Ghana and Uganda. We really want this to be about the future of health. When we say that, we’re talking about empowered consumers. They have a different mindset; their definition of health is wider, more expansive and empowered by technology—both medical and consumer. A lot of people want to be in on the conversation about health. We wanted it to happen here in Minnesota because we’re Minnesotans. We tend to play down who we are. This is actually a place of significant global impact.

Q  Andy, you built (and ran) Optum, the innovation division within Minnesota’s largest health care company, UnitedHealth Group, and then had the perspective of working on health care in Washington under President Obama. From your local and national experience, is Minnesota key to the conversation?

Slavitt: Minnesota was part of the original wave of health care innovation with Mayo Clinic, health care devices, and the overall culture here, which has lent itself to being a leader. I think we’re at a time now, and the opportunity that Mark is seizing on, [when] we need 2.0 of that. We have a health care system that’s largely been developed around people getting sick and going to big institutions when they get sick. We need a new vision—a new vision that takes people out of the mindset of being sick and thinks about physical health, mental health, and fulfillment. People can’t be healthy if they don’t have access to adequate income, transport, jobs, and nutrition. Minnesota is not leading the way in those areas any more. Minnesotans can have a wonderful health care experience or an awful health care experience—a lot depends on what part of the state or city they live in.

Health inequities really are the new transformative idea. How do we make sure the people suffering poor health, but who have very common medical conditions, get access to the best treatment? Minnesota needs to lead the way there.

Minnesotans love to tell ourselves the story of our enlightenment. Lo and behold, we discover that as a fairly homogeneous community, when we broaden the prism and look at people of color, people of low incomes, people outside the Twin Cities, a different picture emerges. We’re not unique in those issues, [and] we’re not uniquely better in ways that I think we thought we were. In many ways, we’ve learned we’re actually behind in disparities. That, to me, is a rallying cry.

Addicks: That’s the opportunity for Manova. Look at the lineup of people we’re bringing forward. We’re getting out of B-to-B verticals. We want to spark the conversations that inspire people from across different disciplines, that go beyond diseases and [medical] conditions. We have the capability to lead that discussion.

Q  President Trump came close to repealing the Affordable Care Act, and continues to try to dismantle it. From your perspective, Andy, does it feel like all the progress you made in Washington is being undone?

Slavitt: It’s not about me at all. The question is, millions of American families who are not part of [an employer-based] system that most other Americans are part of, who rate their insecurity around health care as a threat to their ability to care for their families—that is something that is unresolved. What’s interesting is, since Trump came into office, the ACA’s popularity has increased significantly. The ACA is [actually] worse than it was because of how much they’ve undermined it. [But people like it better] because of the existential threat that repeal has placed on the public. I think the public increasingly believes that everybody should have a right to affordable health care. I think that crosses party lines. Eighty-five percent of Democrats and 60 to 65 percent of Republicans believe everybody should have access to affordable health care. It’s not surprising that in all the special elections, health care has been the No. 1 issue in the exit polls. I think it will be in the midterms as well.

Q  It’s hard to understand the efforts to eliminate protections for preexisting conditions, unless there’s an underlying political motivation.

Slavitt: I don’t think anybody should take the bait of trying to decipher what is in the president’s head. But I think we should we should go by his words. He said during the campaign that he would protect people with preexisting conditions. He’s changed that rhetoric to say he’s getting people great health care, the best health care, and what he’s talking about are the new Trump care policies, which remove any requirements that insurance companies cover anything.

Under current law, insurance providers have to take at least 80 percent of the money that you pay them in premiums to pay for medical costs. That goes away. In fact, these policies spend about 44 cents of every dollar on medical costs. It’s all in the fine print. Premiums will be lower, but people won’t get care they need, and we’ll have both medical and financial hardship. This is not a good-faith effort to reform the ACA and make it better. This is undermining the law. 130 million Americans have preexisting conditions. It’s simple.

Q  Do you talk to President Obama much these days? What does he have to say about the efforts to abolish the Affordable Care Act?

Slavitt: It’s always good to let the president speak for himself. But he is very concerned about and focused on the participatory nature of democracy—things like town halls, voting, the involvement of kids. Health care is one of the issues he cares deeply about, but he’s not obsessed with it in the context of his legacy. Never has been. When he was president, he would always tell us, when we would present an issue, to do what you think is the right thing and don’t worry about the political fallout. I think he’s still very much the same. Second, I think he doesn’t want to be President Trump’s foil by getting deeply involved in issues that would trigger Trump. There are many things he can do behind the scenes, and he’s always available to us to the extent we want his support on something, but I think he expects me to be more visible than he will likely be.

Q  Speaking of visible, you are not shy about your political opinions on Twitter. Do you ever worry that could make it more difficult to gain bipartisan support on health care initiatives?

Slavitt: I started tweeting when I was in the administration. Oddly enough, there are lots of clearance processes for press releases, but not for social media. It’s useful to know what decision-makers are thinking. After leaving the government, I started to build communications relationships with a very specific set of people: moms of kids with chronic conditions—in some cases, terminal conditions. There is no greater expert on health care than the mom of a very sick kid. When I tweet, that’s who I have in mind. I’m not doing this to preserve Senate relationships but to communicate in ways that are helpful to people thinking about this incredibly important topic.

The thing is, I truly believe that health care at its core is not a political issue. It’s the ultimate kitchen-table issue. So if I call out the president because he is going back on his promise or making the issue more challenging for American families, I don’t believe I’m the person politicizing the issue. I call it as I see it.

Q  Walmart is listed as a founding partner of Manova. What’s the retailer’s angle?

Addicks: Walmart has been prioritizing health care for a long time and making business moves in health care. Their vision: affordability, transparency, availability. So they have strong interest in this [conference] from a business standpoint, and a policy and enterprise standpoint.

Q  Since leaving government, Andy, you’ve created a nonprofit focused on access to quality, affordable health care for all Americans, and a venture capital firm for health care solutions. Why both?

Slavitt: I think it’s going to take multiple vehicles. If we just worked on policy, it wouldn’t solve all of our problems. If you wrote a constitutional amendment tomorrow that said everybody should have health care, unless we got our innovation sector to help us, we couldn’t care for those people. And if all we did was innovate, but live by a set of policies that exclude a massive number of Americans, we’d never get there as well. These are decades-long commitments.

Q  What sorts of business ideas excite you from an investment perspective?

Slavitt: When we invest in caring for people, we tend to invest in things that will help Mark and me. There are probably 10 things we can buy that will count our steps. He and I are not the problem—if someone in our families gets sick, we know how to self-advocate, we have the ability to pay, we will get access to good care.

Where we don’t innovate, and where we should innovate, is making it just as easy for someone who lives two buses away from the nearest grocery store and her dialysis center, and if she misses one of her buses, she goes into kidney failure. In every other country in the world, that woman would be doing home dialysis. We in the U.S. have not figured that out yet. We spend around $100 billion a year on people with kidney disease. We wait for them to get sick, and treat them the same way we’ve treated them since the ’70s. There are better ways to do that.

We are looking for about 15 businesses that can transform care delivery with underserved populations.

Q  What will make Manova Summit a success?

Addicks: Keeping innovation front and center here. Keeping companies here, attracting new companies and startups, signaling to talent the fact that Minnesota wants to be front and center—these things make a huge difference.

Slavitt: I want to be sitting here a decade from now with a different health care system. I want to spend my time doing the things that will be most impactful to that goal. There’s no better place than Minnesota to drive a lot of this work.

Allison Kaplan is editor in chief of TCB.

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