Ever Onward Podcast

How Boise, Idaho Was Developed with Skip Oppenheimer | Ever Onward - Ep. 94

• Ahlquist. • Season 1 • Episode 94

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What if the story of a city could be read through the choices of one family—what they built, what they preserved, and where they chose to lean in? We sit down with Skip Oppenheimer, chairman and CEO of Oppenheimer Companies, to trace Boise’s evolution from a pioneer outpost to a dynamic regional hub, and to examine how business, philanthropy, and policy intersect when leaders commit to the long game.

Skip opens with deep roots—his great‑grandfather’s department stores and his parents’ cross‑continental romance—then maps how he and his brother Doug turned a regional operation into a diversified food enterprise. From private‑label frozen desserts and True Whip to a national food service buying group and logistics, he shares how shared infrastructure, long partnerships, and patient strategy kept independents competitive and growth resilient. The conversation shifts downtown, where we unpack the coalition that revitalized Boise’s core: anchor tenants, visionary redevelopment leaders, credible urban planners, and a commitment to local subs. We also get inside The Arthur—named for Skip’s father—to see how thoughtful design, cultural fit, and national‑local collaboration can elevate multifamily living without losing a city’s character.

Healthcare takes center stage with an honest look at system strain: rising costs, value‑based care that hasn’t delivered broad savings, and the challenge of recruiting physicians amid cultural and legal headwinds. Yet there’s real hope in the caliber of local leadership, clinical excellence, and systems sized for both capability and humanity. Education rounds out the arc: literacy as a non‑negotiable, go‑on pathways that include trades and certificates, the outsized returns of early childhood, and the steady, nonpartisan role of Idaho Business for Education and Launch in aligning students with opportunity.

This is a playbook for builders and neighbors: cultivate partnerships that last, back institutions that outlive cycles, and show up long enough to see compounding effects. If you care about how places thrive—and how business can be a force for public good—this conversation will stay with you. If it resonates, share it with a friend, subscribe for more candid leadership stories, and leave a review to help others find the show.

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SPEAKER_02:

Today on the Ever Onward Podcast, we have a good friend, an icon in Idaho, truly one of the best human beings I've ever known in my life. I consider this guy a friend, a mentor, a leader, Skip Oppenheimer. Skip is the chairman and CEO of Oppenheimer Companies. He literally has led and is a leader of almost every effort that's gone on in the state of Idaho for years. He's the current chair of the St. Luke's Health Plan. He's the founding chair and board member of the Idaho Business for Education. He's the president of the Frank Church Institute at BSU. He's a former uh member of the Federal Reserve Bank San Francisco Board of Directors. And again, uh just an unbelievable guy. I can't wait to catch up with Skip and hear all about everything he's got going on. Uh Skip Oppenheimer. Skip, thank you so much for doing this. We've been trying for a while to get you on. It's an honor. Absolute honor to have you on. Uh can't wait to talk to you. Um, we're just getting caught up here a little bit. You've been good?

SPEAKER_01:

Yeah, everything's been good. No complaints. Health is good, the kids are good, grandkids are good. So, and Esther's doing a lot of artwork and having having a good time. So nothing, nothing to complain about.

SPEAKER_02:

I was trying to think as I was getting ready for this, the the first time I met you. It's a long time ago. Skip, we're getting old. That happens, right?

SPEAKER_01:

Did you have to bring that up?

SPEAKER_02:

I mean, that's a horrible place to start with a friend, but but I just uh I I you know you think of Idaho, uh, you know, for me, the last 25 years and everything significant I've ever been involved in or tried to do or whatever, it's it's always revolved around something you're doing, education, infrastructure, um, the community. You name the nonprofit, uh, Skip. You've you've then been there. And then I've also like even uh, you know, we're we're in similar businesses, you have the whole food thing we'll get into, but just development. I just I think the world of you uh as a friend and mentor. So thanks for coming on today. And this will be fun.

SPEAKER_01:

No, I appreciate it. Well, it's a two-way street, Tommy. And I you've done so much in over these years and made talk about an impact. You've done a huge amount. Oh, we live in an incredible place.

SPEAKER_02:

Um, I don't know that I've ever really heard a lot of things we have a lot of business people listen to this, but mostly um we try to inspire people to to be their best selves, and and some of that comes through storytelling. Um, and I don't know that I've ever kind of asked uh a lot of your growing up story. Can we just we start there?

SPEAKER_01:

Sure. Yeah. So I was born here in Boise, and uh my dad was from New York City, and my mother was from Boise. Her family was a very much of a pioneer family. Her great or her grandfather, my great-grandfather, my brother Doug and I, great-grandfather Nathan Falk came here in the 1860s as a 15-year-old kid, and this happened a lot around the country, uh, ended up, I think, ultimately was trying to get to California, but ended up in um Idaho City, where there were really like 10,000 people. It was a big mining city boom up there, right? In those days, now, as we all know, ghost town. But um they ended up just peddling stuff, selling wares to the miners. And I guess turned out to be again, 15-year-old kid, whose brother had already arrived here with 17, started selling stuff, were pretty good at it, ultimately built a department store in Boise, downtown at 8th and Maine, ultimately. And uh as happened in a lot of cities around the country, these kind of independent department stores would would evolve and and do well. They ultimately ended up with four or five department stores in this general area. What was the name of the department store? Fawkes, F-A-L-K-S. And uh ultimately they sold those in the 50s, but that was kind of the genesis of my mother's family here. My mother had moved to New York before World War II to work. Her older sister had moved to New York City, met my dad at a dinner party of some family friends, and uh I saw this actually in her diary. They only talked for like five or ten minutes, and it was apparently a large dining room table, and he was at one end in his uniform, and she was at the other end. And uh she said in her diary, I finally met the man I want to marry. Wow. But then they they saw each other off and off for a few years, and then ultimately got serious, decided they were going to get married, but then the World War II happened, she ended up working and decided to join the Red Cross, ended up outside of London at a rest home. Our dad ended up in the OSS ultimately in London, and uh they ended up after the war coming back and getting married in New York City, and then he had worked for Bloomingdales, and he came out with my mother after they got married to work in the Fox department store. So that's how the family got here. He became a huge lover of Boise, even though she he was born and raised in New York City in Manhattan. So he ended up uh doing that, and when the stores were sold, they ended up going around the world, and that was a big deal in those days for about four months, and kind of left Doug with our aunt in New York when he was like eight months old. My mother used to say, you know, in the more modern times, she probably would be arrested for child neglect or something. But she ended up leaving Doug with our aunt, and he Doug became very close to them, and we ended up with our grandparents here for four months, and then dad got ultimately into the the uh food business as a national broker for various firms, and that's how the food side started. I came back here in 72 and uh ended up joining the business. But as a child, uh we grew up in the north end. It's kind of idyllic, North 23rd between Brumbach and Eastman. Wow, ended up having uh a great time there, and other than three years where we did move back to New York after the stores were sold, and my parents took that trip, pretty much grew up here through high school. And it was great. We had one of those neighborhoods where actually Lisa Growe, who's the CEO of, as you well know, of Ido Power, her mother was the oldest kind of teenage teenager in the neighborhood, and she was the babysitter, Barbara Ballard. Wow. Everybody thought, you know, Barbara Ballard was like the greatest thing that ever any everybody had ever known in their lives. She babysat for everybody, and so Lisa's mother was our babysitter. Um, but anyway, it was a great, kind of a great way to grow up, as as I think a lot of kids find still here in Boise.

SPEAKER_02:

What an incredible story. So you've seen it change.

unknown:

Yeah.

SPEAKER_02:

You've watched it, you've been part of it, you've built it, you've uh we'll get into some of that. But uh so the the food business, I don't know that a lot of people know that part of what you that part of your empire. And uh, and when you have like you have a lot going on here. Yeah. But talk about the food side of it.

SPEAKER_01:

Yeah, I would I don't think I I don't know if I'd say it was an empire, but the food side is um several different aspects of the food business. And again, Doug and I have been partners in that business for probably over 50 years. Um, it's now involved in four or five different areas of the food industry. One is manufacturing. We make frozen desserts at a plant we have in outside of Dayton, Ohio, Troy, Ohio. It's mostly store brand products. So if you go to Albertsons or Kroger or Fred Meyer, which is part of Kroger, that store brand probably would be us. Uh we started with no customers and and over the years, was over the last 25 years have been able to build up that business. We also have True Whip TRU, which is the only all-natural whip topping that you'd see in the stores. The rest of the business doesn't have much retail presence. It's food service. There's a food service buying group that we started and owned that supplies independent food service distributors with pretty much anything a restaurant or a school district or a hospital would buy. There are about 150 members around the country. And we provide them not only with buying power and products to compete with the larger corporate distributors, but we also provide them with a lot of services to kind of be their little back office corporate stuff. So marketing support, they can send their financials in and model them against other non-competing distributors, um, incentive trips, training for their distributor sales reps and their purchasing people, that kind of thing. And then uh we're in the potato business, which is really where it started with Dad, with products co-packed under a brand that we own, Food Service, called Interstate. Okay. And then we have a logistics division that's in trucking uh to not only service our own divisions, but also now more and more third party.

SPEAKER_02:

Hey, when your friends are the Simplots, that may not sound like an empire to you, but it's an empire.

unknown:

Yeah.

SPEAKER_02:

That's a big deal.

SPEAKER_01:

Yeah, Simplot is an empire. I would I would go along with that part.

SPEAKER_02:

That's that's great. And so uh that's awesome. And and uh talk a little bit. I I I'm gonna go all over the place with you. I've been been waiting for this. Uh talk about your relationship with Doug.

SPEAKER_01:

Yeah, Doug and I, you know, as I think we all know, the brothers can be that can be a really good thing or not a really good thing, and family businesses can be a good thing or not really a good thing. We've just been very lucky. Um Doug and I have always been really close. We um are really best friends outside of the business. We hang out together, we go on vacations with Mary and Esther together. So we've always just had a really good relationship. He's he's just a great guy. We we have somewhat different styles, but we really kind of think alike. I'm about to say something and he'll say it, kind of kind of thing. And uh, you know, it's just added a really another kind of meaningful dimension to being in business because if you're in business with your brother and it does work, it just adds another level of of kind of meaning and and enjoyment really of the process. He's as we all know, he's got an incredible sense of humor, so he keeps it fun. And uh so we just had a great time. It's been very uh we feel very grateful for that.

SPEAKER_02:

Do your strengths and weaknesses complement each other? And uh has that been a natural fit or uh I think it really has kind of a natural fit.

SPEAKER_01:

It it uh again, we we have similar instincts, similar values, similar ways of approaching things, but we also approach them in different ways, and I think that's always healthy. And we, you know, we we like we don't ever make a decision really without talking to each other and thinking it through. And so it's kind of a nice thing because you don't have the weight of the world on your shoulders. We don't we have an internal board of the operating heads of each division, and we look at that as sort of a diversified group to look at what we're doing and help us kind of design and create the strategy, but we don't really have an outside board, but we do have some succession going on, you know. People who we've had the good fortune also of just having a lot of people who've been with us a long time, but some of them are now retired. So we've had uh the next generation come along uh in the company, and that's been good. Doug and I have been, you know, working on our own succession strategy, and uh, you know, somebody asked me once in a talk, you know, what is your succession strategy? This was quite a few years ago. So our first choice is don't die. Since that looks less and less likely, we ended up uh, you know, Andrew, who's Doug's one of Doug's So that looks less and less likely. Doug's uh one of Doug's kids, Andrew's in the business and been with us for like six, seven years, done a great job. And then Matt, our youngest son, has had a quite successful career in the in the business world on his own, and he's look very interested in also getting involved around what he's doing now. So the idea is that Matt could become potentially kind of the chairman, and Andrew could be hopefully the the senior level on in the business executive, and they get along real well too, which is a lucky thing. So we've been meeting quarterly, kind of working through all of that kind of stuff.

SPEAKER_02:

As you said that, I was just thinking of a funny story. I I I I hadn't ever been asked that before, but I was recently by a by an employee that's no longer here, by the way. It's kind of funny and wasn't related to this, but after I got to know this person, I'm you know, one day we're sitting there talking and and and she looked at me and said, Um, what's your succession plan? And I honestly I I I I said, What are you talking about? I mean, it's just like it I've never been caught so flat footed in my life. Like, oh and uh anyway, uh yeah, I like I like your response. Well, first don't I? Um that's great. Um well I I've I've really enjoyed watching the two of you um as I've been in your offices and uh I think of your office and all the pictures you have and the history, and it's it's rich. Way too rich for a podcast like this. We're not gonna get into it, but talk a little bit about the development now, because that's also how I know you. Uh you've been very involved in downtown and everywhere else. And and talk talk through the evolution of downtown Boise and your part you played in that.

SPEAKER_01:

Yeah, well, that's been quite a, as we all know, quite an evolution. The the real estate side, the food business is a national firm, really kind of North American, including Canada. The real estate we've kind of done selectively is much around, pretty much around southern Idaho. And and certainly in Boise. We when I first moved back here in the early 70s, Boise's downtown was this kind of bombed-out pit, so to speak. There were, you know, the famous article that I can't remember if it was the Atlantic or Harper's that said boy on the cover, Boise, the city that destroyed itself, or something like that. Um there Mountain, then Mountain Bell was really interested in trying to help revitalize downtown. And a guy named Chuck Hall was the head of the Idaho Mountain Bell uh division, and a great, really great guy, very civic minded. And they were interested in doing a building. So the first one we got involved in was doing that, and we we had I had worked for three months in between business school years at Citibank and knew enough to be just probably really dangerous. There was another guy, a fellow who recently, in the last year or so, passed away, John Runstead, who had just moved back to Seattle and was working for Howard S. Wright Construction, and they were in Student Boise. We all met, and he was, I could tell, a lot more knowledgeable than I was. He'd worked for Kaba Cabin Forbes for five years, and that'd be my three months at Citibank. And I as I recall my assignment during the three months at Citibank, it was to study the REIT market, the real estate investment trust market. Yeah. And I think what I'm pretty positive my recommendation was to go deeper into the REIT market, which turned out to be about four months before the complete collapse of the REIT market. But they actually offered me a job for some reason. But I decided to come out here. And uh so, John, we formed a 50-50 joint venture, and um we went ahead with the project with Mountain Bell as a major tenant. They took about 100,000 square feet, and uh we ended up building the building, and as we were just getting it started, Simplot, whose headquarters in those days was where Fork is in that building. And Jack and Scott and and the whole group was interested in being part of this as a place to move their headquarters because their current building was part of that urban renewal area and was going to be uh bought by the urban renewal district. So they came in as a partner, and and we're all still partners, we've been partners for 52 years, I think. And they've been literally not exaggerating, just a wonderful partners. Everybody's contributed ideas and through all these years together. So um that was the first project in the downtown for of for the urban renewal project. And I remember standing on the flatbelt on 9th Street at the groundbreaking, looking around, and behind me was this completely leveled four-block area, which is now where the convention center, Wells Fargo, US Bank is, and of course, your big piece of that, and uh Clearwater and that that whole project. And uh just thinking to myself, uh God, I hope we know what we're doing. But we ended up doing that, and then it really went from there. But our focus has been primarily downtowns, yeah. And we did Wells Fargo here, we did some work for first security over the years, and including a remodel of that building that's now the Mountain West Bank. Then recently we did the Arthur, which is named after our dad apartment and moved into more of the multifamily area, uh, and did some projects in other like in Caldwell working.

SPEAKER_02:

Yeah, big big project in Caldwell, uh Idol Falls, the building there is beautiful.

SPEAKER_01:

Yeah. And pretty much public-private. We like working with the cities we're involved with. We're doing a project up in uh Sun Valley that's a fairly good-sized residential project between Bellevue and Haley on the east side of 75. So, but a lot of our focus has been on downtown, so we like that.

SPEAKER_02:

Um, I do. So before we before we go on, I I think uh we're doing some work in Reno, downtown Reno now. So we've brought some of those folks over and for visits and put them up and kind of and Skip, you get pretty nostalgic. You think about 20 even so we entered the stage 25 20 years ago, right? But even in the last 20 years, what's happened, but before that was the real significant change. But I'm just so proud of walk. I mean, you walk around, you go to dinner down there, you you walk those streets. Uh just this uh they had um I went and gave a talk uh this week for Greenville, South Carolina, had a whole contingency in town, and I went and talked to talked to them. And it it just you look around, but it it's it was the community really with a vision coming together. And then I was gonna bring this up. Uh Dirk Kim Thorn, we had a little dinner for him a couple weeks ago. Um, and and uh he was very involved. He tells a story of sitting on an on a uh telephone pole that was down, and he was sitting on it with Chuck Winter, and they were looking around at they call it Little Beirut or something is what they called it. Yeah, it was not, you know, we we've had some good fortune, but we've had some really good vision and leadership from both civic leaders and entrepreneurs like yourself that took a chance on Boise.

SPEAKER_01:

Yeah, no question about it. And Dirk was very instrumental when he was mayor of kind of bringing the people together and finally where the mall was going to be got decided, and then his kind of bringing people together around a vision. Another unsung hero, I think, is Pete O'Neill, passed away several years ago. And Pete was a good friend of mine and somebody I have a lot of respect for and learned a lot from, but he was the chairman of the redevelopment agencies, you know, and and uh we were about to start Wells Fargo Center and then was called First Interstate Center, and he came in with Bob Lowry. Bob was had been the the manager of Bogus Basin and Pete had worked with him. Bob didn't know anything about real estate, but Bob was one of those bigger than life, we can get things done kind of person. So Pete brought him in as executive director of the redevelopment agency. They came by the office one day and said, you know, we got to talk. So we got he's they said we got some good news, we got some bad news. What do you want to hear first? I said the bad news. So the bad news is we've got a about nine months of work that's gonna slow your project down nine months. And uh, but do you want to hear the good news? And I said, Well, no, not not really, because the bad news is gonna kill any good news. Doesn't matter what you say. Because first interstate was then in the what is now the key bank building, and their landlord, who's out of San Francisco, has made it clear that they won't extend the lease, and we have to get it done, you know, way before the nine more months. So Pete said, Well, let's Jim Kern was the president, Dave Edson was the executive vice president, Dave's now back here. And uh and has a daughter who's got that LED dance, yeah, which is really quite quite something. We went over and talked to Jim. We went to San Francisco, we talked to the landlord. Turned out the landlord said, actually, I don't have any other prospects, so we can I was being a little, it was kind of bluster. And so we were able to postpone it. And then, but Pete and Bob really, and the agency then, but under their leadership, created the whole master plan. They brought in Rudat, they brought in the AIA, American Institute of Architects, they brought in Zimmer Gonzel Fraska, kind of laid out the whole eight blocks. Yeah. And the the good news that they emphasized was, you know, if we can get through this, we will have some downtown that everybody will be enormously proud of, and it'll be so much better for you and anybody else that does anything downtown. But he was a visionary that really saw that. It was. I you know a lot to do with it.

SPEAKER_02:

I I've never talked about this actually publicly, but um, one of my most cherished lunch meetings that I'll remember my whole life was I met him down at Spurwing Country Club, Pete, and what was supposed to be an hour-long lunch uh turned into two and a half hours, and I just sat there, just me and him, and I I I just kept asking question after question and story after story. It was it was just incredible. He he was such a uh dynamic but kind, just a one one of a kind.

SPEAKER_01:

No, I agree. He was a big mentor to me and and good friend, as I said. But he, you know, there's a lot of those kind of people that you you don't really hear that much about that had such a profound it's because they're so humble.

SPEAKER_02:

I mean, just humbly led and just got it done. And I I I was sitting there with him watching like, you need to write a book. And you were like in the middle of all this, but hey, I I do want to spend a little time. I've it's been really fun to watch um just because the times were in the Arthur. Uh so talk a little bit about the name and then the project. It's absolutely gorgeous. Um, Skip. It's it's unbelievable in downtown Boise, and you guys are exceeding all expectations, and it it's uh we were ripe and ready for it, and it took someone like you to pull it off. But talk about that, the the beautiful Arthur downtown.

SPEAKER_01:

Well, thank you. Yeah, it's been a that was a great process. We ended up, you know, thinking that one of the things that maybe there was a need for was kind of a somewhat of a next level of of quality and design and scale for multifamily. And uh we had kind of looked at different options. One was for condos, but condos were a little hard to finance in the at the time we were looking at it because of some of the legal challenges that sometimes we're we're being landlords were being faced with. But we ended up uh uh meeting through a uh mutual friend, the Weiss family and the Ponsky family who were out of Cleveland. And Maury Weiss was the still is the chairman of American Greeting Cards. He and the Ponsky family have been friends forever. They had developed some really we went, Doug and I and Jeremy Malone and had looked at a bunch of their projects, really liked the projects, and so they were interested in expanding outside and and diversifying outside of those markets, which was primarily Cleveland and Chicago. And it was a good cultural fit. We've had knock on wood, good luck with partnerships, and uh a lot of these partnerships we've had gone on for, like I mentioned, one cap was 50 years. We have uh Dwayne Stickle and and the Drown family. We've got Overland Park with them for over, I think, close to 50 years. Um we've we've had really we had Safeco as a partner in Wells Fargo for 25 years until they got out of the real estate equity side of the business and ultimately sold the company. But um we just felt like these folks would be really good for Boise, really good partners. So we ended up doing this with them, and uh they've been tremendous to work with. And they brought in power construction and SCB architects, both of whom are large firms out of Chicago. Well, you wonder how's that gonna play in Boise, Idaho? But we met them and we really felt like they could fit in really well, and as you know better than anybody, you know, 85-90% of the work is done by local subs, so they got to get along. We kind of brought power together with McElvain, who we'd done a lot with and think the world of. And uh, so they seemed to just mesh with the local subcommunity. And now, like seems to always happen these days in Boise. Out of the six people that moved here full-time for the job, I think four of them really don't want to leave.

SPEAKER_02:

They they stick. Yeah, and and you named it after your father, I think.

SPEAKER_01:

Named it after our dad. We just thought it would be a nice thing to do. And dad was always a huge supporter of downtown and Boise and a huge supporter of Boise, period. So we we went through, you know, the marketing firm and the branding firm, and the and we we sort of started out with the idea of Arthur, but then we tested it with our partners and did all those kind of market, you know, process kind of things. And uh we ended up coming back as a group with the Arthur being the name, or Arthur being the name. So we think dad would be would be happy, and we think dad would be even happier when we get it all leased up.

SPEAKER_02:

Well, it's it's uh it's amazing. Uh, I'm just so happy for you guys, just so pleased, and it it's beautiful. Beautiful. I have so many things to talk to you about. I I think of uh you and for everyone listening to this today. I mean, we just spent however long talking to literally one of the pillars of the business community on food services and this whole thing and then development. But but Skip, you're really known for being the guy that that makes it all happen in the in the nonprofit world on things that really matter. So a couple of them that uh that are near and dear to me too. Healthcare and education. We just spent a little bit of time on those. Uh you have been part of the St. Luke's Health System Board forever. You're current current chair, right?

SPEAKER_01:

Current chair of the health now the health plan. Right?

SPEAKER_02:

The new health plan. But just in the interest of time, I mean, it I I think, man, Skip, I I I'm worried. I just think of, you know, I was I I figured think of when I graduated from medical school, what I learned in medical school, residency, you know, came here in the 90s, and how healthcare has just been turned on its head. I think of really well-intended, smart people trying to guide this thing throughout the years, and you always just wanting to say, yeah, that's gonna work. That's gonna work. That's a great idea, that's gonna work. And now I look back as I get older and I'm like, boy, this is tough. Um, this is tough. And I and I and so I w I wonder, I can't wait to ask you the future of just healthcare in this country and what we're up against and and uh the cost. Uh the real the real explosion in cost, uh, we saw it happening right before our eyes, but there was a time, you know, in the old Dahlberg days, and and you know, you think of um uh medicine was super entrepreneurial when I went into it and came out. It just was. I mean, I became an ER doc, which was tied to the hospital, but you had a bunch of small business owners essentially that were very passionate about patients and care, and they were their patients. I think of J.W. Smith, like one of the stories I love telling, because I had the I had the privilege as an ER doc for whatever reason at the night, uh Catherine Albertson would come into the ER at nighttime, and I I took care of her so many times. And and J uh uh uh Dr. Smith was a cardiologist, but he was her primary care doctor. And I like telling the story because it wouldn't matter what time of night it was. I would call. And it wasn't just because it was her, because he did this with every patient he had. It wouldn't matter. But he would be there like within 10 minutes. He lived by the hospital. And you had this caring, loving, and I love telling the story because that was healthcare then. Whether it was Catherine or anybody else, he was there caring for him. And I'll see you tomorrow in my office. And I I like telling that story because of the stark contrast. So you had largely entrepreneurial people that love people and love patients and were very connected to their patients. And you look at that now then and compare it to healthcare in the world today, they do not look sound, feel anything like they used to. Um, and man, I'm I worry about it. I don't I don't know. And the cost of it, uh, you know, you just think about the whole thing. Where do we where does it go from here?

SPEAKER_01:

Yeah. Well, again, I think you'd be I'd like to hear more of your answer because you're much more of an expert than I am and have been in it at a profoundly different level. But I mean, I I think, you know, on one level, when I think about health care, and I looked initially, let's say, just in this valley, we're, you know, very lucky, I think, to have the two, you know, particularly with the two major hospital systems, uh St. Luke's and St. Als, just the quality of care, the quality of physicians, the on most every metric, it's it's uh the quality level the is is really high on an and and really compare comparable to national well-recognized names in the health system world. So we're we're lucky on that level. But to your point, I I feel the same way you do. It's on on both the kind of care in terms of that personal attention that's delivered, it's just not what it used to be. And I Jim and Mary Smith are also really good friends of ours, and you know, he's a wonderful example of that. I think it's uh it's very different. I think the the basic question is just sustainability. The only thing more and more people seem to agree on is in the US that the system is broke. And so the question is where to your question really, how where does it go from here? You know, this whole idea of outcomes-based medicine, you know, getting paid based on quality, based on outcomes versus based on how many that what the volume of care is, how many back surgeries I do, or how many whatever. I think there is going to be more and more direction and trend in in the outcomes-based and population health, where your healthcare systems are responsible for a population's health, and it and and the reimbursement's gonna be how well they maintain that health care and the and the health of that population that they serve. But I think it's gonna it's gonna take more than even that. I I think, I mean, I look at just what you said, the cost of care is unsustainable, what's gone up over 50 percent in the last 10 years. The the whole uh quality for the kind of investment that's made is is not sustainable. It's not what it should be. So I think we're gonna have to see some pretty radical change at some point.

SPEAKER_02:

Yeah, I don't I don't pretend to have any answers. I really don't, but I I will tell you a couple of pivotal moments for me. Um I think about fundamentally, you know, uh insurance was created, and it would it's been a great thing to have insurance for people. But you think of how the insurance market has made things happen. I think about big legislation, I think about like Obamacare. I remember the night it passed because I was working a shift and when you know Biden whispered in Obama's ears, it's a big F and ill. And and I don't know that it went far enough. I mean, you you could think of because I you could just say, okay, now there's more federal involvement, but probably that's not always a good thing if it if they're not listening to industry. Um so I look at you know PBMs and big pharmaceutical companies and just the way business took over medicine. And, you know, I don't I don't I'm not one of those guys that believes that there was some grand scheme, that there were bad people that were trying to take advantage of the American people. And I don't think that, but I think that corporations and money and layers of bureaucracy certainly make things fatter, and uh so I don't know. And and then and then you get down, I do go back, and I and I and I talk about this a lot because I love the guy, but I go back to Mitt Romney's plan. You know, you I I still keep a copy of that if he would have won his first hundred days, and you go back and read what he would have done with healthcare, and you know, I don't think you'd ever turn back that clock because now you got years and years of of what we've done. And then and then the last thing I'll hit on, and again, I have no answers, is the whole value-based care thing all sounded great, right? It sounded and it still sounds okay to me, but I think now you're in it and you're in the middle of it, and it's just not happening, and you're a decade into it, and you're like, it's not bringing down costs. And so to me, is it it do we just keep switching the way we reimburse? Um and uh I just don't know. I but but it's it's a it it's gonna be the problem of our time. I know that.

SPEAKER_01:

No question about it. And you know, again, locally, how do how do you attract and retain physicians in this state? I mean, that's fundamental to everything. And I think, you know, with some of the legislation and you know, do I really want to practice in Idaho if I'm an OBGYN?

SPEAKER_02:

Look at OBGN's fleeing right and left. I the other thing is you talk, I this comes up, but like you take uh Dr. Smith or family practice doc from 20 years ago and what they would do, and and now you know, the connection of doctors to patients and their productivity per patient. And I mean you start thinking about all of the things and how do we even attract them and and the debt they're coming out of school with, and and it there's just if you look for what are all the challenges, Skip, there there's no short that it's they're everywhere. Yeah, and you're just saying there's just a lot of so hopefully we get leadership somewhere from someone that says, hey, we're gonna try to we're gonna try to fix this.

SPEAKER_01:

Well, and I think that's what it's gonna take somebody with a lot of courage and with with the sort of political leadership skills to kind of get people together because it's it's it's it's not sustainable the way it is. And somebody like you know, like the the Romney plan, something that has sort of an appeal, and then enough people gathered around that to kind of move the kind of the the the play the the uh pieces on the on the puzzle to fundamentally change our approach. I think it's gonna take pretty fundamental change because as you say, it's it's not working the way it is, and it's gonna take some pretty fundamental changes.

SPEAKER_02:

I I will I want to go back to something very positive because with all that said, um I think of our health systems, the people that run them, the way they run them, the way they care, the way I mean you look at our we're we're we're blessed beyond measure, and you only need to have what I've had in the last few years, you know, go need some of this care. We have world-class care, the best of the best, and and and you, and you're just so grateful. Um I'm I'm getting old enough now, and it's funny because back when I used to go in the ER and have a problem going to the hospital, everyone still knew who I was, and now they don't have any idea. Uh so so I I'm I'm now a true consumer. Before I was kind of a uh, you know, I had I was there with, but but it's it's uh I'm just thankful we have that. And and and so it's not the providers. Another thing I was gonna ask you is I I I now go to lunch with some of my old partners, and just the I think COVID uh changed a lot of things, but just the it it it fatigued our providers at every level so much. So you've got all these triple whammies of how people were treated, and just you know, the perception of doctors is not, I mean, you used to be, hey, I'd rather be a developer now, right?

SPEAKER_01:

Yeah, I I hear you. No, but I think you're you're onto something important. I think when you look at the people that are in a lot of the leadership positions, even here specifically here locally, um, the Chris Ross and the people that are leading these organizations, I mean, everybody's trying to do the right thing. Yeah. And people are truly committed to trying to make this better. And I think that alone is kind of fundamental to any kind of change. And the providers, I mean, we have some of the best physicians, as you know, better than anybody in the world, really, and in a lot of cases right here in the Treasure Valley, because everybody lives living in the Treasure Valley that's here, and that bodes well. And I think that's true nationally. I mean, we have amazingly talented physicians, amazingly talented administrators. It's just they're caught up in a system that's not working, and that it's gonna take somebody to break that open. But we got the fund if we didn't have the fundamentals right, then the right people in the right seats, so to speak, then it would be a lot even even harder.

SPEAKER_02:

Yeah, and I'll always bet on America. We'll figure this out, but uh boy, we uh anyway. I listen, before we leave this, Skip, I I thank you for really a lifelong commitment to being part of healthcare solutions. I mean, it's been part of your legacy. You've been there leading, guiding, directing passionately. It's a big deal, it's a big part of your uh of who you are.

SPEAKER_01:

Well, I've been lucky to have the opportunity really to be involved. And I the people like we were just talking about the the institutions, the impact on everybody. Yeah. Everybody, as you know, I mean, that are on these boards too, be beyond the providers, beyond the the staff, beyond the administration of these systems and these healthcare providers, it's it's amazing the commitment, like the it's a different level of commitment, I think, on these healthcare boards because it affects everybody. It it affects me, it affects my friends, my family, everybody. And I think there's just a passion for that work that is pretty impressive.

SPEAKER_02:

I would the other way I'd say it is it it takes the supreme meaning of the word neighbor, right? You're well said, you're the neighbor that also has the privilege, honor, burden, maybe even of saying, hey, I'm gonna, I'm I'm gonna go try to fix the and then you know, St. Luke's community-owned board. I mean, you're you're the neighbor there representing the community on all things from birth to cancer to you know, hospital. I mean, it it it runs the whole gamut.

SPEAKER_01:

Yeah.

SPEAKER_02:

And and in and in in in your neighbor's time of greatness need, that's where we're going.

SPEAKER_01:

Yeah. No, and I think, you know, just speaking to St. Luke's, which is what I'm most familiar with, I mean, they're big and and people see them as a big organization, they're the largest non-governmental employer. But but as systems go, they're not that big. And when you look around the country, they're still they're big enough to do really important work, but they're not so big that they're just a complete bureaucracy. Now, that doesn't, you know, explain away every healthcare system's problem of how do you get in to see a doc, how do you get more physicians, how do you get the best customer service you can find. You know, those are all things everybody's working on. But it's still a scale that's manageable. Yeah. And I think that also bodes well. It's not and and again, every penny that's generated goes back into the community.

SPEAKER_02:

Yeah. Every time we talk about St. Luke's, I get I get pretty nostalgic pretty quick because for me, I mean, you remember the old ER before the remodel, just that you had those two hallways and you had Ed Dahlberg and Gary Fletcher. I'm telling you, Skip, at least once a week, sometimes two times a week, they would come down and plop down in a chair with me, sit and just chat, chit, chat. They knew the name of my kids, they knew when their birthdays were. It was it was the most friend. I mean, I just loved those guys. Yeah. I loved and and and so some of it is as things get big and times change, you know, we become the old guys sitting on our lawn chair in our front yard with our grand Torino and saying, Man, I miss the old days.

SPEAKER_01:

But um well, they've had great leadership. Yeah. I mean, when you think about how many organizations anywhere of any kind, you know, have had basically in the last 90 years four CEOs. Gil Gilbertson was a fabulous, kind of iconic figure, the head of the American Hospital Association. Then you had uh Ed Albert for 20 plus years, who was an amazing leader and the right person at the right time who sort of created the vision of the hospital system for St. Luke's. And then David Pate came in, who was a visionary genius and kind of helped take that platform that Ed and Gil had put together and take it to a whole nother level. And now Chris, who kind of connects really well with everybody, pulling people back into feeling like we're all in this together. So it's been amazing leadership.

SPEAKER_02:

Great, great people, great human beings, great neighbors. Um, can we switch to education? This is going by way too fast. So I want to make sure we hit at least education. Uh another thing for you, uh Skip, you start Idaho Business for Education. You've been involved in every way and kind of every major education initiative. Uh, it's your passion. Um huge successes over the years. How are you feeling about Idaho and education and commitment right now?

SPEAKER_01:

Well, I'm I'm I'm feeling concerned just when I look at just all the things we all try to think are important, I think, which is you know the reading, literacy, a lot of things the governor has mentioned about that literacy reading. I think that's something that we need to continue. And it is improving. So we're making, I think, some progress. Uh, the go-on rate, and the go-on rate doesn't have to be a four-year university, it can be College of Western Idaho, College of Eastern Idaho, College of Northern. It can be um, you know, a two-year associate degree, it can be getting a certificate and being a great, you know, plumber, electrician, uh, welder. I mean, there's all kinds of opportunity, but you got to go on to something beyond high school often. And I worry still about, I think we all do, about the go-on rate in the state. Yeah. Um, but I'm optimistic we'll continue to work that and figure it out. I think the business community has really taken a role through IBE and other organizations to try to influence the quality of education and support, not just here's the problem, but how do we help? And I think that'll continue to hopefully bear fruit. Um, but it's it's the total cliche, but it is the future. And if we don't get that right, good luck for the future of the state and and beyond. I think early childhood education is really important. Everything you ever see or read those first five years, or 80% of brain development. And how do we continue to give kids an opportunity in those early years to really maximize their potential? Because everything sort of points to if you don't get that right, it's it you don't often kids just don't catch up. So I think we got a lot of opportunity. Launch, big deal. Launch is a very big deal, and that's been a big success. I mean, that has worked very well. And that's the kind of initiatives we just all need to get behind.

unknown:

Yeah.

SPEAKER_02:

Well, I uh I really appreciate those efforts because I think, you know, uh you've been at it for decades, literally. And and and sometimes it takes that steady, constant leadership from business community to kind of help, as you know, you think of how many state school superintendents and governors and legislators and you know people come and go, but you've been there that steady hand. And I I think it's with your whole leadership team, it's it's it's been really significant, uh, Skip. So I know you get told this all the time, but it means a lot to to have leaders like you as examples and mentors uh going through this.

SPEAKER_01:

Well, I appreciate that. I you know, there's been a lot of people, including you, who who have been really vitally involved in this whole education thing. And IBE originated, actually, back to Dirk Kimpthorne. He was thinking about forming an advisory group, and and he and I talked, and you know, the the problem with that was just to your point, this isn't gonna be an overnight thing. This is gonna take years. And if you have an advisory group for one governor, then they're gone when the governor's gone. And we kind of talked about would it be better to set up something that would be sustainable independent of any one governor? And so, and then the Albertson Foundation felt that was a really good idea, and they were very encouraging and supported it. We met there, we we've initially got the thing started there, and then when um Rich was in, and then and then particularly then Butch really picked up the ball on the importance of this and really supported how business can be helpful. And it's just been a continuum from there. So it's incredible.

SPEAKER_02:

Well, I know you have a a wedding at your house tonight, and we've gone almost an hour. So uh I do will you take the last word? Any advice you'd give young business? We have a lot of business folks that listen to this that are in the state that uh what what advice or uh counsel would you give us?

SPEAKER_01:

Yeah. Well, and I think you've walked this talk as much as anybody I know, Tommy, but I think just the idea of uh, and I hope this continues, it it's kind of a part of the secret sauce, I think, of this state and many states, but certainly Idaho and and this valley. And that's just to get involved. I I think there's something special about the way people get engaged here, as you well know. I mean, you talk to new people who move here and they go, God, it's so welcoming. I mean, people want me involved. You don't have to live here for, you know, 85 years, you know, your family or something. And I think that engagement and just getting involved, I personally have, you know, again, kind of a cliche, but I've learned so much from being involved, much more than I think I've probably ever contributed, and met people, gotten, you know, to know them in a you know good personal friendship way. I just but uh but trying to just jump in and make a difference, and again, in a smaller, although we've we're growing, still relatively speaking, smaller community. I think you know, Boise, you know, Nampa, Cowell, Meridian, uh, this whole valley, just jump in and and get engaged and make a difference. I worry a little bit sometimes about the tech community. Can how do we get them more engaged because they're some of the smartest people around? And how do we get that younger generation feeling like, hey, I can make a difference and it's worth my time to do so? And I've got a lot of other things on my plate from my family to the business to the all the things that they're doing. But how do we just continue and encourage that kind of thing? Yeah, exactly.

SPEAKER_02:

Hey, well, uh I I love you, uh Skip. You're you're one of a kind. I I just look up to you in so many ways. And um thank you for I mean, you are the example uh of this community and and uh you and Esther, so thank you very much. Well, thank you. It's been a pleasure having you on.

SPEAKER_01:

I appreciate it. It's a two way street. I have a huge amount of respect for you. So thanks for having me on.

SPEAKER_02:

Thanks. Thanks, everybody.