What is the top challenge or obstacle facing health care today?
Our healthcare system is too expensive and does not produce health among the country’s population. We miss opportunities to promote health and prevent disease because we do not invest enough in drivers of prevention – including pediatric care, prenatal care, and primary care in general. We also do not create and support systems that integrate health with all the other community services that support health, such as housing, nutrition, and family support services. We will always be paying large sums for chronic illness management unless we support healthier beginnings and health promotion over the life span.
What is the most promising development in patient care that you have come across, and why?
I love the work supported through Vermont’s Blueprint for Health. With legislation, the State ensures participation from public and private insurers in an expanded set of services for children, which includes connection to community services. The Vermont plan emphasizes the role that primary and preventive care play in population health; it inspires me to think about what we can do differently in my State.
What has you most optimistic about the future of health care?
Federal, state, and local policies are understanding two essential things about health: One, it is the result of so many factors that are beyond the health care system; and two, enhanced health promotion and prevention can change the trajectory of the nation’s health care system from one of providing medical care to one of ensuring the population’s health. Payers, philanthropy, and federal and state agencies are funding demonstration projects and innovative initiatives that can provide guidance on building a new health care system.
What motivates you to keep doing the work that you do?
Change happens. It may be slow, but the delivery of health care is dynamic, with many opportunities to test new ways of addressing old problems. There was a time when we didn’t guarantee health insurance to all people. We now have several mechanisms for insuring health care, public payers for the over-65 population and Medicaid for children in low-income families. At one time, health insurance didn’t cover preventive care; now such services are provided and are not subject to co-pays and deductibles per the Affordable Care Act. Sometimes when it seems like we are getting nowhere at a very slow pace, I need to remind myself that we are looking at new opportunities to improve systems and care. We are now talking about care coordination with community services as essential for ensuring good health. Not too long ago, care coordination only referred to connections with health care services.
What’s one life hack that you have to make your day-to-day life more productive?
Tackle the big stuff. We fill our time with the easy and short-term work and then check the boxes and cross items off the to-do list. We dash off emails and make phone calls, but we put off the long-term projects that need a lot of thinking, planning, collaborating, documenting, and revising. But I feel so much more productive when I make a start or make continued progress on a big project, even if I know that I won’t finish it for several weeks or months. If I don’t tackle the big stuff, it looms over me, and I never feel productive.