Conferences: GLC Reaching Excellence in HMP Symposium and Net Impact Conference @ Ross

Saurabh Vyas

Farewell to Fall,

I am writing this sitting by a huge glass window at a cafe I usually frequent to get my daily fuel – coffee. The weather in the past few days in Ann Arbor has been lovely, and I must say this has been a great Fall with lots of sunshine, a weather to envy and go for a run… As much as I would love to just be outside and soak up the sun, I have been quite caught up with a number of events over the past couple of days. My finance exam was only a fraction of that. One of the biggest events that I am excited about is the upcoming GLC Reaching Excellence in HMP symposium. As I had mentioned in my last blog post (which has been a while ago), the event is all set to be the biggest event at the School of Public Health attracting alumni of the Health Management and Policy program from all over the country. On last count there were more than 600 delegates already registered, consisting of students, alumni and distinguished speakers like Dr. Donald Berwick (Administrator of CMS), John Griffith (distinguished Professor in HMP department), Beth McGlynn (Asso. director RAND corp.), Stephen Shortell (Dean of UC Berkeley School of Public Health) among others. More details regarding the speakers can be found at - http://www.sph.umich.edu/hmp/glc/reaching_excellence/speakers.html The symposium is on November 5th at the Mendelssohn theater in the Michigan League, followed by tailgate and a football game the next day.

So, what makes this symposium so special? For me, there are three major reasons which make it very exciting. First, with the current health reform debate ( I am still unsure if things will actually be ‘implemented’ – more on that in my next post), there are a lot of ideas regarding the implementation and integration with the current health system. This event will be a great platform to hear and even discuss the effects of reform from various healthcare angles – be it provider, insurance, or life-sciences. Second, the biggest alumni event for HMP Department, it is an amazing opportunity to meet and get inspired from alumni around the country, at a single location itself !! It is an unparalleled chance to expand your network. Third, for the students looking for internships, and job opportunities, it provides a platform to meet leaders of organizations and learn more about the organization, and may be they will find something that ‘clicks’ and ‘love’.

Another conference, which starts tomorrow is at the Ross Business School – Net Impact 2010; which will focus on issues ranging from microfinance to social entrepreneurship and corporate sustainability.

As the days pass, the weather will get colder. Though I had vowed to capture the Fall this year with my camera as much as possible, I have fallen behind on that front. But here is a photo that is a glimpse into the beauty of Fall. The photo was taken at the main Diag near the Graduate Library.

Healthcare Reform: A Health Promoter’s Perspective

Carrie Rheingans

As a health promoter, I often think about how to prevent disease from even happening. One characterization I heard about the U.S. healthcare system was from former U.S. Surgeon General Dr. Joycelyn Elders at last year’s Public Health Practice Symposium was that the U.S. doesn’t even have a ‘health’-care system – we have a ‘sick’-care system. I think that is really true – we as a country fund treatment a lot more than prevention activities. I see this same priority in in the field of HIV too. It’s relatively easy to prove that you’ve served the health needs of people living with HIV compared to how much HIV you prevented from happening (measuring what didn’t happen gets tricky, right epid people?!)!

Healthcare reform made me remember something that was said at orientation in fall 2008 when Health Behavior & Health Education (HBHE) Chair Marc Zimmerman was introducing us to the U-M SPH. He gave a general overview of each of the five U-M SPH departments and how they work together. When he got to the Health Management and Policy (HMP) department, he said that we in HBHE really work closely with them. At first, I found this absurd, because I had the impression that HMP was all about making money in the healthcare business and HBHE was all touchy-feely and focused on really working with individuals to cater to their health behavior change needs (neither is entirely true; they are both much, MUCH more than that). His point was that the research that comes out of HBHE can inform the policies that are made – incentives and disincentives (=fees) for example.

All that being said, I really appreciate that this new bill adds more of a focus on prevention and funding prevention research and programs. I have a suspicion that the strength of two large businesses – health insurance and drug companies – has had an effect on the over-focusing on treatment and under-focusing on prevention. Politicians are the ones who make these laws, and they want to keep their jobs, so they vote and make laws in the interests of those who fund their campaigns (which sometimes are their constituents, but are often large, profitable companies). Don’t get me wrong; I’m not a business-hater. We obviously need health insurance and medications with this new bill.

As someone in public health, it’s difficult to argue that over 30 million more people having health insurance is a bad thing… and with the new funding of prevention activities, there may even be job security in my future! Dean Kenneth Warner sent a reflection email to all SPH students, faculty and staff the day after the bill passed claiming “This is an occasion for public health celebration”. On Tuesday in my intro to the U.S. healthcare system class I’m taking this semester with Dr. Richard Lichtenstein in HMP, he was happy that the bill finally passed, though he jokingly lamented having to change all his lecture slides for future semesters. I think that’s a small price to pay for a better quality of life for millions of people living in this country

Here are some thoughts from many faculty in SPH about healthcare reform

Here’s a video of Dr. Lichtenstein discussing healthcare in the U.S. (this video is a very quick synopsis of the class I’m taking with him this semester)

U-M’s University-wide collection of voices from within the University on the healthcare debate

All About Access and Equality

MB Lewis

UM SPH Dean Ken Warner kicked off the 24th Annual Minority Health Conference today by acknowledging the historic moment, since this is the day after health care reform FINALLY got through the U.S. House of Representatives.  Sure, it’s a watered-down version of what it would take to truly address health disparities (perhaps the major issue of concern to public health, Dean Warner noted). But it’s something nonetheless.

Conference keynote speaker Lisa Newman, M.D., M.P.H. prefaced her talk (a sophisticated untangling of socioeconomic and ethnic factors affecting cancer outcomes among races in America) by recalling that Martin Luther King, Jr., declared inequality in health care the most shocking and inhumane form of injustice. I wonder if homegrown themes of access and disparities will overwhelm the planned global focus of this year’s weeklong Minority Health Conference, which features daily events through Friday, March 26. I guess that’s the risk of living in interesting times….

It will take me, and probably most of America, more than a week to absorb what transpired in D.C. last night. I reached out via email to my classmates in the SPH Certificate in the Foundations of Public Health program when the vote went through at midnight and asked them to share their thoughts. We’ve certainly talked about related issues in our Survey of the U.S. Health Care System class this semester.

Rose from the College of Pharmacy said she was celebrating: “This is a new chapter for public health in the U.S.” Charles, on the other hand, said “Any health care reform should have first addressed cost containment before even entertaining coverage and is likely to follow Massachusetts’ path of higher costs.” (See comments from several UM SPH professors, including Rich Lichtenstein who teaches my class. Add your comment to UM SPH’s Facebook page.)

I know this is just the beginning of the road to fixes in our health care system, and discussion in our class this Wednesday evening is going to be lively. There are times when we get so involved that we forget we’re only voices of generic little avatars communicating online… and this will likely be one of those times.

Bring it Back, Take it Forward

Carrie Rheingans

Last weekend (March 12-14), many units at the University of Michigan and the Ann Arbor District Library supported a conference titled “Bring it Back, Take it Forward”, about 50 years of activism in southeastern Michigan. I spoke on Friday on the Health Activism panel as an AIDS activist, along with two physicians who have been activists for healthcare reform and a man who is a former UAW union member working for healthcare reform.

Odile Hugonot Haber (moderator), Dr. James Mitchiner, me (taking notes about what everyone's saying!), Dr. Andrew Zweifler, and Al Gladyck

A video of my panel will be in the Ann Arbor District Library’s video collection if you’d like to see how it went. AnnArbor.com invited Dr. Mitchiner to write a guest column about health reform after the bill passed.

Members of the Latin@ Social Work Coalition with Arturo Rodriguez, U-M alumnus and President of United Farm Workers

Me with Dean Baker, PhD in Economics from U-M and supporter of the financial transaction tax

Me with Arturo Rodriguez and the United Farm Workers flag he signed for me!

Podcast from AADL featuring U-M SSW alumnus Jim Toy and U-M SSW student Elizabeth González.

Springing Forward, in More Ways Than One?

MB Lewis

I watched  students line up in the snow for airport shuttles 2 weeks ago. Now they’re back from break, looking tanned and enjoying  warm days. The snow has melted from all but the north sides of buildings, and 50-plus degrees feels great.  Joggers are out in shirtsleeves,  and fresh green shoots are poking out of the mud. People are like tulips here in Michigan: ready to bloom after winter! A friend said the other day: “How can anyone who lives in a warm climate truly appreciate spring?”

Find trillium and other spring wildflowers starting to peek up at UM's Nichols Arboretum, basically SPH's back yard!

We feel like we own this time of year. The clocks will jump ahead an hour this Sunday, and graduation is generating true excitement  (sure helps being able to look forward to hearing new CDC director Dr. Tom Frieden give his first commencement address at SPH’s ceremony on April  29, and then President Obama  at UM on May 1). Meanwhile, I’m eager for the mud to ease up so I can start taking spring walks at lunch in the Arb.  Its location less than a block from SPH is a blessing. Later in spring, the peony garden will bloom there in Ann Arbor’s second-most-famous football-field size patch of turf.

Another possible rebirth to celebrate: U.S. health care reform may be gasping another gulp of air.  Obama is rallying, and the media pen seems momentarily frozen  as it hovers above a death certificate. Even the establishment New York Times Economix-ists are saying: “…the plan would make progress in all sorts of areas. Insurance exchanges would create more competition. A Medicare oversight board would gain authority over reimbursement rates. Hospitals that committed certain medical errors — harmful, costly errors — would face financial penalties.”

No one I know thinks it’s a perfect bill that may be headed for reconciliation. But we can’t stand still and say just keep things just the way they are, because the situation will get worse: costs will continue to spiral upward in unchecked mania. I hope even public-option devotees will agree that the perfect cannot be the enemy of the good on something this important.

Key Terms for Speaking #HC Reform

MB Lewis

A heavy bag strains my shoulder these days as I lug around reams of articles and notes, hoping to catch a few minutes here and there studying for my first  U.S. health care survey exam. My mind swirls with loaded phrases that succinctly describe why our country needs health care reform, unless we want to sink under $2.5 trillion-plus annual spending in a system that doesn’t work.

Know what I mean? Parlez-vous HC-speak? Let me unload a bit:

• Sick care system: That’s a more accurate term for America than the ubiquitous “health care system,” because bigger money is made treating illness than keeping our population well.
• Being uninsured is bad for your health: So is being poor or a racial minority in a system plagued by health disparities.
• We’re #37: That’s where the WHO ranks us on population health, even though we spend 16 percent of our GDP on health care, much more than any country. (Want to sing it?)
• Paradox of excess and deprivation: Inequalities, especially deep divisions between haves and have-nots, drive our miserable overall health status.
• Geography is destiny: Your health outcome could depend on the number and kinds of doctors where you live, as well as on your environmental stressors.
• The worried well: The economically privileged people who utilize health care services extensively, because they can.
• A built bed is a billed bed: Infrastructure-heavy investments in hospitals and equipment drive “supply-sensitive” spending more in some areas than others.
• Technological imperative: Expensive diagnostic equipment, once purchased, likely will be used–and Medicare will be billed.
• Bending the cost curve: This is what the Obama administration hopes to achieve with reform. Costs will continue to rise, but maybe not at such a steep rate.

If there’s any single image that stays with me most from the hundreds of graphs in Professor Rich Lichtenstein’s lectures this month, it’s this one on what’s killing us now, instead of the infectious diseases of yore:

See that big yellow piece of the pie? Behavior patterns (the food we eat, the exercise we skip, the risks we take) exacerbate chronic conditions and bring us down. Years of lost life are a result, along with many unproductive disability-affected years.  I believe wider insurance coverage and Medicare reform are urgent national priorities, but so is living healthier any way we can.

Thursday with Larry

This past Thursday, I had the opportunity to attend a session on Japanese Health Care at the University of Michigan Alumni Center.  The format was a roundtable moderated by a professor in our medical school between a PBS/Washington Post journalist, an anthropologist from another institution, and a professor from our school of political science.  Prior to the discussion, I was so excited to hear about what all of the panelists had to say, learn about Japanese Health Care, particularly the differences between this particular model of coverage and some of the European models that I am more familiar with and why it works in Japan.

As I arrived at the event, I looked around to find that there were few seats left to choose from.  I walked to the second row because I saw one seat available, in between a balding man and a grey-haired woman.  The man jabbed me in the side and told me that the seat was available and he demanded that I take the seat before a couple walked in and he felt bad and moved.  I thanked him, shook his hand and introduced myself.  He told me that his name was “Larry.”

From this point forward, the conversation flowed.  He asked me what brought me to this event, but then he started to tell me about his working life.  He was a retired endocrinologist who had experiences with the Australian, British and Canadian systems through practice before he wound up practicing here in Ann Arbor.  He informed me about all of the positives and negatives of each of the systems from experiences as a patient and provider.  He gave me rewarding insight into the American system by telling me about things that need to change–fraud that occurs from patients, physicians, insurers, hospital managers and families.  Most of what he was saying was novel and invigorating.  As a student of policy, I understand that anecdotes are not good sources of proof, but they are sure fantastic ways to open eyes to new perspectives and ideas that you never before considered.

Everytime I meet someone with a Michigan connection, it amazes me how knowledgeable, helpful, welcoming and friendly he/she is.

For more information about Japanese Health Care and the systems in five capitalists economies, please turn on PBS for Frontline tomorrow night, Tuesday 10 November, 2009 at 9:00 PM.