Ep 53: An Equal Opportunity for Health

Carina Clawson 0:22
Hi, my name is Carina Clawson and I’m a content writer for Think Medium. At Her Story, we expand the vision of what is possible for healthcare leaders. So today, we are highlighting the topic of health equity, a top issue in the field of healthcare and public health. Race, ethnicity, and socioeconomic status should not define how healthy we are or how long we live. But unfortunately for many, these factors do. Health equity is about changing our systems to ensure that everyone has the opportunity to be their healthiest. achieving health equity is challenging because it requires removing barriers like poverty and discrimination from wide reaching systems like housing, food security, education, and health care. It is a tall order, but thankfully, many healthcare leaders are addressing health equity. So today we are showcasing some of those leaders and hearing their insights. We will begin with Dr. Parveen Parmer. She’s an associate professor of clinical and emergency medicine and chief of the Division of Global Emergency Medicine at the Keck School of Medicine at the University of Southern California. Next, we will turn to Dr. Vivian Lee, the president of health platforms at Verily Life Sciences. To wrap up, we will hear from Dr. Lauren Powell, the President and CEO of the Equitist and Vice President of Health Equity and Community Wellness at Takeda Pharmaceuticals. To begin, let’s listen to Dr. Parmar and her thoughts on what makes healthcare truly equitable.

Dr. Parveen Parmar 1:46
The first thing that you have to realize is important is that every system rations care, every system rations care, there isn’t a single one that doesn’t. And so you can be thoughtful about the way you ration care. You can think about, you know, sort of ensuring that people have a basic level of access, ensuring that people that are the sickest and have most emergent disease get taken care of. You can ration according to ability to pay. You can ration according to citizenship and legal status. You can make those decisions. And I think many of those decisions are made without thought, you know, and they have real effects or they’re made with thought by some and not with thought by others and without appropriate input. And so I think the important thing when thinking about equitable access is to ensure that the right voices are at the table. Quite frankly, we’re not very good at that in the United States. So you know, we’re not good at that in most places, I feel like. And so I think, in terms of ensuring equitable access to care you I think the number one piece is ensuring that all of the voices are at the table when those decisions are being made. Our political systems aren’t in general very good at doing that. But you know, I think that would be a really important thing to work towards.

Carina Clawson 2:54
Rationing is often a taboo word in healthcare. However, healthcare is inherently rationed. When we ignore how that rationing occurs and don’t bring all stakeholders to the discussion, the rationing of care can become inequitable. In the United States, rationing is done subtly through costs and access. Patients are limited quietly by restricting their access to certain types of care or providers, or by cost barriers that discourage frivolous care. However, these rationing mechanisms can easily lead patients to forego necessary and preventative care. One way to address this is to change the payment models, such as value based care, which ties payment to quality and effectiveness. Next, we will hear from Dr. Vivian Lee to discuss how leaders should approach value based models of care.

Dr. Vivian Lee 3:41
The skills that leaders need, I think, in order to be successful in leading value based model of care are probably not that different from what they used to be, but they would include a real understanding of, what are the factors that best, that most improve health outcomes, that most prevent hospitalizations, and, you know, are more focused on the public health and primary care and preventative side, how to use data and predictive analytics to identify which patients need the most focus and need the most care, and then how to really create a system that is really inclusive of all populations. One of our biggest challenges is inequities in this country. That’s the reason why our overall mortality and our overall infant mortality, maternal mortality, life expectancy are low. It’s not because the highest standards aren’t high enough. It’s because our average is so low, because we have so much disparity in this country. So I think that’s the other really important skill set, I think, that the next generation has to bring to the table, which is how can we build a health care system that is much more equitable, that addresses the needs of all of our communities and all of our populations.

Carina Clawson 4:54
In the United States, we have innovative technologies and cutting edge treatments. We have new payment models and reimbursement programs. But from a health equity lens, the problem is not the care itself, rather its distribution. We have the solutions to maternal mortality and infant mortality. But our most vulnerable populations do not have access to the care they need. Many Americans are underinsured or face other barriers that prevent optimal care. These barriers are the disparities that create inequity in health. To wrap up, we will hear from Dr. Lauren Powell and what has given her confidence in her career and health equity.

Dr. Lauren Powell 5:32
I think my personal experience with loss, like unnecessary loss because of health inequities, because of health disparities, because of racism, they’re a double edged sword. They’re both the thorn in my side and like the most hurtful source of pain, but it’s also what motivates me and keeps me going because I don’t want other families to experience the losses that I have. I don’t want other communities to be with this void of, like, wisdom and knowledge and love that they should have from people who passed away from conditions that could have been managed, from better care that they could have received, from a better life that they could have lived if we’d actually worked to create that for them.

Carina Clawson 6:12
The patients that need it the most do not have access to the care they need. Inequity has a real impact and these inequities are life and death. The way that we build health systems should be a reflection of our values as a society. If we value opportunity, equality and representation, then we must design our healthcare, public health, and payment systems to promote health equity, because every person deserves an equal opportunity to pursue a healthier life. At Think Medium we’re thankful for leaders like Parveen, Vivian and Lauren. The world needs leaders that fight for health equity. We hope you will follow Her Story’s journey to hear more stories from female leaders and expand the vision for what is possible in healthcare. We’ll see you on January 5 for the launch of Her Story season three.