New Mexico News
| Taking Health Care Curbside |
| Posted by Peter Phipps (pphipps) on Jun 10 2008 at 7:53 PM |
There seems to be two kinds of health policy thinkers.
Some, like Gov. Bill Richardson and folks who back single-payer health care financing, have big visions involving the transformation of health care, from its financing to its regulation to its pricing. They see new organizations that will bring order to the chaos that is health care. They see conciliatory leaders coaxing New Mexico's feuding interest groups to a shared understanding and thus to consensus on entirely new approaches to financing and health care delivery.
Others are like former Surgeon General of the United States David Satcher, who is fond of saying that after researchers, politicians and philosophers have their inning, someone has to deliver health care at the curbside and in the countryside. If that kind of basic execution doesn't occur (and it often does not occur for a host of economic and cultural reasons) the big-think stuff doesn't matter very much. Therefore, you have to understand and remove the cultural and economic impediments to being healthy and receiving even basic care.
Charlie Ivy is a curbside kind of guy. As the founding president of St. Joseph Community Health, Ivy has overseen successful efforts to bring health care to some of Albuquerque's most under-served neighborhoods. St. Joseph has built networks of neighbors in La Mesa and in the Southeast Heights to help get kids immunized, design a community-friendly health clinic to be built by the University of New Mexico, and improve access to primary care. In partnership with Samaritan Counseling Center, St. Joseph has put mental health services on the curbside in La Mesa and Trumbull. Before St. Joseph started pushing immunization, 58 percent of the children in targeted neighborhoods were current on their vaccinations. Today, 90 percent are current. Samaritan is helping 60 families a month through the St. Joseph Center for Children and Families.
Ivy, who was born at St. Joseph Hospital in Albuquerque and played football for the University of New Mexico, recently resigned from St. Joseph after five years as president to take a Clinton Foundation Fellowship. He will work to improve health care in Ethiopia.
Ivy says the St. Joseph approach has two core principles. First, get to people before they become patients. Ivy says that if you're standing by a river and see babies floating by, you need to pull them out of the river, sure, but you should probably walk upstream to find out why they're falling into the river in the first place. It is a lot easier to keep people healthy in their homes and in their neighborhoods than it is to treat them in a hospital, even if the neighborhood is poor and no one in the home has health insurance.
Second, don't assume you know what will make a neighborhood healthy. Ask the neighbors.
Ivy offers another river analogy, one he picked up when he helped rebuild a hospital in Liberia in 1999 as a United Methodist Church missionary: A monkey began pulling fish out of the river, reasoning that since he could not live under water, fish can't either.
People have to make dreadful choices, Ivy said. Do they buy food or medicine? Do they lose a day of income to stay home with a sick child, or do they send the sick child to school and hope for the best? Do they take a second job?
Ivy said the job is to get neighbors to work together. They decide what the problems and solutions are, once they are helped to realize they have the power to change their own world. It turns out, Ivy said, that people in strong communities thrive and hope and help.
The community needs to get bigger, Ivy said. Businesses and government need to be part of the neighborhood conversation.
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