VOL. 8 | NO. 40 | Saturday, September 26, 2015
Health Care Rx
By Andy Meek
The debate, hand-wringing, expert studies and frustrations over what to do about fixing the nation’s health care system are certainly a testament to the scale of the problem and the elusiveness, so far, of solutions.
One of the first steps to fixing a problem is, of course, properly defining it. And when it comes to health care, that tends to get done by focusing on things like cost and access. That, in turn, leads to support in some corners for the government to work to lower cost and promote wider access through legislative vehicles like the Affordable Care Act.
Even among those for whom access isn’t a problem, cost can seem like an unstoppable force. A study released in recent days by the Kaiser Family Foundation and Health Research & Educational Trust, for example, found that the average general deductible workers are paying this year under their single coverage is $1,077, up from $303 in 2006.
Promises on the current presidential campaign trail to on one side of the aisle fix aspects of the system while on the other to deep-six the controversial ACA are a reminder of how potent the issue remains.
Meanwhile, there are health care professionals like Antony Sheehan, president of the Church Health Center in Memphis, who looks at things through a different lens. He thinks it’s too pat to say care costs too much or that the focus should be on expanding access as an end to itself.
The problem, as he sees it: The focus is too often on the wrong things, and we’re often not thinking big enough.
“First of all, I’m still quite new in America, and there’s a lot of learning going on for me,” said Sheehan, who’s approaching his second anniversary at the CHC, a faith-based organization in Memphis on the front lines of promoting a sustainable model of care for the people who most need it.
From 1999 to 2007, Sheehan worked in the U.K. government as a senior civil servant heading a group within England’s department of health. In addition to working also as the CEO of one of England’s largest community health services, he’s been a prominent figure in developing National Health Services programs in England for more than a decade.
Sheehan also was the 2011-2012 Health Foundation Quality Improvement Fellow at the Institute for Healthcare Improvement in Boston. While there, he ran into Church Health Center founder Dr. Scott Morris, who sold him on the vision for his organization that opened its doors in 1987.
It was a meeting, Sheehan says, that “changed my life.”
As a result of his background, he brings a global perspective to his job in Memphis. Which is particularly relevant to the task at hand, because Sheehan is adamant that health care problems facing the U.S. aren’t exactly unique to the U.S.
“The payment issue is not the most relevant issue, really,” said Sheehan, who will be the keynote speaker at the Oct. 1 health care seminar hosted by The Daily News, sister publication of The Memphis News. “There are many, many more relevant issues than that to tackle.
“We’re struggling in the United States with the high cost of health care, certainly. Seventeen-and-a-half cents of every dollar, we spend on health care. But, to be honest with you, the rest of the world is struggling, as well.”
One of the things that Sheehan plans to talk about during his remarks next week – the seminar will be held at the Memphis Brooks Museum of Art, starting at 3:30 p.m. – is that cost is an important part of the picture, but it’s only a part. Too often, he says, we overlook the inexorable growth in chronic disease and the effects of a large population living with that – a big driver of cost.
Sheehan also is the kind of health care professional who takes pains to point out the multitude of interwoven strands comprising ‘The Health Care Question.’ One example – and here’s where his work with the Church Health Center comes in, which is as concerned with a patient’s wellness as it is with performing checkups – is how Sheehan says health shouldn’t be thought of as separate from health care.
A normal patient’s care, in other words, tends to be a disconnected series of experiences: multiple providers and businesses who don’t always know what the other is doing and who might be more incentivized to run expensive tests than make sure the patient actually gets better. And those patients may not even pay attention to their own care until they actually need it, until there’s a problem that needs to be fixed.
Sheehan is an advocate of expanded primary care, a role the Church Health Center tries to fill especially for the working poor in Memphis.
“One of the things I’m going to argue in my remarks is we need to have strong systems of primary care,” Sheehan said. “Primary care is the part of the health care family that bridges into the community and bridges into those social determinants of health and well-being that hospital systems can’t. A lot of the work of reconnecting health – putting the health back into health care, if you will – rests on the shoulders of people who run primary care organizations.”
For the poor in Memphis, he said, that means the people who run CHC, Christ Community Health Services and the like. Sheehan singled out health care professionals in Memphis like Morris and Resurrection Health CEO Rick Donlon, saying Memphis needs to “stand on the shoulders” of people like them.
Church Health Center Wellness building
(Memphis News/Andrew J. Breig)
Sheehan’s comments about the value of primary care also reflect his belief that it can fill a key “quarterbacking” role in patient care.
Pricing and care coordination, he adds, are just some of the complexity around health care.
“We’ve got a language system that’s complex, a financing system that’s complex and a system of coordination that makes it complex to use,” Sheehan said. “One thing we certainly do at the Church Health Center – we watch over people’s care pathway. Beyond that, I think the model we have tries to stress wellness. So, we will be alongside you in a journey of wellness. We’re not just interested in your physical disease; that isn’t the entirety of you.”
In tandem with a physical ailment, in other words, his organization wants to help elsewhere with aspects of a patient’s emotional life or work life or family life.
To that end, the CHC offers complementary services and amenities. A fitness and wellness center holds classes and creates a place where patients, once their immediate needs have been met or patched up, can focus on the longer-term, ongoing work of staying well.
This is his prescription for how to make a substantive impact on health care-related problems in Memphis, and beyond:
“We can help them with our own services or connections and offer a more complete package of care,” Sheehan said. “We want to try to help people live a good life. Not just a less miserable one.”