not long ago I met a young woman let’s call her Angie who told me about a
call her Angie who told me about a
call her Angie who told me about a recent health care experience
recent health care experience
recent health care experience she said that feeling while so she went
she said that feeling while so she went
she said that feeling while so she went to Urgent Care the nurse told her that
to Urgent Care the nurse told her that
to Urgent Care the nurse told her that she had a bladder infection and gave her
she had a bladder infection and gave her
she had a bladder infection and gave her an antibiotic a prescription for an
an antibiotic a prescription for an
an antibiotic a prescription for an antibiotic she said if she took the
antibiotic she said if she took the
antibiotic she said if she took the antibiotic for five days the infection
antibiotic for five days the infection
antibiotic for five days the infection would go away but Angie didn’t fill the
would go away but Angie didn’t fill the
would go away but Angie didn’t fill the prescription she had to spend $10 to buy
prescription she had to spend $10 to buy
prescription she had to spend $10 to buy diapers for her child
diapers for her child
diapers for her child five days later Angie had a horrible
five days later Angie had a horrible
five days later Angie had a horrible fever and an excruciating pain in her
fever and an excruciating pain in her
fever and an excruciating pain in her side she went to the emergency room
side she went to the emergency room
side she went to the emergency room where she had to wait for six hours
where she had to wait for six hours
where she had to wait for six hours she even passed out in the waiting room
she even passed out in the waiting room
she even passed out in the waiting room when she finally got in to see the
when she finally got in to see the
when she finally got in to see the doctor they did some tests and they told
doctor they did some tests and they told
doctor they did some tests and they told her that the infection had gone into her
her that the infection had gone into her
her that the infection had gone into her kidney and was spreading through her
kidney and was spreading through her
kidney and was spreading through her bloodstream the emergency room visit
bloodstream the emergency room visit
bloodstream the emergency room visit cost $1,900 and the hospital stay she
cost $1,900 and the hospital stay she
cost $1,900 and the hospital stay she had to be in the hospital
had to be in the hospital
had to be in the hospital in intensive care for two days
in intensive care for two days
in intensive care for two days and another three days in the hospital
and another three days in the hospital
and another three days in the hospital the hospital stay cost her ten thousand
the hospital stay cost her ten thousand
the hospital stay cost her ten thousand dollars and then she had to spend a
dollars and then she had to spend a
dollars and then she had to spend a hundred dollars to give to a neighbor to
hundred dollars to give to a neighbor to
hundred dollars to give to a neighbor to take care of her young child the the
take care of her young child the the
take care of her young child the the prescription would have cost
prescription would have cost
prescription would have cost Angie five dollars but instead she was
Angie five dollars but instead she was
Angie five dollars but instead she was in debt for $12,000 and then because she
in debt for $12,000 and then because she
in debt for $12,000 and then because she missed five days of work she lost her
missed five days of work she lost her
missed five days of work she lost her job thinking about how to make solutions
job thinking about how to make solutions
job thinking about how to make solutions for young women like Angie is a big part
for young women like Angie is a big part
for young women like Angie is a big part of my job as the Dean of the University
of my job as the Dean of the University
of my job as the Dean of the University of New Mexico college population health
of New Mexico college population health
of New Mexico college population health that’s big mouthful so the u.s. spends
that’s big mouthful so the u.s. spends
that’s big mouthful so the u.s. spends three point two trillion dollars a year
three point two trillion dollars a year
three point two trillion dollars a year on health care that’s with the T
on health care that’s with the T
on health care that’s with the T trillion we have pretty bad health
trillion we have pretty bad health
trillion we have pretty bad health statistics that’s three point two
statistics that’s three point two
statistics that’s three point two trillion dollars is more than five times
trillion dollars is more than five times
trillion dollars is more than five times the budget of the entire US Department
the budget of the entire US Department
the budget of the entire US Department of Defense but these help bad health
of Defense but these help bad health
of Defense but these help bad health statistics for example we are maternal
statistics for example we are maternal
statistics for example we are maternal mortality rate meaning the women who
mortality rate meaning the women who
mortality rate meaning the women who died in childbirth is going up but for
died in childbirth is going up but for
died in childbirth is going up but for all other countries it’s going down and
all other countries it’s going down and
all other countries it’s going down and our quality indicators we have the worst
our quality indicators we have the worst
our quality indicators we have the worst quality indicators of any health system
quality indicators of any health system
quality indicators of any health system in the industrialized world only three
in the industrialized world only three
in the industrialized world only three percent of the money we spend on health
percent of the money we spend on health
percent of the money we spend on health cares for prevention like smoking
cares for prevention like smoking
cares for prevention like smoking cessation or immunizations or screening
cessation or immunizations or screening
cessation or immunizations or screening tests we spend about twenty five percent
tests we spend about twenty five percent
tests we spend about twenty five percent of our total lifetime health
of our total lifetime health
of our total lifetime health expenditures in the last six months of
expenditures in the last six months of
expenditures in the last six months of our lives
my dad who had heart disease and kidney
my dad who had heart disease and kidney failure and diabetes spent the last two
failure and diabetes spent the last two
failure and diabetes spent the last two weeks of his life in the hospital the
weeks of his life in the hospital the
weeks of his life in the hospital the bill was $100,000 he was a nut cold and
bill was $100,000 he was a nut cold and
bill was $100,000 he was a nut cold and unfriendly environment away from his
unfriendly environment away from his
unfriendly environment away from his friends and most of his family he was
friends and most of his family he was
friends and most of his family he was scared and he was in pain and there was
scared and he was in pain and there was
scared and he was in pain and there was nothing that I could do about it he got
nothing that I could do about it he got
nothing that I could do about it he got poked and prodded by nurses and every
poked and prodded by nurses and every
poked and prodded by nurses and every specialist wanted to do something
specialist wanted to do something
specialist wanted to do something different to save him finally he had had
different to save him finally he had had
different to save him finally he had had enough and he said to the doctor oh
enough and he said to the doctor oh
enough and he said to the doctor oh please I just want to go home to die and
please I just want to go home to die and
please I just want to go home to die and the doctor said Mel if you leave without
the doctor said Mel if you leave without
the doctor said Mel if you leave without our permission Medicare won’t reimburse
our permission Medicare won’t reimburse
our permission Medicare won’t reimburse us for your stay and your daughters my
us for your stay and your daughters my
us for your stay and your daughters my sister and I will be left with a huge
sister and I will be left with a huge
sister and I will be left with a huge burden
and then to make it worse he said to him
and then to make it worse he said to him but she won’t make it home alive anyway
but she won’t make it home alive anyway
but she won’t make it home alive anyway so instead of being able to give my dad
so instead of being able to give my dad
so instead of being able to give my dad the send-off that he deserved full of
the send-off that he deserved full of
the send-off that he deserved full of love and dignity my sister and I are
love and dignity my sister and I are
love and dignity my sister and I are left with this terrible memory of the
left with this terrible memory of the
left with this terrible memory of the last two weeks of my father’s life our
last two weeks of my father’s life our
last two weeks of my father’s life our whole health system is focused on
whole health system is focused on
whole health system is focused on illness doctors and hospitals only get
illness doctors and hospitals only get
illness doctors and hospitals only get paid when their patients are sick we
paid when their patients are sick we
paid when their patients are sick we need to figure out how they can make
need to figure out how they can make
need to figure out how they can make money by saving money I think we need to
money by saving money I think we need to
money by saving money I think we need to take the eye out of illness and replace
take the eye out of illness and replace
take the eye out of illness and replace it with a we for wellness about 80% of
it with a we for wellness about 80% of
it with a we for wellness about 80% of the factors that affect our health come
the factors that affect our health come
the factors that affect our health come from our environment our social
from our environment our social
from our environment our social situation and our health behavior we
situation and our health behavior we
situation and our health behavior we call these social determinants of health
call these social determinants of health
call these social determinants of health if we really wanted to have a healthy
if we really wanted to have a healthy
if we really wanted to have a healthy country we would make sure that
country we would make sure that
country we would make sure that everybody had access to healthy food
everybody had access to healthy food
everybody had access to healthy food lived in safe neighborhoods and had
lived in safe neighborhoods and had
lived in safe neighborhoods and had access to low-cost transportation at
access to low-cost transportation at
access to low-cost transportation at your last medical visit did your doctor
your last medical visit did your doctor
your last medical visit did your doctor ask you if you shopped in a store that
ask you if you shopped in a store that
ask you if you shopped in a store that had fresh fruits and vegetables or how
had fresh fruits and vegetables or how
had fresh fruits and vegetables or how many times in the last week you ate fast
many times in the last week you ate fast
many times in the last week you ate fast food in our work in the rural areas of
food in our work in the rural areas of
food in our work in the rural areas of New Mexico we find that for many people
New Mexico we find that for many people
New Mexico we find that for many people the only fruits and vegetables they have
the only fruits and vegetables they have
the only fruits and vegetables they have come in cans packed in high salt water
come in cans packed in high salt water
come in cans packed in high salt water or high sugar syrup the least expensive
or high sugar syrup the least expensive
or high sugar syrup the least expensive foods are chips and salsa and those
foods are chips and salsa and those
foods are chips and salsa and those stores are making a lot of money off of
stores are making a lot of money off of
stores are making a lot of money off of selling tobacco and alcohol our focus on
selling tobacco and alcohol our focus on
selling tobacco and alcohol our focus on illness is costly and often ineffective
illness is costly and often ineffective
illness is costly and often ineffective my friends the doctors who I work with
my friends the doctors who I work with
my friends the doctors who I work with say that because we can’t address the
say that because we can’t address the
say that because we can’t address the social determinants of health for our
social determinants of health for our
social determinants of health for our pay
pay
pay Asians that the patient’s health suffers
Asians that the patient’s health suffers
Asians that the patient’s health suffers and the medical care they give is often
and the medical care they give is often
and the medical care they give is often ineffective why do we need the we in
ineffective why do we need the we in
ineffective why do we need the we in wellness we should make communities the
wellness we should make communities the
wellness we should make communities the focus of our health investments we know
focus of our health investments we know
focus of our health investments we know why some people have trouble taking care
why some people have trouble taking care
why some people have trouble taking care of themselves
of themselves
of themselves we can identify Geographic pockets of
we can identify Geographic pockets of
we can identify Geographic pockets of poor health our communities would
poor health our communities would
poor health our communities would benefit if our health systems were to
benefit if our health systems were to
benefit if our health systems were to repurpose some of their resources to
repurpose some of their resources to
repurpose some of their resources to collaborate to partner with community
collaborate to partner with community
collaborate to partner with community organizations can you imagine if our
organizations can you imagine if our
organizations can you imagine if our doctors could give out prescriptions for
doctors could give out prescriptions for
doctors could give out prescriptions for housing or transportation or food we
housing or transportation or food we
housing or transportation or food we could use innovations to address some of
could use innovations to address some of
could use innovations to address some of these problems we can have a less
these problems we can have a less
these problems we can have a less expensive form of uber to pick people up
expensive form of uber to pick people up
expensive form of uber to pick people up and take them to their doctor
and take them to their doctor
and take them to their doctor appointments or to some place they could
appointments or to some place they could
appointments or to some place they could exercise or learn to cook right we could
exercise or learn to cook right we could
exercise or learn to cook right we could deliver fresh fruits and vegetables to a
deliver fresh fruits and vegetables to a
deliver fresh fruits and vegetables to a central area in the rural parts of New
central area in the rural parts of New
central area in the rural parts of New Mexico with a drone we do that for
Mexico with a drone we do that for
Mexico with a drone we do that for refugees why not our own population
refugees why not our own population
refugees why not our own population homeless shelters are good for
homeless shelters are good for
homeless shelters are good for emergencies but couldn’t we take some of
emergencies but couldn’t we take some of
emergencies but couldn’t we take some of those unused motels and repurpose them
those unused motels and repurpose them
those unused motels and repurpose them as apartments for the homeless these
as apartments for the homeless these
as apartments for the homeless these solutions are available so why aren’t we
solutions are available so why aren’t we
solutions are available so why aren’t we already using them as a standard of care
already using them as a standard of care
already using them as a standard of care for our poorest and our sickest I think
for our poorest and our sickest I think
for our poorest and our sickest I think when we change from illness to wellness
when we change from illness to wellness
when we change from illness to wellness our health systems will think of a
our health systems will think of a
our health systems will think of a different way to provide care that
different way to provide care that
different way to provide care that urgent care clinics will ask people do
urgent care clinics will ask people do
urgent care clinics will ask people do you have the money to pay for this
you have the money to pay for this
you have the money to pay for this prescription and then they’ll call them
prescription and then they’ll call them
prescription and then they’ll call them to see if they took their medication
to see if they took their medication
to see if they took their medication young women like Angie will be able to
young women like Angie will be able to
young women like Angie will be able to take care of themselves and their young
take care of themselves and their young
take care of themselves and their young children be able to
children be able to
children be able to keep their jobs and stay out of debt I
keep their jobs and stay out of debt I
keep their jobs and stay out of debt I think if we can address the social
think if we can address the social
think if we can address the social determinants of health for all of our
determinants of health for all of our
determinants of health for all of our populations the US will be a healthier
populations the US will be a healthier
populations the US will be a healthier place to live
”
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