Washington University is bringing former U.S. Health and Human Services Secretary Louis W. Sullivan, M.D., to St. Louis to discuss “Challenges and Changes in America’s Health System.”
Sullivan, the 17th Secretary under President George H.W. Bush, will speak at 4 p.m. Wednesday, April 11 at the Eric P. Newman Education Center at 320 S. Euclid on the campus of the Medical School.
Sullivan said he will talk about dramatic advances in America’s health system over the past 100 years in public health, vaccine development and return on investment in biomedical research.
He said a major problem exists, however, in how health care is spread across the population.
“They really boil down to what I call a deficiency in our distribution system,” Sullivan said. “Not everyone in our society benefits equally from these advances, and the people who are most left out of full enjoyment of these benefits are the poor, or people of minority populations – blacks, Hispanics, native Americans.
He said this is because of a complex variety of factors, including poverty, lower educational levels, “subtle discrimination” and the underrepresentation of minorities in health professions.
“When you look at the health professions today, rather than one-third of our health professionals being black, Latino or Native American, less than 10 percent of health professionals come from one of these minority populations,” Sullivan said.
“So one of the ways to help assure that the minority populations get the care they need is by having more diversity among our nation’s physicians, nurses, dentists and other professionals.”
Because minority physicians typically have a higher percentage of Medicaid and uninsured patients, Sullivan said efforts to reach impoverished populations would be enhanced by greater physician diversity – which has other economic benefits.
“Physicians and other health professionals serve as centers of economic activity when they settle in minority populations, because they have to hire nurses, office assistants, purchase supplies and services, and so they help improve the economic activity in the community,” Sullivan said.
He said the synergy between minority doctors and patients builds trust.
“When the individual is from that minority population, he is trusted more,” Sullivan said.
“Dedication is more effective, and the believability of recommendations given by the health professional are greater so that compliance is more likely to occur.”
Also, minority health professionals have a better understanding of the value system of minority patients and their economic and social circumstances. So, he said, “they are less likely to give the patient a prescription that might cost, let’s say, a hundred dollars or more if that patient really cannot afford that.”
Affordable Care Act
Sullivan also will discuss the Affordable Care Act, which currently is under review by the U.S. Supreme Court.
“We’d be much better off by working to improve the features of the bill that are not as strong as they should be or not as well-refined as they should be rather than repeal it,” Sullivan said.
“If this bill is repealed then it’s not going to be next year or the year after that we’ll have alternative legislation – it’ll be a number of years to reach consensus.”
By that time, Sullivan predicted, “Rather than health consuming 20 percent of GNP [gross national product], it could be consuming 27 or 28 or even 30 percent of GNP.”
This is a recipe for disinvestment in other needed services, because “dollars that are needed for transportation, for education, for a number of other goods and services are eaten up by the health care system.”
In 1965, when Medicaid and Medicare were passed, there was a lot of resistance, Sullivan reminded.
“But the bill passed and this has really reduced poverty among the elderly; it has brought services to not only the elderly, but the poor; and it has really worked generally well, although we really have to work to make some changes to decrease the rate of increase in health care cost,” Sullivan said. “But many of the same people who now are protesting to roll back the legislation are also saying, ‘Don’t touch my Medicare.’ Over time, people have understood and appreciated it and what this legislation has contributed to improving access to health services.”
Register online to attend Sullivan’s remarks at bit.ly/z2aeqJ or find more information at publichealth.wustl.edu.
