This past weekend, our very own Peter Williams was invited to speak on a panel at the , an annual gathering that brings together academics, researchers and professionals working in areas as diverse as public policy, education, biomechatronics, architecture and chocolate.
The title of the panel was “Raising Safety and Quality Expectations in African Health Systems,” and sitting alongside Peter was Joseph Boateng (Physician Specialist at Nyaho Medical Center and Lecturer at University of Cape Coast School of Medical Sciences) and Iyabo Obasanjo (former Commissioner for Health, Ogun State and former Senator, Federal Republic of Nigeria). Each panelist shared their passion for and rich experience with identifying, assessing and improving the quality of healthcare in Africa.
Although the discussion was in the context of Africa, the problems that these panelists spoke of are also happening right here in the US. Panel moderator Ashish Jha from Harvard School of Public Health opened the session by drawing attention to the relationship between economics and health. Referring in particular to the recent political efforts to improve access to healthcare, specifically the Affordable Care Act, Dr. Jha asked: what are we really giving people access to?
This past Monday marked the closing of the first enrollment period for insurance plans offered under the Affordable Care Act. Explored in a recent , there are conflicting responses to the new law from patients and healthcare practitioners alike.
Not only does the Affordable Care Act expose just how many people have, for decades, lived on the periphery of the healthcare system, but it also reveals the inadequacies of this system to ensure universal access. Access to healthcare was granted only to those who could afford insurance, excluding the many citizens of this country with an insufficient income, unable to pay the expensive premiums. Now, with an overwhelming number of newly insured patients pursuing long overdue visits to the doctor, the challenge has shifted from that of caring for the number of people who are uninsured to the challenge of caring for those who have insurance and are reclaiming their right to healthcare.
This challenge identifies the problem that arises when we consider insurance as intrinsic to healthcare. By understanding healthcare this way, we end up with insurance inflation: more people securing insurance should mean more people will receive care. But as we are discovering, this is not the case; there is a battle between quantity and quality.
Who will be most affected by this challenge? The efforts of already exhausted doctors, nurses and practitioners are more than strained, and with the added difficulties of expensive medical technology, administrative requirements and adequate space, providing high quality care may be more unattainable than ever. Additionally, newly insured patients often suffer from ailments that have gone unattended for far too long, making the treatment of such complications much more difficult. Patients are frustrated when navigating the nuances of their individual plans, trying to determine which clinics they can visit, which drugs are approved and which pharmacies accept their insurance. Further, those who remain uninsured despite the Affordable Care Act will see the costs of their healthcare-related expenses going up, further limiting their access.
Thus, policies intended to improve accessibility and affordability of healthcare do not guarantee an improvement in health, especially among those who it is thought to benefit most. This is precisely the point at which ARCHIVE Global asks: what more can be done?
The necessity of integrating both preventative and treatment-based approaches to health and healthcare could not be more urgent. Improving health is a complex science of engagement and should not only be the responsibility of healthcare practitioners, policy makers and the insurance companies that have become necessary in this system, but also of architects, engineers, environmental health professionals, urban planners and others who contribute to designing the spaces in which we live. Designing these spaces demands not only an aesthetic and philosophical investigation of sorts, but also a psychological, sociological, political and anthropological one as well, requiring acute observations and an understanding of human “everydayness” along with the ability to synthesize such observations with their specialized technical expertise.
By constructing our environments, these professionals have tremendous capacity to improve our health by influencing our habits, behaviors, ways of thinking and thus the ways in which we interact with our environment and with one another. The kind of change that is initiated as a result of interdisciplinary engagement is limitless, and this is precisely where efforts to improve health should begin.
-Sangie Zaitsoff; Grants Officer