Brenda Sharpe of the REACH Foundation addresses the issue of striking a balance between managing expectations and improving the lives of the underinsured or uninsured. David Miles of H&R Block Foundation and Jan Leonard of UMB Bank follow with interest.
Finding the Balance
“We are confronting,” said Bill Bruning, “a system that is broken.” On this point he got little argument. The question that Bruning raised for the group was whether the participants ought to use their collective resources to effect systemic change or should they continue to rearrange the deck chairs on the proverbial Titanic.
From the perspective of Brenda Sharpe of the REACH Foundation, “It is not a system at all.” Like Bruning, she addressed the issue of finding a balance between managing the expectations of a community on the one hand and taking a serious look at what a system could be like were it to improve the lives of the uninsured and underinsured.
Dr. Bridget McCandless of the Health Care Foundation of Greater KC spoke to the difficulty of finding the balance between paying for immediate direct care and putting money in long term projects like education, prevention and health care policy research for which the results are neither immediate nor tangible.
“If everyone is looking for a clear victory,” noted Bob St. Peter, “we are missing opportunities.” The opportunities that need to be heeded are those that promise systemic improvements, especially through preventive care, even if the payoff is not immediate. “We need to find a balance,” added St. Peter.
“That’s the big question facing us,” said Gayla Brockman of the Menorah Legacy Foundation. “As a new foundation, do we want to effect change or do a lot of good?” All things being equal, Brockman would prefer to effect change, specifically to get people to start thinking about the fostering of health rather than the treating of illness.
Bob St. Peter of the Kansas Health Institute advocates the need to continue the dialogue among health care foundations and industry professionals. Shown from the left: Dr. Mike Jurkovich, Gayla Brockman, Sheridan Wood and Jeff Ellis.
For Hilda Fuentes of the Kansas City Health Department, the debate is much the same—between a focus on public policy on one hand and direct service on the other. “Do we continue to fund primary care,” asked Fuentes, “or do we look at prevention?” She argued that the “bang for the buck” comes with preventive care. Even then, however, the question remains as to how to shape policy so that prevention gets adequate attention. Airat Aitniakov, a Siberian native working with the City of Kansas City, agreed that prevention is as critical a part of the system as the delivery of service.
Jay Menitove of the Community Blood Center of Kansas City related a story from earlier in his career that has affected his thinking since. At the time, he heard Joseph Califano, former secretary of Health under Jimmy Carter, address a group of oncologists. On hearing the oncologists’ request for funding for bone marrow research, Califano asked whether the money might be spent on smoking and blood pressure and cholesterol and other early stage issues. “We don’t do enough at the stages where you can make a difference,” said Mentove. “We do a lot at the end. We need to bridge the gap. The payoff would be enormous.”