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Dispensing Monetary Meds to U.S. Health Care

June 23, 2005
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Q:After spending the better part of two decades grappling with health-policy issues at the federal and local governmental level, do you now find yourself in a dream job, where you're simply supposed to give money away to worthy causes?

A:"It is a dream job. It's a huge opportunity to be able to have an impact on the problems and issues I have cared about passionately for my entire career. You figure, you have a foundation with $9 billion in assets, so what's so hard?
"But health care accounts for 15 percent of the nation's economy. It's pretty difficult to figure out how to use the resources we're blessed with. It's harder than you think in figuring out how to create permanent change."

As a whole, how do you think the American health-care system is faring?
"Not well. There's a lot to be proud of. You can see the very best of health care in this country. But one of the studies that we did points out that, on average, people receive [only] the recommended standard of care.
"It's not that any one part of the system is broken. Part of it is there is not enough support for physicians who are trying to practice medicine in a very difficult environment.
"For example, if a doctor takes half-an-hour to figure out how to change your diet, he won't get paid for it; if he sends you off for an expensive procedure, he will. The system really doesn't support them in doing the right thing. A doctor could look at [his or her] records and figure out all the patients and see who hasn't seen them in a year, who needs to have their blood sugar checked, but no [insurance company] adds an incentive or payment for this."

And the 45 million Americans, including some 8 million children, who are not covered by health insurance?
"We just completed the third-annual 'Cover the Uninsured Week' to call attention to a problem that makes every other problem much worse.
"If we were living in a society where everyone was covered, a lot of other things would get better right away. Our focus has been on keeping the pressure on the polarized, partisan system, and remind them that there are plenty of good ideas out there about how to fix it."

Surely, here in Philadelphia, which boasts a plethora of first-class medical institutions, residents must enjoy top-notched care?
"What we do know is that having a lot of hospitals and a large supply of doctors is not a guarantee that people in a community are getting high-quality health care - or a good value for their health-care dollar.
"We have many people here in Philadelphia who have no access to health care."

What projects and initiatives is the foundation supporting in Philadelphia?
"We have over 100 grants active right now in Philadelphia, accounting for $100 million. One interesting project we have at the Temple University Health Center is called 'Hablamos Juntos' or 'We Speak Together.'
"It is looking at ways that we can reduce the impact of language barriers on health-care outcomes for Spanish-speaking patients. It is looking at how we can use interpreters efficiently. We also gave a grant to something called 'Food Trust,' which has to do with childhood obesity.
"I'm optimistic that as a society, we can make choices together that can make a brighter future for our children."

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