The Colorado Health Symposium

Symposium U: Inspiration and "An Uneasy Alliance: Health Care and the Media"

Mannat Singh recently graduated with a master's in public administration from the University of Colorado, Denver, School of Public Affairs. Her interests are in public will and advocacy, and how they can promote new and innovative health policies. Singh is attending the Symposium as part of its Symposium University program.

Initially, this blog entry was going to focus on the Discovery Session "An Uneasy Alliance: Health Care and the Media" but I cannot help but first touch on the inspirational morning session we had, even though I can't possibly do it justice.

This morning, Kelly Brownell, co-founder and director for the Yale Rudd Center for Food Policy & Obesity, Will Allen, founder and CEO of Growing Power, Inc., Larry Cohen, founder and executive director for the Prevention Institute, and Pedro Jose Greer Jr., MD, assistant dean for Academic Affairs of the Florida International University School of Medicine, together captivated a massive hall full of health professionals, who all wanted to understand "The View from the Street." Watching these phenomenal leaders was an experienced unmatched to any other. The roles they have taken upon themselves, the passion they have for their causes, and the unendingly positive, optimistic, and encouraging attitudes with which they carry out their work is something to aspire to. You could literally feel a growing buzz of excitement and ideas in the room as these presenters shared their experiences.

After the morning session and a lunch break, I headed for the Discovery Session on "Health Care and the Media." In attendance were Michael Booth from The Denver Post, Diane Carman from the School of Public Affairs and the University of Colorado Denver (my campus!), Cynthia Hessin from Rocky Mountain PBS, Andis Robeznieks from Modern Healthcare, Eric Whitney for Colorado Public Radio and Tim Wieland of CBS4 Denver. The facilitator for this discussion was the great T.R. Reid, who also participated in the exciting interactive debate last night.

Themes included: The importance of trust and reliability in reporting; the development of a fan based on that trust and loyalty; the inability to separate the politics out of content when discussing health care in the news arena; the tendency of reporters to turn back to politics (because it is harder to get to the "nitty-gritty" of the actual policy issue than to discuss the politics surrounding the issue); the dramatically changing landscape of media; and the problem with American objectivism (that the objective culture in journalism is effectively watering down opinions - my attempt to paraphrase a somewhat controversial issue), and "if it bleeds it leads."

In the end, I saw the "uneasy alliance" as an issue of dependency. Individuals need a news outlet that discusses health policy issues, and news outlets need experts who can accurately cover issues of health policy. Those experts need to be able to effectively reach their audience (the public), and in order to do so health policy needs to be broken down into understandable terms. What can be lost in translation can also be lost in politics, and because individuals rely on the media for health policy issues this is effectively their only source of information. This increases the importance of accuracy in reporting but also ease of understanding. As I see it and reflected upon it, it becomes a loop of potential for miscommunication - making all the panelists' roles all the more crucial.

Symposium U: Excuse me sir, your shirt is on backwards...

Dang will be attending graduate school at Colorado State University in the fall to study molecular, cellular and integrative neurosciences. She believes that understanding policy is crucial to the next generation of health care leaders. Dang is attending the Symposium as part of its Symposium University program.

How often do you walk out of your house with your shirt on backwards? Not often (I hope). And if you did, someone would let you know. Yet when you are drinking a 20 oz. bottle of soda with your combo meal from McDonald's, would anyone step in and say "That's a bad choice?" No, because as a society we would consider that rude.

My point: Do we have notions and opinions about health in our communities backwards? We are more worried about a person's apparel and would easily voice our opinion to save a person from embarrassment, but we may never be vocal about health risks that can potentially save a person's life. The solution to this problem is not to call this person out, shouting "You're the root of the obesity epidemic!" but to change the mentality of the community to value the importance of health, making that the norm.

Today's morning session, entitled "The View from the Street" featured epic speakers discussing the hard realities—the battles and triumphs of creating health in their community.

Larry Cohen, founder and executive director of the Prevention Institute, showed the audience an advertisement from KFC, stating "Buy a mega jug of soda for $2.99 and KFC will donate $1 to JDRF." Sounds wonderful, except that JDRF stands for the "Juvenile Diabetes Research Foundation." We emphasize the importance of preventative care (which by the way only makes up four percent of current medical expenditures), yet live in a society that does not nurture or support health as much as it should.

Dr. Kelly Brownell, co-founder and director of the Yale Rudd Center for Food Policy & Obesity, furthered the point of why most people don't live healthy lifestyles and are not in a rush to change. What he considers "disastrous defaults" includes the acceptance of bad foods (i.e. deep fried butter), inappropriate portions and food marketing from various industries. The average teen in the United States sees five fast food ads per day. Preschoolers see more than 1,000 ads per year for unhealthy foods. Have you heard of Bunnies or Puffins? These are among the healthiest cereals according to a report by the Yale Rudd Center. But I guarantee most people have heard of Reese's Puffs and Lucky Charms, deemed as the lowest nutritional cereals.

"It is unreasonable to expect people to change their behavior easily when so many forces in the social, cultural and physical environment conspire against such change," quoted Cohen. We need to make health the goal of the majority. It needs to be the default option for everyone—rather than making recommendations about taking care of yourself, change the mentality to a more compulsory concept.

How do we approach this problem? Some say education, but is that enough? The majority know that soda is bad for you, but the average person consumes approximately 50 gallons a year. We need action.

Take the amazing example of Will Allen, the founder and CEO of Growing Power, Inc.. This former professional basketball player created the farm and community food center in Milwaukee. He received the "genius grant" from the John D. and Catherine T. MacArthur Foundation by thinking outside of the norms and creating effective urban farming. We need more Will Allen revolutions in the world.

Dr. Brownell had a proposal of taxing one penny per ounce of sugar-sweetened beverages to deter people from drinking empty calories. Doesn't sound like much, but he projected that the tax can decrease consumption of these beverages by 10-23 percent, reduce health care costs by $50 billion over 10 years, and even generate $150 billion in tax revenue for Colorado in 10 years. Do you think this a practical solution?

Thus far, it is not mainstream to be healthy when we have so many influences from industries that advertise otherwise. We need change. Maybe one day it won't be strange to say to someone, "Excuse me ma'am, you're drinking a soda and taking years off of your own life."

Symposium U: Under-Represented and Minority Students in Medicine...My Perspective

Wade Faulk is an MD/MBA candidate at the University of Colorado School of Medicine. He plans to pursue a residency and career in orthopedic surgery. Faulk is attending the Symposium as part of its Symposium University program.

During this morning's session, "The View from the Street," I had the pleasure of hearing Dr. Pedro Jose Greer Jr. speak. He is assistant dean of Academic Affairs and chair of the Department of Humanities, Health and Society at the Florida International University School of Medicine. As a medical intern, he founded the Camullus Health Concern, which now serves more than 10,000 homeless individuals a year in Miami-Dade County. In 1991, he founded the Saint John Bosco Clinic, which serves disadvantaged people in Little Havana, and serves as its medical director. Dr. Greer is the recipient of many awards, including three Papal medals, the MacArthur Genius Fellowship and the Presidential Medal of Freedom Service Award. In 1994 he was named one of Time Magazine's 50 Young American Leaders Under the Age of 40.

Born to parents who emigrated from Cuba, Dr. Greer graduated from the University of Florida with a BS in chemistry and earned his MD from the Pontificia Universidad Católica Madre y Maestra. He spoke of the need to change how we educate medical students and practice medicine. He gave insight on how we need to be more aware of the social causes of disease and the realities of poverty and social injustice, stating, "We can take care of a patient's disease, but what we need to ask ourselves is what can we do to take care of his or her life." He overcame many obstacles as an individual of Cuban descent and a disadvantaged background. His story is absolutely awe-inspiring and helps me see where I can go, and reminds me to never forget where I came from.

Statistically, I am not supposed to be where I am in life. I was born to a mechanic father with a high school education and an immigrant mother who has not yet achieved her GED. Growing up, my parents were never able to clench a position for our family above the poverty line, but we still had a great life. The real challenge came when I was 14 years old. My father died suddenly from a heart attack at age 41. He was always my role model and his death was a crippling blow to my entire family. My younger brother was then only 3 years old and my mother, from South Korea, was forced to work at night for minimal wages as a result of her limited job choices in Julesburg, Colo. At the time of my father's death, I was the oldest male in our household and my two older sisters were away at college. Consequently, I was faced with the challenge of being a father-figure to my younger brother and being a breadwinner at 14 years of age. Each person in my family contributed in every way that we could to the family income and to provide moral support for one another. My sisters worked to support themselves in college and send home money for groceries and bills. For my contribution, I washed dishes at a local restaurant during the week and worked on farms and ranches on the weekends. I also took care of my brother. He came with me everywhere. I brought him to class with me some mornings when my mom was not able to make it home early enough from her night shifts. He would come with me to sports practice where he participated as the "waterboy" and I would play with him between drills. I excelled in school and in my athletic endeavors. My efforts were directed at setting an example for my brother and earning scholarships, which would enable me to attend college and pursue my dream of becoming a doctor. Today, I am a fourth year medical student at the University of Colorado School of Medicine earning a dual MD/MBA.

As Dr. Greer alluded to, and as I have experienced, minorities in medical school are few and far between. Many more programs should be put in place to enable more minority and lower socioeconomic (these tend to go hand-in-hand) students to attend higher education. Medical schools across the U.S. must take responsibility for this lack of diversity, in both the student body and faculty and these schools should be held accountable if this issue is not addressed.

According to the AAMC Data Warehouse: Minority Physician Database, while African Americans and Latinos are among the fastest growing segments of the population, they are also the most severely underrepresented minorities in medicine. Today, African Americans, Latinos, and Native Americans together make up 28% of the U.S. population. However, only 6% of practicing doctors come from these groups. Currently, only about 14% of students applying to and graduating from U.S. medical schools are African American, Latino, or Native American. In the next 15-20 years, the nation is projected to confront an overall shortage of physicians, but the need is, and will continue to be, particularly great for minority physicians. By 2050, racial and ethnic minorities are projected to account for half of the U.S. population. Although the number of minority students entering into medical school is increasing, this number is not growing at a rate that will ensure the nation has the supply of minority physicians it needs.

Studies show that minority physicians are more likely to treat minority patients and indigent patients and to practice in underserved communities. Studies also indicate that when minority patients can select a health care professional, they are more likely to choose someone of their own racial and ethnic background. These relationships are characterized by higher levels of trust, respect, and the increased likelihood that patients will recommend their physician to others. The nation needs a culturally competent health care workforce—one with the knowledge, skills, attitudes, and behaviors required to provide the best care to a diverse population. Exposure to racial and ethnic diversity in medical school contributes importantly to the cultural competence of all of tomorrow's doctors. A diverse student body brings an array of ideas to the learning environment; helps students challenge their assumptions; and broadens their perspectives regarding racial, ethnic, and cultural differences.

Who knows who the next Dr. Greer (½ man, ½ amazing) will be, but more of us should be given that chance.

Works Cited

1. AAMC Data Warehouse: Minority Physician Database, Applicant-Matriculant File, and AMA Physician Masterfile, as of March 16, 2006.

2. AspiringDocs.Org: An AAMC Campaign to Increase Diversity in Medicine. 2006.

3. Diversity in Medical Education: Facts & Figures 2008

4. Diversity in the Physician Workforce: Facts & Figures 2006

5. Institute of Medicine Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care. Smedley BD, Stith AY, Nelson AR (eds). Unequal Treatment: Confronting Racial & Ethnic Disparities in Healthcare. Washington, DC: National Academic Press, 2003.

6. Kaiser Family Foundation, based on Table 3: Annual Estimates of the Population by Sex, Race and Hispanic or Latino Origin for the United States: April 1, 2000 to July 1, 2007 (NC-EST2007-03). Population Division, U.S. Census Bureau.

7. U.S. Census Bureau, Population Division and Housing and Household Economic Statistics Division.

Symposium U: Public Health takes the stage at the Colorado Health Symposium

 Amber Banducci is an MPH candidate at the Colorado School of Public Health. Banducci is interested in health care policy, particularly when it affects hospital administration operations, and the resulting health outcomes of patients. Banducci is attending the Symposium as part of its Symposium University program.

Three engaging speakers with important public health messages started off the second day of the Symposium. The focus shifted from medical care yesterday to prevention today. As a young public health professional, these were the messages I was craving to hear. Improved medical care is an important part of improving the health of our nation, but as emphasized by Larry Cohen from the Prevention Institute, behavioral and environmental factors play a significantly larger role in determining health. Prevention through behavioral and environmental change to improve health, extend life, and improve quality of life is at the heart of public health.

Kelly Brownell from the Yale Rudd Center for Food Policy and Obesity brought up several critical points for effecting widespread change that will improve the health of many. Within the scope of the obesity epidemic in the United States, Brownell highlighted that current mechanisms to address health problems have had minimal impact on improved health outcomes. He stressed that legislation that creates new and improved "defaults" before the individual's decision-making process will lead to a healthier environment and help individuals make better choices, specifically when it comes to diet and obesity.

Larry Cohen echoed and expanded on those ideas. Educating people on the benefits of exercising, healthy diet and other healthy behaviors is ineffective without an environment that is conducive to engagement in healthy behaviors. Changes such as building sidewalks for safe walking, building parks for exercise, and zoning for increased access to healthy foods are necessary for people to engage in safe and healthy behaviors. Will Allen, the founder and CEO of Growing Power Inc. shared his efforts that coincide with the methods and goals Cohen and Brownell highlighted. Allen's inspirational story of engaging children in farming for healthier eating, increased activity and increased sense of responsibility led to a standing ovation.

As a current MPH student and an aspiring physician, Dr. Joe Greer Jr., assistant dean for Academic Affairs and chair of the Humanities, Health and Society at Florida International University, gave an inspirational speech that particularly resonated with me. I plan on attending medical school in the near future, and people often ask me why I am earning an MPH degree. I would give me best answer and reply that I want to understand the complex health system in which I will be practicing, understand the big picture of health to be a better physician, and participate in local public health policy. After today's discussion, I am even more confident in my decision to obtain an MPH. A hot word today was "integrate" — integrating public health principles and evidence into the practice of medicine is a necessary step in improving our nation's health. Dr. Greer asserted that fundamental changes in American medical student education must occur so students can learn to practice with compassion and address the social determinants of health.

As Dr. Greer put it, the audience and speakers today are truly "led by passion and guided by their intellect". The presentations today inspired the audience and stimulated honest discussion that will hopefully inform their public health and medical care practice. I am ecstatic that health professionals understand public health's many opportunities to significantly improve our nation's health. There are a couple take-home messages from today's discussion. First, prevention, particularly through legislation and policy, is critical in making significant improvements to our nation's health. Second, better integration of public health into medical education will develop physicians with a broader scope of health knowledge that they can use to practice with compassion and a deeper understanding of the social determinants of health. I am leaving today inspired and confident that I can be part of the solution.

How do you feel about the emphasis on public health in improving our nation's health? How do we take these stories of success and inspiration and apply them in practice?

Discovery Session: The spectrum of health care challenges and the media assigned to tell its stories

 Alexis Anderson is a senior director of communications at GroundFloor Media, a Denver-based public relations agency. In her role, she focuses on the development and implementation of traditional and non-traditional media and influencer programs for health care, consumer, nonprofit, and professional services organizations.

Some of Colorado's most respected health care reporters – including Michael Booth, Diane Carman, Cynthia Hessin, Andis Robeznieks, Eric Whitney and Tim Wieland – sat together this afternoon at the Colorado Health Symposium on a panel entitled, "An Uneasy Alliance: Health Care and the Media." Their mission was to explain, and at times defend, the role of the media and the job that media organizations are doing to explain and properly represent the complex issues of health care.

Within minutes, certain similarities became clear – the media, just like its public, struggle with the complexities of health care reform, and often only have a few minutes or a few columns with which to examine the issues, share all sides of the story and challenge perceptions if they need to be challenged. Combine that with misinformed and often disengaged readers (because as Booth pointed out, a lot of people grab The Denver Post just to check the lottery scores) and you have the perfect storm for a daily uphill battle to generate articles or segments that accurately portray the state of health care in our state.

Shrinking budgets, dried up advertising revenue streams and fewer beat reporters also contribute to the hurdles media face when covering this industry. For example, Whitney of Colorado Public Radio noted that he would love to cover more wellness stories, such as obesity. But because his organization needed to hone in on a certain focus for its health care coverage, the majority of his assignments are dedicated to access to care. Carman of Health Policy Solutions has the opposite problem. She has the online space to delve deeper into issues than her mainstream counterparts, but struggles to attract the "eyeballs" that The Denver Post and CBS4 Denver inherently attract daily.

So what is the solution? According to the panel, there are many. Coloradans should support Colorado Public Radio and Rocky Mountain PBS with donations, and outlets like The Denver Post with subscriptions. Health care trade magazine readers can engage more deeply with outlets like Modern Healthcare and the work of Robeznieks by purchasing survey data and participating in programs such as "best places to work." Aside from monetary support, Booth noted that he desires to demand more from his readers – to read, watch and listen beyond the stories they "like" to know about, and to spend more time on the stories they "need" to know about and understand.

In the end it is prudent to take away the following from the panelists – we are all responsible for how health care is covered in Colorado. Why? Because as consumers we need to demand the highest quality of journalism by publicly supporting and celebrating the journalists who strive to go beyond the hype, cable network screaming and first layer of political bickering to cover what is real, fair and balanced.

Do you think the Colorado media is doing a good job covering health care issues? If not, what do you think it will take to improve on what they deliver?

Discovery Session: What's in the farm bill, anyway?

 Monica Lyle is a program officer for Healthy Living at the Colorado Health Foundation.

And why on earth would it be relevant to the issues we deal with as health professionals?

One of Thursday afternoon's Discovery Sessions focused on the connection between one of the most important federal policies—the Food, Conservation and Energy Act of 2008—more commonly referred to as the "farm bill"—and the health of Americans.

Kelly Brownell of the Rudd Center for Food Policy and Obesity and Jennifer Billig from the Institute for Agriculture and Trade Policy provided some background on the farm bill. Reauthorized every five years, the bill contains 15 different titles addressing many different areas, from commodity foods to Supplemental Nutrition Assistance Programs (SNAP, or food stamps) to land conservation to loan programs for farmers. Both also emphasized that the farm bill is not only a "food bill" but also should be considered a "health bill," since the majority of titles have something to do with health. Regardless of whether we think the federal government should play a role in determining what we eat, the reality is that the farm bill is a huge driver of our food environment; it affects what foods are available to us, where it is grown, how it is grown, how it gets to our supermarkets and how it is priced. A limited set of food crops such as corn, soybeans and wheat, which largely enable the availability of inexpensive, processed food, are incentivized over some of the more nutritious fruits and vegetables. Policies in the bill are in turn connected to issues such as hunger, food insecurity and obesity.

Will Allen, of Growing Power in Milwaukee, WI and Coby Gould of the Growhaus in the Elyria-Swansea neighborhood of Denver, Colo., provided perspective of why the farm bill matters on the ground. Their urban agriculture programs are just two great examples of how local food production models can not only inform better policy but also work to address issues of food justice and ensuring people of all backgrounds have access to a variety of healthy and nutritious food.

So how do we ensure that the next farm bill (due to be reauthorized in 2013) moves us toward more healthy and sustainable food systems? Panelists agreed that more balanced policies that incentivize a greater variety of fruit and vegetable crops would make a significant impact. Many have been inspired by the White House Garden, spearheaded by Michelle Obama. The variety of fruits and vegetables, from kale to spinach to blueberries to herbs would impress foodies everywhere. But consider what the garden would look like if it were planted as a "Farm Bill Subsidy Garden". Which one looks more appealing to you? And furthermore, which one would promote the health of Americans today and in the future?

Discovery Session: Health in Crisis: Addressing Colorado's Structural Imbalance

Amy Latham is the senior program officer for Health Coverage at the Colorado Health Foundation.

The structural imbalance in Colorado's state budget is bad and getting worse, according to an expert panel discussion at the Colorado Health Symposium. In fact, education, health care and corrections will, together, consume nearly all of the combined General Fund and State Education Fund revenue by 2025, according to projections from the University of Denver's Center for Colorado's Economic Future.

Medicaid currently consumes nearly 24 percent of the state's general fund. The Colorado Department of Health Care Policy and Financing is exploring all options to limit increases in expenditures, including experimenting with delivery system changes such as accountable care organizations and value-based benefit design. However, HCPF is challenged with increasing caseloads, rising health care costs and an aging population that will drive increases in long-term care expenditures.

So what are the options for addressing the state's fiscal woes? Charlie Brown, who directs Denver University's Center for Colorado's Economic Future, presented a variety of options for both changing the way the state funds K-12 education as well as how the state could raise revenue. The Center's report is due later this year.

You can test your own ideas about how to address Colorado's structural imbalance with the Backseat Budgeter, an interactive online tool developed by Engaged Public and funded by the Colorado Health Foundation.

Symposium Today: July 28, 2011

Editor's note: Throughout the 2011 Colorado Health Symposium, July 27-29, we will provide a daily summary of news, quotes, insights and media coverage through the Symposium Highlights blog posting.

Quote of the day:

"If the main cause of disease is social, the solution has to be social." – Dr. Pedro Jose Greer Jr., assistant dean, Florida International University School of Medicine

Health from the ground up
With the obesity epidemic and poverty taking its toll on children and low-income communities, a panel of experts discussed solutions at Day Two of the Colorado Health Symposium at the Keystone Resort & Conference Center. Today's morning session focused on "the view from the street" and the role that communities, business and policymakers play on influencing health.

Kelly Brownell, co-founder and director of the Yale Rudd Center for Food Policy & Obesity, kicked off the discussion with some sobering statistics. Brownell pointed out that, for the first time in history, American children are expected to live shorter lives than their parents. Only 25 percent of the U.S. population gets enough exercise and fruits and vegetables – a figure that has moved little over the last two decades, despite education efforts from public health organizations. Meanwhile, Brownell said African-American kids in low-income communities are expected to live 15 years less than white children from affluent neighborhoods. Brownell added that there's a clear link between health, social disparities, environment and how unhealthy food is marketed.

"Our children are being robbed of their future," Brownell said, adding that food companies are largely to blame for the rising obesity rate among kids. "Some people deserve to have their finger pointed at." He noted the average preschooler in America is exposed to more than 1,000 fast food advertisements a year. Fortunately, there are places around the country where the trend is shifting. Brownell credited "change agents," including non-government organizations, legislators, attorneys general and litigators for driving the shift. For example, Santa Clara, Calif. and San Francisco banned "kids' meals" that don't meet specific nutritional criteria – an action that will ultimately be "slugged out" in courts. Some states and municipalities are taxing sweetened beverages. Brownell estimates that the state of Colorado could raise $198 million a year if it imposed a 1-cent an ounce tax on sweetened beverages. Studies show such taxes decrease consumption of sweetened beverages by as much as 23 percent and could reduce overall health costs nationwide by as much as $50 billion over a 10-year period.

"Environment is absolutely fundamental when it comes to medical issues," said Larry Cohen, founder and executive director of the Prevention Institute in Oakland, Calif. But Cohen conceded that social, cultural and economic forces conspiring against healthy environments are overwhelming. For instance, he cited a promotion where KFC donated $1 to the Junior Diabetes Research Foundation for every "mega jug" of Pepsi sold. Cohen doesn't appreciate the irony. "This has to be stopped," he said. "The money needs to be sent back. It's costing our health care system too much." Brownell noted that the beverage industry – anticipating a crackdown from policymakers and civic leaders – spends $40 billion a year on lobbying and "goodwill" efforts.

Will Allen talked about the growing field of urban agriculture and how it could make a difference in communities that lack access to good nutrition. A one-time professional basketball player, Allen is the founder and CEO of Growing Power Inc., a farm and community food center in Milwaukee. With farmland vanishing in the United States and worldwide, Allen believes urban farming holds the key for cultivating fruits and vegetables in poor neighborhoods. "Everybody wants to live in sustainable communities, but we can never have sustainable communities if we don't have a sustainable food system," Allen said. Growing Power employs inner-city youth who might have trouble finding employment elsewhere. "Not only are they growing healthy food, but they're getting exercise," he said. In order to replicate the urban farming model elsewhere, Allen said advocates need to work closely with communities, government entities and businesses. He also encouraged advocates to lobby for more funding for sustainable farming as the farm bill is up for renewal. "The farm bill that's coming up is the most important farm bill ever."

Dr. Pedro Jose Greer Jr. wrapped up the morning session with his inspiring story of how he founded various free clinics for the homeless, undocumented and migrant poor of Miami. The son of Irish and Cuban immigrants, Greer took aim at social disparities as "the No. 1 cause of disease." Greer founded his first clinic in Miami in 1991, after observing how people on the fringes live and die there. "I saw a window into a world of poverty in my own backyard that shouldn't be under all that glamour." As an assistant dean for Florida International University's School of Medicine, Greer established requirements for medical students to do field work in impoverished areas and lobby for better living environments – including safer walkways for residents. "If you want to improve health in America, you need to address social and political policy…A physician's role is not to cure, but to improve the quality of life for an individual." To do that, Greer said Americans need to examine the social and cultural factors that drive poverty. "We have the science down, but the social science we don't."

Follow the Symposium live
For those who can't attend the Symposium, the plenary sessions are available via Ustream. You can also follow the Symposium via Twitter by reading tweets posted throughout the event. We'll use the #11CHS hashtag for 2011 Symposium posts. Also, stay updated on Symposium happenings by "liking" our official Facebook page. These online resources extend the Symposium beyond the walls of the conference center. You can follow the discovery sessions at the Symposium through the Symposium blog. We hope you will add your two cents to the discussion by commenting on the postings.

Debate provokes thoughts, chuckles
Interactive polling shows the Symposium's debate didn't change many minds about the health care reform act. Still, the event generated witty repartee and feisty discourse from all sides of the political spectrum, including Jon Caldara, president or the Independence Institute; Len Nichols, director of the Center for Health Policy Research and Ethics at George Mason University; T.R. Reid, author; and documentarian; and Grace-Marie Turner, founder, president and trustee of the Galen Institute, all of whom made interesting and valid arguments for and against the Affordable Care Act. Check out the full debate on Ustream for proof that health policy can be funny and entertaining.

Speaker slides available online
Looking for great statistics or tidbits from this year's Colorado Health Symposium? Many speakers' PowerPoint presentations are posted on our website.

Next up: The business of health care
The third and final day of the Colorado Health Symposium will focus on how health, health care and health care reform impacts business. Tune in tomorrow for more facts, figures and insights.

Symposium U: Tackling health care issues at the Symposium

An Dang will be attending graduate school at Colorado State University in the fall to study molecular, cellular and integrative neurosciences. She believes that understanding policy is crucial to the next generation of health care leaders. Dang is attending the Symposium as part of its Symposium University program.

"All of us inherently strive for the same ideals." Jo Luck, President of the Heifer Project International, as the keynote speaker at this year's Colorado Health Symposium says it all. We are looking for a solution to today's health care situation—but what is that solution?

Signed on March 23, 2010, there are many aspects of the Affordable Care Act (ACA) that strive to make changes, including insurance coverage to an additional 32 million people in the United States, expansion of Medicare/ Medicaid programs, no discrimination against those with preexisting conditions, no lifetime/annual caps, etc.

The theme of today's session is to grasp the meaning of "patient-centered care" and how it is the next big step in improving health care. Dr. Kavita Patel moderated this morning's discussion and asked the following questions of the panelists: Are we patient-centered in name only? How do we measure this? What does it really mean? And does it really matter?

Patient-centered care was emphasized as one of the critical orienting values by Dr. George Bussey in providing the highest quality care, doing patients no harm, and having an engaging environment to satisfy the valuable staff and patients. Dr. Deborah Trautman explained the importance of this concept and how it includes everyone: hospital staff, families, patients, students, faculty and literature. Dr. Brieanna Seefeldt highlighted that integrated health professionals can help individuals create self-directed goals for themselves. This model of patient-centered care is a step for the public to feel involved while establishing personal responsibility for their own health.

This group of health care professionals and all attendees at the Colorado Health Symposium need to be commended for their work in promoting health and bravely taking a stab to resolve such a complex concept. It is a daunting task, yet we're not going to stop at doing nothing.

This afternoon, we learned tactics from successful campaigns of the Colorado Meth Project and LiveWell Colorado on how to utilize social media as the tool to change the public opinion from apathy to activism. Lastly, our Colorado policymakers spoke about finding pragmatic and impacting solutions, specifically targeting and strategizing issues including prevention and looking at long term effects of our current policies. Thus far, The Colorado Health Foundation is accomplishing its goals for the "State of Health," truly seizing opportunities and finding solutions to achieve results.

Symposium U: Change is at Hand: Health Care Delivery, Partnerships and Decision Making

Amber Banducci is an MPH candidate at the Colorado School of Public Health. Banducci is interested in health care policy, particularly when it affects hospital administration operations, and the resulting health outcomes of patients. Banducci is attending the Symposium as part of its Symposium University program.

A central topic of discussion has been the concept of the patient-centered model. Many of the speakers this morning stressed the importance of shifting toward a patient-centered model of health care. Dr. Kavita Patel, however, posed a couple important questions, "Is this a good thing?" and "Does it matter?"

We can all agree with Dr. Stephen Shogan's statement that the rate of health care spending in the United States is unsustainable. The discussion of the patient-centered care model did not involve an explanation of how this model would improve care while reducing costs. An audience member during the panel discussion brought up an important point of the inherent conflict between patient-centered care and over utilization increasing health care costs. If a patient is directing the type of care they receive, that will likely lead to over utilization of care, especially given that the cost of care is not generally available before the care is provided. Both Dr. Brieanna Seefeldt and Dr. Patel discussed how the cost of care before and at the point of care is a mystery to both the patient and physician. Empowering patients to be more engaged in their health is difficult when the patient is unaware of the care they will be receiving and the cost of that care before their appointment. Are cost/quality transparency and consumer-driven health plans necessary for successful patient-centered care?

The issues identified by the panel speakers this morning were focused on the delivery of medical care. Although it was not discussed during this morning's panel discussion, public health has an important role in improving health care delivery. Public health might not be as focused on an individual's experience in the health care system, but system-level changes and programs that result in improved health of a population that support medical care efforts are largely a public health matter. Public health is engaged in many activities that are folded into the delivery of health care. What is the role of public health in implementing cost-effective, patient-centered care? What other health care mechanisms must be in place for patient-centered care to be successful?

Furthermore, the role of public health as part of the solution was severely limited. The term "social determinants" came up a couple times in discussing what health facets when improved would result in the greatest improvement in health. During the Colorado Policymakers Panel, Sen. Jeanne Nicholson emphasized the importance of public health due to the low impact health care improvements have on health outcomes. Why were public health solutions such a limited part of the discussion?