Jul 17
July 17, 2013

Healthcare is Local


The great newsman Walter Cronkite famously said, “America's health care system is neither healthy, caring, nor a system.” He was half-kidding, at best. Still, he probably wouldn’t be surprised to learn that one of the keys to fixing American health care lies in communities, like his one-time home of Houston. Today, it takes a community to provide better healthcare – or, more specifically, it takes local collaboration to provide access to consistent high-quality and affordable care that delivers on its promise of healthy outcomes.

The challenge we face is as great as ever. In 2010 the United States spent nearly a fifth of its GDP on healthcare, higher than any other developed nation. With childhood obesity, an aging population and the prevalence of chronic diseases, cost pressures are entrenched as part of the health care equation. When you add the fact that in this country, on average, there are only 25 physicians for every 10,000 patients, you begin to get an even clearer picture of a system that remains overwhelmed and threatens US competitiveness. One study found that, “ballooning dollar figures place a heavy burden on companies doing business in the United States and can put them at a substantial competitive disadvantage.”

While the national story is compelling, the truth is communities feel the real burden. In Harris County, close to 30 percent remain uninsured, surpassing the national average. The rising rate of obesity in Houston– the conditions it exacerbates and the diseases it causes-- remains the single biggest threat to the health of the city and its families. To paraphrase, all healthcare is local.

That may be the answer, too. Because all healthcare is delivered locally, the healthcare system should be designed locally. It is at the local, community level where we are most likely to innovate and implement new healthcare delivery solutions. By piloting healthcare programs in specific markets we will be able to determine what works best in that particular city or region. Doing that while driving results, however, requires a systems approach and effective collaboration among multiple stakeholders — including policy-makers, providers (physicians and hospitals), purchasers (large-scale employers, etc.), and health plans (insurers). We are already seeing this approach working in cities around the country.

GE, like many other companies big and small, works to control costs by helping make employees more informed healthcare consumers. But the company also realized that those efforts, while effective, could only go so far because they did not address the system as a whole. So in cities like Cincinnati, and now Houston, GE is using its presence to help bring together stakeholders to improve the quality of healthcare delivery and coordinate primary care with a focus on prevention. In Cincinnati, these efforts are helping to produce better health results for pediatric asthma patients and diabetics.

Similarly, through its Clinton Health Matters Initiative (CHMI), the Clinton Foundation is supporting efforts to engage multiple sectors in improving the unique heath indicators for each community and lowering health care costs. Many outside of southeastern California do not realize that Coachella Valley, home to Palm Springs, also has a child poverty rate of near 70 percent and some of the nation’s poorest citizens. Using the County Health Rankings model for defining the contributing factors to morbidity and mortality, CHMI brought together local stakeholders to create a targeted plan of action. It is addressing the health behaviors, clinical care issues, and other factors that contribute to health outcomes in the region.

Starting today, we are bringing this approach to Houston. We strongly believe that you cannot solve a problem as big as healthcare without the participation of multiple stakeholders at the local level. Even as the country implements the Affordable Care Act lowering the number of uninsured nationwide, local collaboration remains the best remedy for delivering better health and healthcare value.

Additionally, we know that improving healthcare is a local challenge but also one that requires a long-term investment. Just as we are determined to help bring people together, we are equally committed to making sure that Houston’s health care transformation is measureable and sustainable.

When stakeholders are fully engaged in a shared vision, results follow. We encourage others – businesses, local health and education practitioners, policy makers, hospital and clinic administrators, public health workers and local community leaders — to the table. With Houston’s committed leadership, civic-minded business community and world-class universities and hospitals, there is no reason why we can’t succeed. Together we can make a difference. In Houston, we can make the American health care system healthy, caring and a system that works.

NOTE: This piece originally appeared on