« November 2014 Issue

Reflections from My Sabbatical: Connections Across Health Systems

In this article, Community Catalyst's Executive Director, Rob Restuccia reflects on his first-ever sabbatical.

This past summer I took a sabbatical, during which my wife Emily and I spent three weeks in Vietnam. While on our trip, we combined being tourists with learning about the Vietnamese health system. Emily has a strong interest in Vietnam through her work. She is a Pediatric Nurse Practitioner at the Dorchester House Neighborhood Health Center and many of her patients are Vietnamese. Also, Emily is connected to the large Vietnamese community around the Health Center through her research and teachings as a professor of Public Health and Medicine at Boston University.

We were fortunate to have many connections to Vietnam before our trip. One of Emily’s patients graciously arranged for us to stay with their family in Ho Chi Min City. A former doctoral candidate in Emily’s department at B.U. is now an official in the Ministry of Health in Hanoi. Through The Atlantic Philanthropies, a foundation that supports Community Catalyst and has been a major funder of the health system in Vietnam, we connected with people working in the country including Jeff Markuns, a physician who heads the Global Family Medicine Practice at Boston Medical Center.

Our travels took us to the Hanoi School of Public Health where Emily lectured about her research on children. In Hue, the imperial city in central Vietnam, we met with the faculty of the School of Medicine and Pharmacology and exchanged information about our respective projects. We learned that while there are great differences in our health infrastructures, political environments and cultures, the health systems in United States and Vietnam are confronting similar issues related to enrollment in and use of health insurance.

Vietnam has a health insurance system that resembles our system under the Affordable Care Act. In both countries, entitlement is complex, with rules and categories that are hard even for experts to understand. Multiple levels of government are involved, adding an administrative burden to enrollment. Even with financial assistance to help with the cost of coverage, many people find health care unaffordable. In both countries, minorities are much more likely to be uninsured. We heard about many of these difficulties in SaPa, a town in the mountainous northwest of Vietnam where we stayed with a Hmong family. 

No American who grew up in the 1960s goes to Vietnam without thinking about the Vietnam War. Forty years later, the impacts are still visible. Many museums and historical sites are about the war, but it was more powerful to see the impacts that the war is still having on the lives of real people. Agent Orange poisoning, concentrated near the site of a former American airbase, is still a medical issue. Friendship Village, which is on the outskirts of Hanoi, still cares for children poisoned by Agent Orange. A wonderful group of international staff there provide therapy and medical care, as well as educational and vocational training, for over 100 children with a variety of mental and physical conditions. In addition to treating children exposed to Agent Orange, Vietnam is addressing the toxic pollution problem at its root and through an aggressive public health initiative around Da Nang, the major site of the dumping.

Emily and I came back from Vietnam with a great appreciation of the challenges of health care in a developing country, and the progress that has been made addressing important public health issues. In the end, we realized that there is a lot we can learn from each other. To that end, in August Community Catalyst hosted a site visit of Vietnamese physicians to begin to explore how we might work together. It is exciting to think that lessons of our years working to support consumers here in the U.S. could help the Vietnamese people.

Rob Restuccia, Executive Director 

O N   T H E   W I R E

Even in challenging environments, outreach and enrollment under the ACA was hugely successful last year. Community Catalyst’s  new video, Getting to Covered, tells the story of enrollment in three Southern States – Alabama, Florida and North Carolina. Thank you to everyone who worked to make the video a reality and to all the video participants. Special thanks to Jim Carnes with Alabama Arise, Ryan Morris with Florida CHAIN, and Nicole Dozier and Adam Linker with North Carolina Justice Center.

The New England Alliance for Children’s Health (NEACH) convened advocates from all six New England states at the 2014 Children’s Health Care Summit on November 12. NEACH celebrated this year’s Children’s Champion, Sandi Van Scoyoc, for her dedication to the health of children in New Hampshire and the true impact her work as president of the HNH Foundation created for them. Lieutenant Governor Elizabeth Roberts of Rhode Island spoke about her role as a child health advocate and the importance of such advocacy going forward.

More than 70 advocates, geriatrics provider experts, speakers and panelists attended the Voices for Better Health second annual Convening, held October 22 through 24 in Chicago, participating in sessions covering a wide array of topics central to the dual eligible demonstration projects. A highlight was the inspirational keynote address delivered by Marca Bristo, President and CEO of Access Living, Chicago’s center for independent living. Ms. Bristo helped draft and win passage of the ADA and is currently leading a campaign to promote the ratification in the United States of the UN Convention on the Rights of People with Disabilities.

Christine Barber, Senior Policy Analyst, and Eva Marie Stahl, New England Alliance for Children’s Health Director, explain to U.S. News & World Report how coverage options like the Children’s Health Insurance Program help children remain covered.

Dara Taylor, Director of the Expanding Coverage through Consumer Assistance Program in Missouri, explained successful strategies to engage the uninsured to enroll in coverage on KCUR 89.3FM.

Michael Miller, Director of Strategic Policy, discusses in the Washington Post the importance of hospital finance assistance, even as more consumers gain coverage.

Join us in welcoming new staff members: Sherry Dai, Sadie DeCourcy, Amber Ma, Trevon Mayers, Meredith Munn, Puja Patel, Jackie Rivera and Tory Stephens.

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