Kim links King’s ideas, health care
By Marina Villeneuve
Published on Thursday, January 21, 2010
College President Jim Yong Kim discussed tentative plans to create a national health care delivery institute utilizing the resources of the College and Dartmouth-Hitchcock Medical Center in his Martin Luther King Jr. keynote speech at Dartmouth Medical School on Wednesday. Students, community members and College employees filled Kellogg Auditorium as Kim also challenged the political nature of the nation’s health care system and linked King’s philosophy to the current Haitian crisis and American medicine.
Kim spoke with enthusiasm about the proposed institute, which would also draw on resources from the Tuck School of Business and DMS. He plans to launch the institute within a year, he said.
The institute will be a center where the ideas behind health care delivery can be studied in hopes of discarding ineffective methods of providing medical care, Kim said. By focusing on maximizing the quality of care and reducing the cost, Kim said he hopes the institute will change the conversation surrounding health care.
“We can do research, we can do education, we can work with business analysts like [Harvard Business School’s] Michael Porter with developing curriculum on how to run high value, low cost, high quality health care systems,” Kim said. “We can leverage cross-campus collaborations to build the future of the science of health care delivery.”
The proposed institute would draw on the expertise of employees of the Dartmouth Institute for Health Policy and Clinical Practice, as well as systems engineers at the Thayer School of Engineering, Kim said.
“If you’re going to start a new field, it’s a big deal,” Kim said. “This is a moment in history where lots of forces come together.”
The study of the science of health care delivery — as an entirely new area of focus — may yield better social institutions, Kim said. New models for medical care may also help in chaotic regions such as disaster-stricken Haiti, he added.
Current politicians and activists can draw on King’s philosophy to use the power of ideas and words to strategically “take on a world that thinks [today’s health care system] is a normal and acceptable reality,” Kim said.
In his speech, Kim blamed the politicization of the health care system for much of its current dysfunction.
“When health care came to be only about deficits, when health care came to be about partisan divides in the U.S. Congress, when it came to be about whether a particular president or party would be successful or unsuccessful, we lost the battle,” Kim said. “We lost control of the moral discourse of what we’re trying to do in health care.”
Americans must “fundamentally rethink” how to proceed with health care reform, Kim said.
Kim pointed to excessive spending as the primary problem in American health care, posing the question of what King would have done to fix today’s medical institutions.
“He would have helped us frame the issue in the right way, a rational and reasonable way of thinking: high quality and low cost,” Kim said. “If we don’t do it this way, costs are going to rise.”
Universal coverage and access to care are both “essential, but not enough,” Kim said.
“Changing the way you pay doesn’t necessarily lead to change in the system,” Kim said. “We have not paid attention to how we can fundamentally change the system.”
Health care value, measured in patient health outcome per dollar spent, is the central issue of health care reform, Kim said, citing research conducted by Greg Judd, director of the Center for Health Value Innovation.
Modern medical technology is often delivered through 19th century organization structures, management practices and pricing models, Kim said of Judd’s research. The financial success of the system does not necessarily result in patient success.
“One thing you often hear is that value is free.” Kim said. “But it’s been shown that higher quality lowers the cost [of health care]. Higher costs come from poor outcomes, wasted resources and [continually] caring for sick people.
An interdisciplinary liberal arts institution like Dartmouth equips people to solve problems like the Haitian crisis and the faults of the health care system by teaching them to look at problems from many perspectives, Kim said.
Kim challenged the audience to follow King’s example of utilizing available resources to change the world. He cited Mark Harrington, an HIV/AIDS activist, as someone who embodies King’s example of taking a “social goal and implementing it” through the use of nonviolent protest and action.
Kim’s comparison between spending money on health care in the U.S. and rebuilding Haiti shows them to be essentially the same issue, attendee and Montgomery Fellow Terry Tempest Williams said.
“[Kim pointed to] the fundamental meaning of what it means to be human,” Williams said. “I think it can start here, at Dartmouth College.”