Kenneth Olden

His talk, "Health Care in America: It Is Broken; It Can Be Fixed," was the second in a new series organized by the HSPH Faculty Diversity Initiative. The Initiative was formed to emphasize issues related to diversity in health and in public health, as well as health disparities within and between countries, explained Dean Barry Bloom.

Trained as a bench scientist, Dr. Olden has returned to the lab, and he maintains ties to HSPH and HMS, where he was a research fellow and instructor. He is a co-recipient of this year's Julius B. Richmond Award and was introduced at Monday's lecture by Douglas Dockery, chair of the Department of Environmental Health.

Said Dr. Olden, "We need a new vision for health care-a vision that emphasizes health promotion and disease prevention. A vision that ensures access to health care for all Americans, irrespective of their capacity to pay."

The U.S. ranked 37th among 191 member countries of the World Health Organization (WHO) on health system performance, according to a WHO survey published in 2002. This middling ranking came despite the fact that the U.S. spent more than 14 percent of its GDP on health care in 2001.

"The return on this massive investment is very poor, given that Americans are no healthier than many people in other nations who are spending far less," said Dr. Olden. He said there was a disconnect between the country's capacity to provide top-notch care and the reality of health care delivery.

Dr. Olden suggested that one factor influencing that disconnect is the individualized, doctor-patient model of care prominent in the U.S. With millions of Americans uninsured or underinsured, there is too little access and too much expense to make the health care system as efficient as it can be.

He called for the formation of an independent body with representatives from health care, government, academe, industry, private citizens, and others that could agree upon standards of care. Then, the U.S. government, which already pays for a significant percent of health care in the country through programs such as Medicare, could provide a population-based, quality health care system that would reduce widespread variation and would help address health disparities, asserted Dr. Olden.

"Bad policy makes bad medicine," said Dr. Olden. "Furthermore, demographic projections of population growth and growth rates in poverty, coupled with growth rates in health care, suggest that we don't have a long time. We need now to begin to reform our health care delivery system, or otherwise, many more members of our society will have limited or no access to many preventive or curative advances that are available to those of us who are either insured or can afford from our own resources to buy a better quality of care."