Fixing U.S. Health Care by Thinking Global
World Health Organization/Gail Reed

Fixing U.S. Health Care by Thinking Global

RWJF is searching the globe for solutions it can bring back to America

Ever since President Obama announced the restoration of diplomatic ties between the U.S. and Cuba, American businesses and organizations have been investigating ways to help bolster Cuba’s economy and infrastructure. At the Robert Wood Johnson Foundation (RWJF) we are also looking at Cuba, but from a different perspective: We believe the U.S. can learn a lot about health care from the island nation.

Despite very limited resources, Cuba has universal, widely available medical and dental care – and enviable health outcomes. The country  has a low infant mortality rate and the lowest HIV rate in the Americas, in part because the central government views education, housing, and public safety all through a health lens.

MEDICC, an RWJF-supported organization, is applying lessons gleaned from Cuba’s health system to four medically underserved communities in the United States: South Los Angeles, Oakland, Albuquerque, and the Bronx. To get an even closer look, a team from the Foundation visited Cuba in 2014. They found that a physician and nurse live and work in each community, where they make yearly home visits and keep updated health records on all household members. There is a strong emphasis on healthy aging, with vibrant community senior centers that offer a range of activities. And because most of the elderly are cared for by relatives, there is a lot of support for family caregivers. 

The overarching lesson is larger than Cuba, however. RWJF is striving to build a Culture of Health, where every person in America has the opportunity to live the healthiest life possible, no matter where they live, the color of their skin, or their economic status. This vision is already a reality in many countries, and it’s time we asked them how they do it. Given that only 5 percent of the world’s population lives in the U.S., the other 95 percent surely has some good ideas. 

In an effort to find out why other countries are doing so much better on cost and quality, RWJF is for the first time openly soliciting proposals from around the world that can help us build a Culture of Health at home. We’ve put out a call for ideas, from both U.S.-based applicants who want to adapt an overseas model to the U.S., and from international applicants with programs that could work here. We are eager to discover approaches that haven’t been tried in the U.S., and have a chance of working in our unique health care system. And we want to hear from people in a wide range of fields and disciplines beyond the health sector.

American companies have long known the advantages of looking beyond our shores -- they've been incorporating ideas and innovations from other countries since the nation began. Some recent examples: University of Florida scientists based their Gatorade formula on a combination of sugar, carbohydrates, and salt commonly used in Bangladesh to treat cholera; Telkom Kenya came up with a way of banking by mobile phone that attracted the attention of IBM and Barclays, and is now being rolled out in the U.S.; Kickstarter is modeled on “microloans” pioneered by Bangladeshi economist Muhammad Yunus, who won a Nobel Prize for the concept; Apple followed Samsung’s lead and designed a larger iPhone despite originally dismissing the idea of a bigger device as unwieldy.

Similar global innovations are certain to exist in health. In a recent survey by the Commonwealth Fund, the U.S. came in dead last among 11 industrialized nations on measures of health system quality, efficiency, access to care, equity, and healthy lives. The World Health Organization ranks the U.S. health care system 37th in the world on quality, even though we spend far more per capita on health care than any other nation. These countries clearly are doing things differently than the U.S.  It's time we learn from them.

If you think you have a project that might work please click on this link, or share it with someone who might. I’d also love to hear your ideas in the comments. It’s about time the U.S. invests as much in the health of the population as Cuba does.

joe guarracino

maintenance plowing contractor

8 年

whatever we can do to help that's important to me that would give me such a pleasure and honor

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Dwayne Proctor, Ph.D.

President & CEO at Missouri Foundation for Health

8 年

This is a big step in the right direction! As the US can boast that immigrants, students and New American populations are a part of our growing diversity, it makes sense to understand solutions from their homes and experiences as we welcome them here and work with others to build a Culture of Health .

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Chris Webb

Modifying care one patient at a time through solid steadfast Airway Management education to physicians, Respiratory Therapist and Nursing alike.

8 年

Through my years as a student I have spent many hours in many hospitals. I have come to ask myself why is it not a one medical professional has the same routine as another. When you go to one Dr. It is one thing, as soon as the shift changes it is a completely different approach. No 2 Healthcare providers work the same, they don't provide the same medications or even the same treatments. No 2 hospitals are the same one focuses on one thing and the next focuses on something completely different. How can we provide a standard of care when the standards are so generic. I have spent many hours looking into this issue, just due to the fact if we can get respiratory departments on the same page patient outcomes would become better. If we could get the nursing on board we could improve even further.

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ADRIANA P. PALMA M.

Hospital & Health Care Professional

8 年

Great article, it is impressive how a third world could exceed by far a developed country, especially how they overcame individuals to educate its population interests, and care for the health of their inhabitants with so few resources. There is much to learn! , Especially the most marginalized communities around the world. It is a fact that generates the need for major changes and big ideas !!

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We are all bits of sand which make up the whole beach......

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