BLOOMINGTON, Ill.— More than 130 students, faculty, staff and community members gathered
at Illinois Wesleyan University Monday for the University’s annual Teach-In honoring
Dr. Martin Luther King, Jr. Several campus and community leaders spoke on this year’s
theme: health care and social justice.
In introducing the topic, IWU’s William Munro, the Betty Ritchie-Birrer ’47 and Ivan
Birrer, Ph.D. Endowed Professor, drew attention to King's remarks at a 1966 convention of the Medical Committee for Human Rights. Munro said King called
injustice in health care “shocking.”
Regarding health-care financing, Professor of Political Science Greg Shaw spoke about
two dominant models: government-financed or market-driven. “We have this rather messy
hybrid way of doing it in the United States,” explained Shaw, who is the author of
The Healthcare Debate, a book that traces the history of the government’s role in health-care financing.
“We have a lot of public dollars, we have a lot of private dollars, and we mainly
have private providers, with lots of nonprofit providers as well.”
In explaining a consumer-driven health care (CDHC) movement, Shaw noted the CDHC’s
main tenet says when individuals more directly experience the true cost of the health-care
goods and services they might consume, they consume fewer services, and in ways that
most appropriately meet their needs.
Citing findings from a federally funded study — the late 1970s-era RAND Corporation
project that remains the ‘gold standard’ on the topic — Shaw noted that people do
not consume medical services in any direct proportion to their incomes.
“Wealthy people do not care about a new intestinal procedure and say ‘I’m going to
go out and get that right away,’ the way they might about a new vehicle or a house,”
Shaw said. “On the other end of things, lower-income people do not refrain from services
altogether, especially for their kids. They go and find a way to get those.”
Shaw said approximately 70 percent of U.S. health-care dollars are spent on 10 percent
of the population in a typical year.
“The healthy 50 percent of the population only account for about three percent of
the health-care dollars we spend,” explained Shaw. “We need to understand that imposing
cost-sharing on the wealthy won’t save us much.”
Shaw reminded the audience that the Affordable Care Act (ACA) focuses mostly on enhanced
coverage; it focuses very little on quality or costs. The Affordable Care Act will
extend coverage for more than 40 million people who have not been insured in recent
years, while America still spends 17 to 18 percent of gross domestic product on health
A market-driven model is a piece of the puzzle, but “it’s not going to be our salvation,”
Shaw said. “We do have some coverage of a generalized nature, Medicare, Medicaid,
county health, but those are not intended to be universal. So we do have this hybrid
model. But I do want us to think about efficient ways to get to universal coverage,
that don’t involve imagining that buying surgery or a band-aid or an antibiotic is
just like buying a sweater or a car.”
Other speakers included Dr. Trina Scott, medical director of Immanuel Health Center
in Bloomington, and Angie McLaughlin, executive director of Community Health Care
Clinic in Normal. Both spoke about local health-care delivery and financing issues.
Immanuel Health Center opened in 2013 to provide a holistic approach for primary medical
care, social and behavioral services, counseling and spiritual care, and community
referrals for Medicare, Medicaid, uninsured and underinsured clients.
McLaughlin explained that even with expanded coverage for millions under the Affordable
Care Act, there will still be tremendous need for her free clinic which serves uninsured
or low-income McLean County residents. She said an information gap remains, noting
that many of the clinic’s clients were unaware of the Affordable Care Act or how to
enroll for coverage in recent weeks.
Chair of Sociology and Anthropology and Associate Professor of Anthropology Rebecca
Gearhart and Stutzman Peace Fellow Jennifer Prochotsky ’16 presented the day’s last
session on international models of health-care delivery, particularly in rural areas
of the developing world. The two related the characteristics and sustainability of
Prochotsky’s experience in international health care comes from her “gap year” between
high school and college, when she volunteered in West Africa with Mercy Ships, the
largest non-governmental hospital ship in the world. Mercy Ships provide free health
care, community development projects, community health education, mental health programs,
agriculture projects, and palliative care for terminally ill patients.
Gearhart described several models, from the “guinea pig model” to the “surgical safari
model.” She said a common problem with these models is that health-care providers
trained in Western facilities are not culturally competent everywhere in the world.
“Each society has a unique cultural framework in which its members understand illness
and wellness, which health-care providers need to understand in which to successfully
operate within it. It is critical to delivering quality healthcare,” Gearhart said.
“The notion that inadequate health care is better than no health care is also false,”
she added. “If medical intervention does not include necessary follow up and rehabilitation,
it’s not a valid form of health care.”
The Action Research Center, the John and Emma Stutzman Peace Fellows Program and Unraveling
Inequality, a liberal arts cluster of courses that explore human rights and social
justice issues, sponsored this year’s Teach-In.