Continued Quest for Equity in Health: Thoughts from Morehouse School of Medicine Founder and former HHS Secretary Dr. Louis Sullivan
Dr. Louis Wade Sullivan
Marianne O'Hare : Welcome to Conversations on Health Care with Mark Masselli and
Margaret Flinter, a show where we speak to the top thought leaders
in health policy, health innovation and technology and the great
minds who are shaping the healthcare of the future.
This week, Mark and Margaret speak with Dr. Louis Wade Sullivan,
Founding Dean and President Emeritus at the Morehouse College of
Medicine , t he first predominantly black college of medicine in the
20 th century. He also served as Health and Human Se rvices Secretary
under the first Bush Administration dedicating his life’s work to
promoting equity in the health professions and equity and access to
health care for all Americans.
Lori Robertson also checks in, the Managing Editor of FactCheck.org,
look s at misstatement s spoken about health policy in the public
domain, separating the fake from the facts . We end with a Bright Idea
that's improving health and well - being in everyday lives. If you have
comments, please e - mail us at [email protected] or find us on
Facebook or Twitter. We love hearing from you or you can find us on
iTunes, SoundCloud or ask Alexa to play the program Conversations
on Health Care.
Now , stay tuned for our interview with former HHS Secretar y Dr. Louis
Wade Sullivan on Conversations on Health Care.
Mark Masselli: We’re speaking today with the honorable Dr. Louis Wade Sullivan,
Founding Dean and President Emeritus at the Morehouse School of
Medicine , t he first predominantly black medical schoo l in the 20 th
century. He is the former Secretary of the U.S. Department of Health
and Human Services under President George H. W. Bush and as
Chairman of the Sullivan Alliance which seeks to increase diversity in
the health care workforce. He’s authored m any publications and
several books including his 2014 autobiography, “ Breaking Ground:
My Life in Medicine ” . He's received numerous honors including being
inducted this year into Modern Health Care's Hall of Fame. He earned
his medical degree from Boston U niversity School of Medicine and
completed his residency in hematology at Cornell Medical Center in
New York. Dr. Sullivan , Welcome to Conversations on Health Care.
Dr. Sullivan: Well my pleasure to join you.
Mark Masselli: Yeah. We are honored to have you here. You've made your life
mission to foster health equity in this country and really around the
globe from a childhood in segregated south to your time as the only
student of color in your medical class in the 1950s to the founding of
Morehouse School o f Medicine, to serving as Secretary of HHS in the
first Bush administration. As you look back on the collective body of
your work in healthcare, health policy, health equity, what do you
view as some of your greatest achievements?
Dr. Louis Wade Sullivan
Dr. Sullivan: Well, I wou ld say the most significant achievement I think is serving as
a Founding Dean and Initial President of Morehouse School of
Medicine. That school was founded because of the severe shortage of
African - American physicians as well as other minority physicians , so I
view that institution as one which hopefully will be around for
200/300 years or more to really address that. The second obviously
would be having served as U.S. Secretary of Health and Human
Services, but have had many opportunities for service duri ng my life
and I'm pleased to have had those opportunities.
Margaret Flinter: Well Dr. Sullivan, I had the pleasure of reading your autobiography
and I think I would put up there on the list of good fortune or
opportunity. It sounds like you had amazing pa rents instilling values
and purpose.
Dr. Sullivan: Well, I was very fortunate than my older brother Walter as well, that
my parents are very dedicated to us getting as strong an education as
they could provide us . In rural Georgia, during the years of
segr egation the schools for blacks were very inferior in terms of books
and other things. So t hat's why my parents, when I was in 5th grade
sent us away to live with relatives in Savannah for a year and the
following year took us to Atlanta to attend school th ere. We would
get a much better education.
Margaret Flinter: You know, Dr. Sullivan, I can't help but think, as we review your work
and your life of the quote from Dr. Martin Luther King who said that
“Of all the forms of inequality, injustice in health ca re is the most
shocking and inhumane.” And you've said that , while there were flaws
for sure in the health law, the Affordable Care Act, it did so much to
address that fundamental concept of injustice in health care that Dr.
King spoke of , t he health law h as suffered challenges and setbacks
and attacks, but it's still standing. Maybe you could share with us your
vision for how you hope to see the country now move forward on
health reform?
Dr. Sullivan: Oh yes. I'm very committed to improving access to healt h care
because from my perspective, the two most important things that we
can provide young people and really more broadly to provide our
country are healthy , well educated citizens , i t means investing in
education and in health. We want to have citizens w ho are healthy so
they can be independent, provide income for themselves and their
communities. I see investing in health and in education as an
investment, not only in these citizens, but more broadly investing in
the manpower that we need as a country 20 years from now, 30 years
from now. I see this as very clear , and I have always been mystified by
the fact that we spend as a nation tremendous energies and times
arguing about whether we should provide health care or not, because
the data show that if you provide things such as vaccines, good
Dr. Louis Wade Sullivan
nutrition, medical checkups, give people information they need to
protect their health such as not smoking and not abusing alcohol and
drugs, all of these things lead to a healthier individual , and therefore a
more pr oductive citizen. We as a country should have better access to
health for everyone and I ’d say the government does have a role , t he
private sector has a role , i ndividuals have a role. We should really all
be working together rather than finding reasons not to invest in our
health system because it's simply makes good sense as well as a good
humanitarian argument to have healthy citizens who are more
productive and who can contribute to the welfare of everyone.
Mark Masselli: Well, Dr. Sullivan, as the HHS S ecretary under President Bush, you
were able to take some significant steps to address health disparities
as well as initiate measures aimed at moving the whole country
towards better health. I'm wondering if you could talk to our listeners
about the Healt hy People initiative as well as the other significant
health policies that you were able to launch at that time.
Dr. Sullivan: We released Healthy People 2000 in September of 1990 . This was an
outline for the things that individuals and families can do to protect
and enhance their health. Vaccines are a tremendous development ;
and we have eliminated smallpox from the world , w e have diminished
greatly other communicable diseases such as polio which is close to
being eliminated from the world , t hings such as measles, diphtheria,
mumps, and other childhood communicable diseases. While a
number of children who get these diseases really will pass through a
phase and recover , u nfortunately there are complications that do
occur in some children ; deafness, meningiti s, even death. So vaccines
for children given at the appropriate time w ill have a major impact in
protecting the health of that individual.
We know that we should avoid tobacco use. We also have very solid
evidence that having an active lifestyle, exercisi ng , really leads to a
better health, longer life , some evidence suggest that the likelihood of
developing Al zheimer's is less if you are active. So the Healthy People
2000 initiative was launched to inform the public about those things
that they can do and should do to protect their health. In 1990 this
was considered soft science, but there's no questi on about the data
and its importance.
The other thing that we did was to work to increase the racial , and
ethnic , and gender diversity in the department beca use I often say
that the health professions are science based professions delivered in
a social setting. You need to have the well trained, knowledgeable
scientists , b ut that person also should know how to relate to that
individual who has come seeking hel p our information, because these
are very sensitive issues for so many people. If you don't demonstrate
that you are an individual who has empathy then you won't get that
Dr. Louis Wade Sullivan
information from the patient. The cultural competence of the
individual is important.
We were able to appoint the first female director of the Na tional
Institutes of Health, Dr. Bernadine Healy . We formed a Women's
Health Research Program at NIH. We were able to appoint the first
minority and first female Surgeon General Dr. Antonia Novell o , th e
first black social security commissioner we had appointed, the first
administrative for the healthcare financing administration which is
now set up for Medicaid services. The reason that was important to
have people who have had different life exper iences bring their
experience, so that we can learn how to interact with our general
public and provide the services that the public needs. We created the
Office for Research and Minority Health and National Institutes of
Health that now has become the Nat ional Institute for Minority
Health and Health Disparities. So people really with their cultural
differences, the ir language, the ir histories, they might see themselves
represented in the health system if they are to trust it and to utilize it
effectively. So th at's why we need to have more racial and ethnic and
gender diversity in the health professions.
Margaret Flinter: Well Dr. Sullivan you also -- we are just wrapping up there talking
about increasing the diversity in the health profession workf orce, I
wonder if you could comment how well have we done with that?
What's your sense of how we're doing?
Dr. Sullivan: Well, we've made some progress, but the amount of progress has
been far less than what we had expected. For example, in 1950 2% of
America ’s p hysicians were African American, when African Americans
represented about 10% of the population. Today, 5% of the physicians
in America are African American whereas we now represent 12% of
the population , 17% of our population today is Hispanic and our
His panic physician s are only approximately 6% . So we have made
some progress, but far from what is needed , s o that's why we -- all of
us – must still work to see that we have much more diversity in our
health profession. All of us as Americans really need to see that we
have healthy citizens, well educated citizens that will lead to us
continuing to be leading the world in terms of innovation, scientific
discovery, a strong economy. So t hat's why everyone should be
interested in this and has a stake in seeing that we reach those goals.
Mark Masselli: We are speaking today with the honorable Dr. Louis Wade Sullivan,
Founding Dean and President Emeritus at the Morehouse School of
Medicine . He is former secretary of HHS under President George H.
W. Bush and is cha irman of the Sullivan Alliance which seeks to
increase diversity in healthcare workforce. Dr. Sullivan , in 2005 you
launched the Sullivan Alliance which seeks to not only promote health
careers for people of color, but also to educate minority populations
Dr. Louis Wade Sullivan
to be aware of the undue health risks they face. I’m wondering if you
could talk about the mission at the Sullivan Alliance and how you’re
reaching into the most vulnerable communities to make a difference.
Dr. Sullivan: The Sullivan Alliance came about as a result of an initiative from the
Kellogg Foundation which formed a committee that’s called the
Sullivan Commission to look at ways to increase diversity in the health
professions. We issued a report titled “Missing Persons: Minorities in
the Health Prof essions… and a relative to shortage of minorities in the
health professions. We were then funded to form what we call the
Sullivan Alliance.
The Sullivan Alliance in 2005 when it began had its mission to
implement the many recommendations coming from the S ullivan
Commission as well as from the Institute of Medicine Committee
changing the educational environment in health profession schools to
be more cooperative, less competitive, having commitment from the
leaders of these institutions to have a diverse st udent body and
faculty. Thirdly, having adequate financial resources so that students
would not have to go into tremendous debt , and w e've done very
poorly on that as a nation . We have made it more difficult from a
financial perspective for a young person to become a health
professional. Those who do make it through end up with debt of
$ 200 ,000 , $300,000 which interferes with their ability to buy a home
or to establish a practice. The Sullivan Alliance has worked to really try
and address the need for suffi cient financial resources. Things are
very different from the mid - 50s w hen I went to medical school,
students of my generation really did not graduate with such a
burdensome debt as our students today. The Alliance has worked to
form alliances within state s around the country , so we are operating
in Ohio, Florida, in North Carolina, Virginia .
We developed alliances between academic health centers and
colleges that have significant numbers of minority students to develop
programs that involve counseling, yo ung people, mentoring them,
financial planning, as well as academic courses, etc. Health is so
essential to having a strong nation , I always say , there's no such thing
as a wealthy nation that has an unhealthy population. That's why
having a healthy popula tion and an educated population I see as a
national priority that's in the interest not only of the individuals who
benefit from that but our larger society that benefits from that
directly in so many ways.
Margaret Flinter: Dr. Sullivan , you worked should er to shoulder and alongside some of
the leading civil rights activists in the United States, like Martin Luther
King, Andrew Young and others , but I know you also collaborated with
global leaders such as the late South African President, Nelson
Mandela, w ho fought so hard against injustice in his country. What
Dr. Louis Wade Sullivan
did you learn from your work with President Mandela and other
global health warriors over the years , and are there bright spots
around the globe in the advancement of the cause of health equity?
Dr. Sullivan: I've learned a lot and benefited a lot from the people I have met and
interacted with. President Mandela, Martin Luther King Jr., Andy
Young and others , but my work with President Mandela was part of
an effort to increase the number of black heal th professionals in
South Africa. There was an organization that was formed called
Medical Education for South African Blacks formed in 1983 by Herbert
and Joy Kaiser. Herb Kaiser had been a career member of the U . S .
Foreign Service and had served in South Africa and he saw the
condition there for blacks. At the time there were only 200 black
doctors in South Africa with the black population some 43 or 44
million. When he retired, he formed this organization and I was
invited and later becam e chairman of th e organization.
Our purpose was to raise funds for scholarship support for black
stu dents attending medical, nursing, dental and other health
profession schools in South Africa b ecause at the time the apartheid
regime was being dismantled and blacks were being admitted to the
universities for the first time. But no financial aid was a part of the
process , and the absence of financial aid meant they really did not
have the resources to attend the university. So w ith a board made up
of Americans and South Af ricans worked to raise funds for
scholarships for these students. The organization supported more
than 10,000 students who became doctors, nurses, dentists and other
health professionals in South Africa. Nelson Mandela was one of our
advisors and we would have a dinner in New York annually to Ana
[PH] and American and South Africa n who ha d helped the effort , a nd
so Mandela was one of our honorees one year . Mandela was a great
leader for South Africa and an example for all of us around the world
because havi ng suffered under apartheid, his goal of redemption and
a peaceful, orderly society really has met all of the difference in South
Afric a between a possible holocausts, they could have had indeed,
they've been retribution after the rollback of apartheid . So uth Africa
has been the beneficiary of that as well as other countries around the
world , s o working with him has been a great example for me.
One other thing I would mention pertaining to South Africa because
we've had one student from South Africa who att ended Morehouse
School of Medicine. He graduated in 1991 , h e had to fleet South
Africa in 1976 protesting against apartheid, but he came to America,
attended Morehouse College, my Alma Mater, he at the Medical
School in Morehouse trained as a surgeon, but he then learned blood
banking system because he then went back to South Africa and
found ed the first nationwide blood banking system for South Africa .
T hat was important because one of the problems in South Africa and
Dr. Louis Wade Sullivan
many places including America is HIV, t he AIDS virus, some 8% to 10%
of the population was carriers of that virus. By establishing the blood
banking system, he was able to make the blood supply safe so that
was a major achievement, and we consider that a significant
contribution from the Moreh ouse School of Medicine to South Africa.
And so those are the kinds of things that give me great personal
satisfaction that we've been able to contribute to.
Mark Masselli: It's been our pleasure today to be speaking with the honorable Dr.
Louis Wade Sulli van , Founding Dean and President Emeritus at the
Morehouse School of Medicine, Former Secretary of Health and
Human Services and Chairman of the Sullivan Alliance. You can learn
more about body of his work and his mission by going to the
www.sullivanalliance.org or follow them on Twitter @ Sullivan Alliance
[PH] . Dr. Sullivan , thank you for your remarkable contributions to
health education, health equity, your great leadership , w e appreciate
you joining us tod ay at Conversations on Health Care.
Dr. Sullivan : Thank you very much. It is my honor to spend this time with you.
[Music]
Margaret Flinter: At Conversations on Health Care, we want our audience to be truly in
the know when it comes to the facts about heal th care reform and
policy. Lori Robertson is an award - winning journalist and Managing
Editor of FactCheck.org, a nonpartisan, nonprofit consumer advocate
for voters that aim to reduce the level of deception in U.S. politics.
Lori, what have you got for us this week?
Lori Robertson: The Trump Administration instituted new rules to expand association
health plans and short - term limited duration plans which are
expected to be less expensive options with fewer benefit
requirements than plans sold on the Afforda ble Care Act ’ s
marketplaces such as www.healthcare.gov .
The nonpartisan Congressional Budget Office has released a new
report on the impact of such plans. The CBO estimated that 5 million
additional people would e nroll in association or short - term plans each
year over the next 10 years because of the new rules . Most would be
those who would have purchased plan s in the small group or
individual market , but 1 million would be newly insured . The rules
would cause prem iums for the small group and individual markets to
go up by about 3% . Insurance plans offered by association s couldn't
deny coverage or charge more based on health status , but they
wouldn't have to cover the 10 essential health benefits the ACA
requires of plans on the small group market or individual market.
Also association plans could price plans based on age, gender, or
occupation. Under the ACA , plans are limited to varying pricing based
Dr. Louis Wade Sullivan
on age, family size, tobacco use and geographic area. The short - t erm
plan don't have to meet ACA requirements, including those essential
health benefits, premium pricing restrictions and prohibitions against
denying or pricing coverage based on health status. They were limited
to a duration of less than three months und er an Obama era rule that
took effect in 2017 .
Trump Administration rule allows insurers to extend plans for up to
three years. The CBO report said , the new association in short - term
plans would be less expensive on average th a n small group and
individual market plans since the new plans don't have to meet many
of the ACA requirements and to the plans are expected to attract
those with low medical costs. The association plans can set premiums
based on each individual association expected medical spending an d
therefore benefit by attracting groups with low risk employees. For
the short - term plan , they can exclude those with higher health care
costs . And that's my fact check for this week, I'm Lori Robertson,
Managing Editor of FactCheck.org.
[Music]
Margaret Flinter: FactCheck.org is committed to factual accuracy from the country's
major political players and is a project of the Annenberg Public Policy
Center at the University of Pennsylvania. If you have a fact that you'd
like checked, e - mail us at www.chcradio.com . We'll have
FactCheck.org's Lori Robertson check it out for you here on
Conversations on Health Care.
[Music]
Margaret Flinter: Each week Conversations highlights a Bright Idea about how to make
wellness a pa rt of our communities and everyday lives. As the saying
goes, music soothes the savage beast and according to a recent study
conducted by Queens University in Belfast, Ireland, there's some
empirical data to back that up . In a first of a kind longitudinal study,
children suffering from a variety of behavioral and emotional
conditions who are exposed to music therapy in addition to
traditional therapies, ha d far better outcomes than those children in a
control group that offered traditional therapy without m usic therapy.
Dr. Sam Porter: It's not a matter of them being given music or choosing music , t hey
actually make music along with music therapist assisting them. So the
idea is for them to e xpress themselves through music.
Margaret Flinter: Lead researcher, Dr. Sam Porter , said it's been anecdotal evidence
that music improves mood in children and adolescents as well as
adults, but his study reveal ed just how effective the music therapy
was.
Dr. Sam Porter: -- and improvement in communication , they were very two very
Dr. Louis Wade Sullivan
interesting secondary outcomes, levels of depression , levels of self -
esteem . And then the secondary outcomes we find is statistically
significant difference between the control group and the intervention
group.
Margaret Flinter: Dr. Porter says in the group given musical therapy, it showed over
time more interaction with their surroundings and a better response
to the traditional therapies as well . He says , the effects were
sustained over time.
Dr. Sam Porter: There are no side effects. It is not a dangerous therapy to get kids
involved in it. It is just such a good way and a harmless way of doing
things.
Margaret Flinter: A simple targeted music therapy approach, age appropriate and
showing great efficacy and improving outcomes for young patients
w ith minimal side effects and lasting benefits , n ow that's a Bright
Idea.
[Music]
Mark Masselli: You've been listening to Conversations on Health Care. I'm Mark
Masselli.
Margaret Flinter: And I'm Margaret Flinter.
Mark Masselli: Peace and health.
Marianne O'Hare : Conversations on Health Care is recorded at WESU at Wesleyan
University streaming live at www.chcradio.com , iTunes, or wherever
you listen to podcasts. If you have comments, please e - mail us at
[email protected] , or find us on Facebook or Twitter. We love
hearing from you. This show is brought to you by the Community
Health Center.
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