As the national debate over health care rages, we’re asking Schweitzer Fellows and Fellows for Life — who are working directly with the populations whose needs are unmet under our current health care system — to weigh in.
Today, we speak with 1997-98 North Carolina Schweitzer Fellow
Timothy Lahey, MD, MMSc, now an assistant professor at Dartmouth Medical School. While a Fellow (and a student at Duke University School of Medicine), Lahey formed a three-tiered support network for individuals newly diagnosed with diabetes and hypertension. Since his initial Fellowship year ended, Lahey has maintained his commitment to meeting the health needs of the underserved, and has even mentored new Schweitzer Fellows.
Do you think the structure of our health care system needs to be changed, in order to truly address, reduce, and ultimately eliminate health disparities? How so? 

Yes, our health care system needs change. A fragmented system driven by this year’s profits is ill-equipped to address the long term health needs of any in our population, particularly the most vulnerable members of our society who simultaneously lack ideal commercial health insurance and are at higher risk for poor medical outcomes.

Piecemeal change will not fix this core problem. However, grand change has not yet come because people are still making money on the status quo. The day will come when it will be profitable for our nation to undertake grand change. The day has passed when waiting for that change costs us anything less than the lives of our poor and our children.

What is the single most important issue meaningful health care reform needs to address?

Universal coverage.

From your personal experience, is there a certain specific anecdote that best illustrates what’s broken about our health care system? 

One of my HIV patients called in with acute onset left sided arm and leg numbness that could be from a number of life-threatening conditions such as stroke or mass lesion in the brain. I advised him to present to an emergency room immediately, but he declined because he has no health insurance.

Unfortunately, our clinic can’t see him because we commute two hours to see him and only have funding to do so a few times each month. His primary care doc didn’t have open appointments, either.

This patient would surely get better care of the support infrastructure was less strapped for cash, and less shaped by a profit-driven medical care system.

Are you encouraged or discouraged by the current political conversations about health care reform? Why? 

I think the enhanced media coverage and public dialogue engendered by the Obama administration’s effort to change the system can only lead to improved understanding and change, if not today then in the future.

What news sources do you follow to stay informed re. discussions about health care reform? Do you feel that news coverage of these discussions is adequate, or are there perspectives out there that aren’t getting heard?

Internet news: GoogleNews, BBCNews, CNN, NY Times. I think the issue is so complex that even most health care providers like me are unsure who’s at the table making exactly which decisions based on which variables. I am worried that this level of widespread ignorance, which relates only in part to the complexity of the health care reform problem,  will empower profit motivated bodies to either continue to derail the ongoing reform process or at the very least skew it toward their interests and away from those who most need better access to healthcare.