Welcome back students!

Welcome to our ~1050 returning students and our ~540 new students!

I was so pleased to meet some of you on Saturday at the “Supporting Diversity at SPH” orientation and on Monday at the “School-wide Welcome” for new students that was organized by Assistant Dean for Students, Felicia Mebane (on right extending her hand) and her team (Office of Student Affairs). I am so impressed by the enthusiasm, commitment and curiosity our new students showed.

We’re committed to the full expression of diversity—race, ethnicity, gender, age, country of origin, sexual orientation, political views and disability.

We’re a tolerant school with a track record of civil discourse (unlike those health care town halls!). We don’t tolerate intolerance.

As a dean, I’m accountable. Public health is grounded in diversity, and we want to be more diverse. Help us!

I’m looking forward to Thursday’s “BSPH Welcome/Welcome Back” event.

To all SPH students

I hope your year at UNC Gillings School of Global Public Health is an exceptional one. Please don’t hesitate to e-mail me (brimer@unc.edu) and let me know about your successes and concerns.  Most of all, enjoy your time here, including our incomparable Carolina fall! Go Heels!

Happy Monday.

Barbara

Health care reform — another chimera?

Note: I wrote this Saturday, August 15th. When I got the papers Monday morning, front page articles splashed the news that President Obama might be willing to support a health reform plan without a public plan. It’s a huge change, but one that might make the legislation more palatable — or not. Saturday, it seemed that the whole thing was unraveling. So I wrote…

A lot of people all over the country are talking about what kind of health reform package we will have. I am an optimist on most things. When it comes to health reform, my optimism is shaded with deep concern. The igniting of extreme passions (illustrated by the appearance of guns at health reform rallies), especially on the part of anti-health care reformers, is causing me to worry that, yet again, health care reform will be just another chimera, a vision and dream deferred. Each time health care reform seems breathtakingly close, fear-mongering drowns out rational voices. I spent a few hours in the Atlanta airport last week and found myself speaking back to Lou Dobbs (on CNN) as he authoritatively spoke one mistruth after another about health reform. There was no one answering him but me — mostly under my breath.

The problems with our health care non-system have been catalogued — more than 47 million Americans uninsured, great disparities between those who are minority and those who are not, access problems, waste, geographic mal-distribution of health care, uneven quality of care, and health outcomes that, for many indicators, are worse in the US than in other countries. As Gawande, Berwick, Fisher and McClellan wrote in the New York Times August 13th, “So we are trying to decide if we are willing to change-willing to ensure that everyone can have coverage.” In 2009, we should conclude that we are willing to ensure that all Americans can have health care coverage.

There are many good analyses of the current bills. The bills have many common themes — guaranteed issue, administrative simplification, some but not all cover preventive services, transparent purchasing marketplace, minimum benefit package, individual mandates in some but not all plans, health care delivery reforms, workforce reform (includes public health), and allowable services dependent in part on comparative effectiveness. There’s a lot more, but these are some of the common elements. There’s no discussion of tort reform, but that needs to be fixed.

John Oberlander, PhD, Associate Professor of Health Policy and Management at our school, is one of the most astute commentators about health reform. Here are some links to his recent articles.

There’s no perfect system, but we can do better. We should do better.

Welcome back students!

I look forward to meeting our new students and talking with those who are returning. I love the fact that the sounds of students have begun to replace the sounds of silence in our atrium. Wishing you all a great year!

Happy Monday, Barbara

• Learning from Failure in Health Care ReformPicking the Right Poison — Options for Funding Health Care Reform, N Engl J Med 360:2045, May 14, 2009 Perspective

• Great Expectations — The Obama Administration and Health Care Reform
  N Engl J Med 360:321, January 22, 2009 Perspective

• Health Care and the Recession, N Engl J Med 360:e5, January 22, 2009 Perspective

• The Partisan Divide — The McCain and Obama Plans for U.S. Health Care Reform, N Engl J Med 359:781, August 21, 2008 Perspective

• Health of the Nation — Coverage for All Americans,N Engl J Med 359:777, August 21, 2008 Perspective

• Presidential Politics and the Resurgence of Health Care Reform, N Engl J Med 357:2101, November 22, 2007 Perspective

Been away — a few quick thoughts

Travel seems to go in batches. I’m nearing the end of three almost back-to-back trips — California, Texas and Georgia. The deans from schools of public health met in California a couple weeks ago. In the four years I have been attending the meetings, turnover in deans is dramatic, so dramatic, that I am becoming a senior dean! And the number of schools continues to rise each year — now, we are 40. States increasingly see schools of public health as valuable. I worry that if we don’t step up the training pace, we will all be competing for a very finite number of students and faculty, especially minority students and faculty. I really value discussions with fellow deans. We share many common challenges and struggles — like the 2009 budget crisis. No matter how bad the budget crisis may seem here at times, it’s much worse many other places. I’m grateful that North Carolina has been so supportive of its universities.

Reading on the road

The Kindle, an electronic reader, is really great for traveling on the road. The fact that it can be loaded with books and magazines is great for an over-packer like me. (By the time I have packed work and workout clothes, I’m always right at the carry-on limit.) I read Fool’s Gold by Gillian Tett on the California trip. It’s a fascinating look at the banking crisis and how we got into the mess that helped to fuel a global economic crisis. One cautionary note is the focus on banking innovations that few could understand-perhaps something for people in public health and medicine to ponder. Innovation is important, but not innovation merely for the sake of innovation.

For several years, I rarely read anything that wasn’t non-fiction, but I’ve gotten back into some fiction, including a fascinating mystery series by Josephine Winspear that has a very public health theme running through it-infectious disease deaths to disproportionately poorer people in the aftermath of World War I, suffering of soldiers that is forgotten as people move on after war and attention to the emotional toll of war. I’ve now read all the books in the Maisie Dobbs series and was captivated. Usually, on a long plane ride, I intersperse a stack of journal articles with a few more light reads-my own reward system. There’s a lot to read these days. No general journal is covering health reform more consistently and thoroughly than the New England Journal of Medicine.

New grants and articles to and by School’s faculty

Check out our home page to view the slides with news about new grants to our faculty and articles published by faculty, many with student co-authors. They’ve really done great in landing new grants to address significant research questions.

UNC Wellness Super Sprint Triathlon

Congratulations to Charlotte Nuñez-Wolff and Viktor Bovberg (and anyone else in the School) who completed the UNC Wellness Triathlon Sunday, Aug. 9, a hot, muggy summer day. The race website described the course this way: after a 5 lap swim, athletes transition to a rolling 9 mile bike course and rolling 5K run. Let me tell you, it’s more than a rolling run, speaking as someone whose house is on the route, and my street is quite a hill on the way to the finish line.