Episode 52-Chris Allen

Brian Kruger:

Welcome to the podcast The Common Bridge with Richard Helppie. Rich is a successful entrepreneur in the technology, health and finance space. He and his wife Leslie are also philanthropists with interest in civic and artistic endeavors, but with a primary focus on medically and educationally under-served children. My name is Brian Kruger, and from time to time I’ll be the moderator and host of this podcast.

Rich Helppie:

Welcome to the Common Bridge. We have a very distinguished guest with us today. Chris Allen has devoted his life to healthcare. He is very deeply involved with civic affairs and civic development. And now the general public is beginning to hear about something called the social determinants of health. And Chris was actually doing this way before the term was ever even invented. Today we are going to talk about the social determinants of health. We’re going to talk about the sickness care versus the wellness care design of our healthcare system, how physicians are trained and what impacts that has. And very importantly, you’re going to hear from a very learned person, very deeply experienced person, about what changes we can make. And that is what the Common Bridge is all about. So I’d like to welcome my friend and colleague Chris Allen to the Common Bridge. Chris, good morning.

Chris Allen:

I’m happy to be here and thank you Rich, for inviting me to be a part of this podcast this morning.

Rich Helppie:

That’s an honor. Chris, let’s tell the audience a little bit about yourself. Where did you grow up and what were some of your early experiences?

Chris Allen:

Grew up in Detroit, went to the Detroit public school system, was very active in scouting as a child, my parents-my mother-was a den mother in the Cub Scouts, and my father was an assistant scout master with the Boy Scouts, and was honored to become an Eagle scout and spent a lot of time camping in the wonderful parts of Michigan.

Rich Helppie:

And you still live in Detroit today and still continue to support the community through all of the many changes that we’ve experienced in Detroit.

Chris Allen:

I have been blessed in a wonderful career in healthcare and I choose to live in Detroit by choice. I live in a wonderful community in Detroit, and I know my neighbors and they know me and we all look out for one another.

Rich Helppie:

It’s a great city. And more people should begin to know that. Chris, as you graduated high school and started out in the world, I understand you spent some time with the United States Air Force.

Chris Allen:

I served my country for four years in the Air Force, two of my years where it was on a strategic air command base in Oklahoma-Burns Flat, Oklahoma, leaving Detroit, going to this barren part of Oklahoma where they had the B 52 bombers. And the last two years of my life [in the air force] was spent on an intelligence base near Istanbul Turkey.

Rich Helppie:

And then you returned to attend college further, including at the University of Michigan School of Public Health.

Chris Allen:

My undergrad was at Wayne State University. I was really honored to play the team captain at the Wayne State basketball team, and was also fortunate, a few years later, Wayne state was very good to me, and I gave back to the university and became president of the Wayne State Alumni Association. Following my time at Wayne State, I spent two years in a graduate program at the University of Michigan School of Public Health and trained to be a hospital administrator.

Rich Helppie:

And that hospital administration work that you did, particularly at Hutzel Hospital, over 8,000 babies delivered a year, the most in the state of Michigan, that was really a pivotal time in your career. Would you mind just talking a little bit through your experiences as a hospital administrator and kind of that arc that led to Authority Health?

Chris Allen:

We were-at Hutzel Hospital-we were known for delivering babies, our orthopedic program, and the Kresge Eye Institute at that time. And during the early nineties we were delivering 8,000 babies a year, the highest in the state of Michigan. And 2,000 of those babies were about the size of my hand. And we had 46 bassinets in our neonatal intensive care unit and daily, I would walk through the neonatal unit and just observe these small children and the wonderful staff that we had in our NICU. Again, we had nine neonatologists, 13 parentologists, 26 nurse midwives, and so when it came to the OB business, OB product or service, we were able to meet a number of needs, until I had a meeting one day from the state health department, the Maternal and Child Health Division, a young lady came to me and she said, Mr. Allen, whenever there was an issue around health policy or Medicaid reimbursement for the moms and the babies, we would always come to Hutzel because you were doing it very well. All of our faculty, all of our physicians at Hutzel were clinical faculty at the Wayne State School of Medicine. So we had clinical academicians and we could do a great deal of work and were really proud of our performance inside of the hospital. Terry Wright was the young lady’s name from the state, and she came to me and she said, I appreciate all the things you’re doing around maternal, I mean, around babies. But my question has to do with infant mortality among African American babies in Detroit. And she pointed her finger at me and asked me, what was I doing about it? Where it was 23 deaths per thousand live births time. And then she said there were seven children killed in a house fire. Three of those children were born at Hutzel. What could you have done differently? Like, whoa-I trained at Michigan to be a hospital administrator. And the questions that Terry Wright was asking were things happening outside of the four walls of my hospital. And that was a challenge to me. And over the next month, I assembled a number of people, including some physicians, some of our key nurses, and we had a PhD social anthropologist from the Wayne State School of Medicine. And we met to talk about understanding why is it that 90% of the children in our neonatal intensive care unit were children of color? And why is that happening? And why aren’t those moms going to full term to deliver seven and eight pound babies? And that started me on this journey of social determinants and equity. And through a series of focus groups, we found both, men and women, women who recently delivered at Hutzel in the prior two years and young men that were husbands or young men with the women. We did focus groups where we paid them $50 a piece. And we asked a lot of questions around why is it that if you are eligible for prenatal care, why aren’t you using that? And why are women showing up at our hospital in the labor room or in the emergency room ready to deliver with little or no prenatal care. And what we learned was that there were too many other things going on in their lives. While they were pregnant and happy to be pregnant there were other things in their lives that puts food on the table, that just getting through the acts of daily living. As a result of those interviews, within the next year at Hutzel Hospital, we opened a program called Family Road Care Centers. And in Family Road Care Centers, we appreciated everything we learned in our community in focus groups. And at a 6,000 square foot space in the inside of the hospital, near the exit elevator, when young moms would leave our hospital, we wanted to make sure that young families were equipped with information to get their child through their first year of life. Within six months of opening Family Road, we won the Michigan Hospital Associations Community Service Award. Six months later, we won the American Hospital Association’s Nova Award for creative programming and community around a key issue like infant mortality. I came home one day and told my wife that I was going to quit my job, and I was going to take Family Road around the country. So in 1995, I quit my job as a key administrator, Executive Vice President of Hutzel Hospital, and created this company called Family Road Care Centers. And for the next 10 years traveled around the country, working in communities that had infant mortality of 16 deaths per thousand live births or higher. And I would meet with the hospital administrators. I would meet with community groups. I would meet with local public health departments, around the creation of a Family Road Program. And I was honored, Rich, to have you on my board for that time.

Rich Helppie:

Look Chris, it was a very easy decision to join your board and lean in to support you. So, Chris, we were talking about the design of the healthcare system in the United States, and I think you’ve accurately portrayed it as sickness care versus wellness care. Why is that? How did we get here? And is there a way out?

Chris Allen:

We pride ourselves on the wonderful work that happens in hospitals. And in the greater Detroit area, we have some of the best hospitals and health systems in the United States. And yet when we look at the health of the population in total, we aren’t as good as other communities. The way physicians train, the way professionals are trained in the business, it’s around a sick care model. It’s around when people get sick, you go to the emergency room or you go to the hospital, care is provided. Unlike other parts of the world, where there is this feeling that if I can keep you well and healthy and away from the hospital, that’s a good thing. Costs are going to be lower and the overall population is going to be healthier. There was, as part of my work at Authority Health, we had a Population Health Council. And on this council, we had all of the organizations that had anything to do with social determinants. And I’m going to just define that. The social determinants of health are the economic and social conditions that influence an individual or group’s difference in health status. So, as we were looking at the data in Detroit and wondering why things were the way they are, the Robert Wood Johnson Foundation in partnership with the University of Wisconsin, they created this program, going on seven years now, call County Health Rankings. Every county in the United States is ranked on morbidity, disease, mortality, death. Of the 83 counties in Michigan, Wayne County, with all of the wonderful resource that we have available to us, including a very fine medical school, we were at the bottom of the list in morbidity and mortality in almost every category. So what it suggests is that we do sick care, but when it comes to the wellness of Wayne County and the greater area, we aren’t doing as well as we could.

Rich Helppie:

And let me punctuate that just a little bit. I mean, the takeaway is that if you’re sick or injured, our healthcare providers do amazing miracles. And you were working at the Detroit Medical Center, Detroit Receiving, if you were in an accident on the freeway, or you were a victim of violence of some type, you’d want to be at Receiving because they were able to get into neurosurgery and have a patient-from the door to the time they actually were working on their brain-was like 28 minutes-phenomenal medicine. But the things that really affect people’s health, like food, housing, education, economic opportunity, those kinds of stressors that we today know are impacting people’s health. We don’t do a very good job of, until someone shows up in an ER or at a physician with an acute case.

Chris Allen:

Yes. What we found, we were reading the disease rather than the person. And it’s my philosophy today, after 43 years-20 years as a hospital administrator and the last 23, starting with Family Road, I spent my last 23 years understanding social determinants of health and population health. And with the learning is that we should move away from hospital specific data, and we should move toward a 30,000 feet looking at the health of a total population. And what are the influences on health and why is it that certain segments of our population seem to have more chronic disease, diabetes, hypertension, side effects of obesity, why is that occurring in certain pockets rather than others. And during my work with Authority Health and our Population Health Council, I would get graduate students, post-graduation there were administrative fellows and they spent a year with me on different projects. And one fellow spent her clinical year with me looking at spatial racism and health. Defined, it’s where people live and its impact on health. And part of this young lady’s work was doing research on Detroit, and she found this savings and loan document in 1939-it was real specific around mortgages. And if you had a green score, you could live anywhere. If you had a yellow score-a marginal score-although white, you could live in certain areas, but if you were black or of color, there were only certain areas in the city of Detroit where you could live. And unfortunately, it was in manufacturing, it was near dumpsites, it was in highly industrial areas. And so the influence on airborne toxins had impact on their health. And infrastructure in these areas were not as robust as the communities that had a green score or a yellow score. And there’s one zip code, 48217, that has the highest asthma rate in the state of Michigan. So when we look at public policy decisions made in 1939, that was endorsed by the mayor of the city of Detroit, the city council and FHA, we moved from 1939 to 2020, and most of the chronic disease in this city are public policy decisions made in the thirties.

Rich Helppie:

That is a completely logical and more outrageous because if you think about this-80 years later, after that 1939 policy United Health Care, one of the largest insurers in the United States said, we’ve determined that affordable quality housing is directly linked to health status and health outcomes. And it is something that we should have known 80 years ago, but by public policy, let ourselves into this chronic spatial racism. And it’s an outrage.

Chris Allen:

When I think about the early work with Family Road and wondering why these young moms were not coming in for prenatal care, housing was a significant comment around-they would move five or six times during their pregnancy, trying to find affordable, decent housing that would accommodate their family.

Rich Helppie:

And this is where, as we’re looking at healthy communities, the pillars that I’ve been working on-it’s about education, healthcare, economic opportunity, which of course translates to housing, food, recreation, and transport. And if we can get those things right, we’re going to take a lot of pressure off the healthcare system while we preserve our ability to deal with injury and illnesses that will come our way. Chris, what are some of the other social determinants of health that we know impact the quality of people’s health status?

Chris Allen:

There is water as a public health issue, is a key one if you don’t have fresh water, clean water. And so there was an issue in the city of Detroit around water shutoffs because of nonpayment of the bills. A senior living in a second floor apartment or flat, and the water’s turned off, not a good thing. A pregnant mom trying to do the right thing, water turned off, not a good thing. And so I know that there are efforts underway addressing those issues. But there’s another more important-as important-is the food we put in our bodies. And the areas of the city where chronic disease is prevalent, it is unlikely that there is one sit down restaurant with healthy foods. We have a fast food industry that has taken over these areas. And the net result is obesity, hypertension-because if you eat these foods every day, and they’re priced at a level where it’s really convenient, it’s easy, you can go, but the nutrients necessary and the diet necessary to be a healthy person, those options are not available. And through my work at Authority Health, we worked in six communities where at the local gas station or party store, we put in-in partnership with a couple of other organizations-freezers. And we had healthy foods prepared and placed in those freezers to see whether or not someone would bypass some other non nutritious foods and go after the more healthier foods, because the notion was, well, they’re not going to eat this food anyway, why are we…well, guess what, the sales were as high or higher than other affluent communities around that same food product. And what we learned was, guess what, if we give people choice and we share the importance of a healthy diet and nutrition, we’re going to see healthy communities. And so I get passionate about this because more work needs to be accomplished in this space, rather than focusing in on people when they get sick. We need to be moving-it’s called health equity, where you go upstream and you try to understand the causative factors that impact health.

Rich Helppie:

You made mention of the food quality. And I was particularly struck during the Katrina disaster and that there were people being rescued from the impoverished ninth ward, and many of them morbidly obese. There was a time when being impoverished, a person might be emaciated. And you had some experience directly during Katrina that gave you further insight into the healthcare system and some of our deficiencies today. Do you mind sharing just a little bit of that with our listeners?

Chris Allen:

During that time of Katrina, I was Senior Vice Chair of the American Red Cross and the United States. The chair of the board was appointed by the president of the United States. And when Katrina occurred I was asked to fly to Washington, and on a private jet, we flew to Baton Rouge, Louisiana, which is one hour from New Orleans. And in Baton Rouge, we visited the convention center that was filled with little cots and little black bags-where everyone’s belongings were in those bags, hundreds and thousands of people were there. And as a hospital executive, I was like, wow, it was like a major mash unit. And what we-the ICUs, critical care units, step down units-that were in New Orleans, all of a sudden they were in this convention center with no records.

Rich Helppie:

No records of?

Chris Allen:

There was no records of their care. And so, as clinicians in Baton Rouge, we’re trying to care for people with no pertinent or relevant information. There was only one patient cohort that had all of their records in intact, and that were the veterans, veterans of the United States. They could go anywhere in the world and the government has provided a technology that allows that person’s record to follow them wherever they are. And what it identified, how woefully unprepared we were as a nation when a disaster occurred.

Rich Helppie:

Chris, you and I’ve talked many times about the design of the healthcare system and the interoperability of data-something that I’ve been passionate about for many decades. And the progress just isn’t enough. And I’ve had some businesses that succeeded and one in particular that failed commercially, although we could exchange information, which would be so helpful during this current pandemic. But our design of our health system and where I’ve suggested that what we need to do is take all of our tax supported great care-Medicare, Medicaid, Tri-Care, and such, and make it one universal system for everybody. Pay for it on a sliding scale, allow a secondary market if people want to get other types of care, they can do that with the proviso that there would be shall issue rules and such, but not let that be paid for by tax free dollars if an employer provides it. And that’s what most countries around the world are doing. And we have some special advantages.

And during this time on the Common Bridge, we’ve talked about that design with experts like Brian Peters of the Michigan Health and Hospital Association. Nate Kaufman, Nate is one of the preeminent authorities on healthcare system design, and lately has really been railing about the unfair business practices of the big health plans. And then most recently, Hunter Howard, who has an interesting background in three different healthcare ventures, and then was a COVID-19 patient, and is now leading the Global Pandemic Coalition. I wanted to try to put those kind of markers down because as we are in the throws of this pandemic, talk to us a little bit about how these social determinants of health and the design of our healthcare system are being affected or revealed, exposed by the pandemic. And perhaps what can we do about this from a policy point of view?

Chris Allen:

Well, it is the work that I did in Family Road in better understanding the social determinants and the work at Authority Health. It became blatantly clear that unless and until we have reform around, moving away from a sick care to a wellness model and putting in energy in neighborhoods where that chronic disease occurs, putting energy around healthy food options, put in energy around reducing the stress that’s occurring in many of these areas, because toxic stress is real. One of my-another fellow, spent a year talking about working in an area called toxic stress and its impact on health. And so when you look at all of the components of the social determinants, there’s a lot of stress that’s happening in communities of color. And it could trigger other health issues that for the average person we take for granted, we don’t even acknowledge it, but it’s real, it’s happening. And so housing, transportation, and employment, it’s all very, very, very, very important.

Rich Helppie:

So this pandemic, the COVID-19, is yet one more disease that’s spreading, it’s impacting the disadvantaged communities, communities of color, who have greater population density, already under toxic stress from education and economic opportunities being depressed, housing not as good because of some of the spatial racism and other causes, perhaps not access to fresh water. So it’s pretty obvious why this is progressing. What do we know today about the hospitalization and the recovery and death rates in areas that have adverse social determinants of health?

Chris Allen:

We know that the most of the mortality are people of color. And there is a realization today among hospitals and health systems is that, wait, we’re going to have to do something different. I’m privileged to serve as chair of the Bon Secour Mercy National Board of Directors. We’re in seven states in 13 markets, at 47-48 hospitals. And so I keep my hand in this work. And what we find is we have to do more, rather than waiting til people come in the hospital, we’re going to have to get out more, better understand what’s happening in zip codes, because there is a correlation, I believe, that most of the-there’s a term called 30 day re-admission. The person comes, is discharged from the hospital and within 30 days, they’re back because of another reason. And I think there’s a correlation between that 30 day re-admit and their home address. Again, our work at Authority Health, we learn that your home address is a great predictor for life expectancy and what chronic disease you are likely to have based on where you live. That’s pretty powerful.

Rich Helppie:

Very powerful. And the pandemic is exposing that at a rapid rate. When you look at the experience of urban centers like New York, where people are crowded, they’re taking public transportation, they’re playing volleyball with that virus. And similarly in Michigan, our greatest outbreaks were in our urban areas. And in particularly in the city of Detroit. I’d like to, while I’m mentioning that, and give a shout out to our healthcare providers who did absolutely heroic work on the front lines, but we could have made their job a lot easier had we addressed further upstream about the social determinants of health.

Chris Allen:

Our hospitals, they do wonderful, wonderful work, but the discussion we’re having is-it’s outside of the hospital, and there’s a term that I’d like for your listeners to look up and it’s called adverse childhood experience. Just Google on the internet “adverse childhood experiences”. And it’s gaining more momentum around the country. What these adverse childhood experiences, there are 10 questions. And if a person scores…if seven of the 10 questions are yes, then there is a 90% probability of substance abuse or mental health with that individual and that family. That’s adverse childhood experiences. And what it suggests is that if you’re exposed to this every day, all day. And so we wonder why children become adults and the adults are having health issues and mental health issues and substance abuse issues, there is science now that says, if we keep doing the same thing, we’re going to have the same outcome.

I really enjoy working with really bright people. And my young administrative fellows out of graduate programs are pushing the envelope. They’re challenging the norm. And I love it. I worked with the College of Creative studies here in Detroit, at the graduate level. And the faculty at the university, they knew a little bit about my work, and asked if they could work with me on a project for their students. Now within the College of Creative studies they have a division called structural and system integration. And here, I thought it was car design, fashion design, home design. Well this structural and system integration is how do we use technology and other means on integrating things, or structurally, how do you create it? So they want to do a project on one of the social determinants. And so they were working with me and then we landed on, well, let’s do a project on infant mortality in Detroit. We had six grad students, English as their third language. And they were from Russia, China, Spain, Turkey. So the lens that they’re looking out of was very different than people who work in that field every day. So they did the quantitative and qualitative analysis for a full semester. Were able to get funding from the Ford fund at $25,000 a piece per graduate student to help support this initiative. And the work that that resulted from that semester was very powerful in saying that if you follow the money, the amount of money that’s coming into communities around maternal and child health, and there’s so many silos, and the cross-fertilization among those organizations, it’s not happening. So the net result is we’re spending money, money, money, but when we look at the county health rankings or population health based data, it suggests that there may be another way of using resource to get a better outcome. The industry today it’s a wonderful space for creative and imaginative people around change. And that’s why I love it.

Rich Helppie:

Indeed. And you, and I share that passion for a better world. And because of our work in healthcare, we understand that healthcare catches everything and is really quite a mirror on society. You mentioned about the adverse childhood experiences. We had Judge Milt Mack on the program some episodes ago, and his work in mental health. My primary charity today, Champions of Wayne, it’s a mentoring and incentive program at Wayne Memorial High School in Wayne. Our kids, not all of them, but many of the kids, have many of the markers on these adverse childhood events. And they’ve oftentimes never interacted with an educationally or economically successful adult. And what a little bit of attention from that adult helping that young person get to their goals has been amazing. And I know when you were at the family road, Chris-and I don’t know if we’ll leave this on the podcast after editing-but I remember all the work you did with the young men, who were very young and were becoming fathers, and frankly didn’t know what to do, and you were very instrumental, I know, in making their lives and the lives of their children better.

Chris Allen:

I think the young men, they have just as much responsibility as the mom, in terms of being a good parent. And what we felt at Family Road is the more knowledgeable a father was about his responsibilities, being a parent, the better that child’s going to be long term. Whether they were married or not we want to make sure that they have the right skill sets. And we worked with the court systems if there was a domestic violence issue, if there was someone-and we had courses at at Family Road that young men would come and learn what was really important about parenting. And through focus groups, what we think we know and what comes out of their mouth is really totally different. I’m behind a double blinded mirror, I’m listening to men in focus groups in over 25 cities listening to around what it means to be a father. And so what it told us is that we needed a curriculum, we needed coursework, we needed programming to make sure that we work with our young men around better choices.

Rich Helppie:

Indeed. And that continues to be an important part of your life work and mine as well. Chris, this has been a very, very good conversation. And what are some things that we did not cover today that perhaps we should have discussed?

Chris Allen:

I wanted to talk about the way we train physicians. In 2011, I believe, Riverview Hospital closed on the East side of Detroit, it was part of the Ascension Hospital System, and St. John was the parent, the large parent here or larger hospital in Detroit. While as the CEO of Authority Health, I received calls from city council and the county commission that why is St. John Hospital closing Riverview when they made a commitment to stay. And there were four zip codes on the lower East side of Detroit, where that was where this community went and there was an emergency room associated or aligned with Riverview Hospital. One of my colleagues in grad school was the CEO there, and I called him and I said, you might want to have a meeting with the city council or community leaders, and talk about a strategic plan for care delivery in that area. And the comment, well, they can come over to St. John Hospital, we’re going to close this hospital.

What often occurs when you close a hospital, the professional office building next door, those physicians leave. Now there was already a physician shortage in those four zip codes to begin with. And now we’ve only exacerbated that problem by closing the hospital and the medical office building next door. That bothered me a great deal. And I started-within our organization we had a primary care network council of all of the safety net providers in the region. And I shared with them that we needed to look at this a little closer. Sister Mary Ellen Howard and Dr. Herb Smitherman co-Chaired a group called the East side Planning Group. And we convened this group for well over a year, and we looked at a lot of issues related to physician availability, dentists availability, and other resources, and what the net result was, there was a big void. This was just around the time of the Affordable Care Act. And within the Affordable Care Act was a provision for funding to create additional medical residency slots or positions for physicians, because there were not enough physicians and there still aren’t enough physicians in the country. So I, my organization, we applied for a teaching health center grant that would train pediatricians, family medicine physicians, internal medicine physicians, psychiatry, OB, and we had a geriatric fellowship that we applied for. And with our own resources, and as a small organization, we were granted over $20 million to start a community based medical residency program just like you would find in a hospital today. We had 55 practice sites and every practice site was in a medically under-served area. And that almost immediately, you put a licensed physician in that community. And we had a relationship with five hospitals. It was called Authority Health Graduate Medical Education Program. Within our first year, we had 84 residents, and anyone that knows graduate medical education, it’s very difficult to recruit graduating medical students to a new program. Well, we provided some incentives and we were able to recruit residents from around the country.

One year later, I’m looking at our curriculum and I said, there’s something missing here. And it has to do with the social determinants of health. And we residents and medical medical students have little or no discussion around social determinants. It has been historically around a disease and almost all the residency program are hospital based. And so our medical residents are learning the acute care model and their continuity clinic or their practice clinic is often next door to the hospital. Well, ours was totally different, but there was something missing. I went to the University of Michigan School of Public health. I met with faculty and I said, I want to create a two year curriculum in addition to our traditional residency program. And I met with Dr. Phyllis Meadows and she created and her faculty created a curriculum that exposed our medical residents to this whole power of place and the things that we’ve been talking about. So when they graduate from our program, they have their degree from Michigan State University and a certification from the University of Michigan School of Public Health in Population Health. Now, we are one of the few programs in the United States that can have any discussion around that. And I was invited to speak by the Associate Dean of the Medical School at the University of Michigan, and it was a Midwest meeting of all of the graduate medical education programs in the Midwest. And I talked about this little program in Detroit that has a community based residency program certification in population health. And our residents are working in medically under-served areas as they train. The president of the Macy Foundation, who represents most of the clinical and scholarly research in the United States, was in the audience. And he stood up among his peer group and said, we need to get out of our ivory tower and do things like this little program here in Detroit. So I could not be more proud of our graduate medical education program. Third year into our program, no solicitation, we have 23 to 25 residency slot opening the year. And we have over 3,000 applicants for those 23 slots.

Rich Helppie:

And this pivot to something that we call population health, is where we need to go as a nation. We’ve talked about our financing methods, which I refuse to call the system because it’s not a system, a system would have some sense to it. The ineffectiveness of people getting their health insurance from their employer may have made sense for my grandfather who was 40 years at Chrysler, but doesn’t make sense today in a world where people change jobs frequently, or are in a gig type of economy, that we do need to be bold in pivoting the design of our healthcare system. Chris, this has been a great opportunity to talk to somebody who’s making a difference in the lives of so many, and who has done that for years, any closing thoughts or any advice on what would be the best kind of policy solutions we should be seeking as a nation, and perhaps what would be some of the worst things we could do?

Chris Allen:

Couple of things. One, there’s a term that we use in my world it’s called health in all policies. As we grow as an economy, as we start new businesses, health in all policies is taking a health lens through this new, whatever it is. I’ll give you one example, in San Francisco they have a health in all policies plan, and the net result-there are only two McDonald’s in the entire city of San Francisco. Two, while I like a good hamburger, we shouldn’t celebrate every time we open a new hamburger place.

Rich Helppie:

Indeed, that’s a lot of what we measure as economic activity, may not be healthy for us. Better to go to the farmer market and get some local ingredients and eat that, versus going and participating in fast food, which again, that was designed to be a treat, not to be a staple. And it’s way out of whack today.

Chris Allen:

And the other comment I’ll make is if you don’t know another person of color, find a way to have an interaction. You’re going to find that we are probably more alike than not. Experience has shown me that if you’ve not had any exposure or experience with another race, there’s this fear factor. There’s these unknowns, there’s all this noise. One example was, there was a Facebook post about one of my hospitals in Virginia, where an alleged comment made by one of the employees about-it was very negative about race and racism-and it turns out, it was false. There’s an evil element out here that wants to keep the separation of the races. But if your audience, if you have another person of color, I would have that bold conversation, it is kind of important around change. And unless we are bold enough to have conversations, and sometimes it’s really difficult, it’s sensitive to have a discussion about race because of all this other stuff that’s out here. Find a way to have a conversation or to meet someone of another race and just have a conversation.

Rich Helppie:

I could not be more enthusiastic about endorsing that. That is what the Common Bridge is about. And to your point, a foundation of the Common Bridge is this, that if we need to cross a river or a chasm, and if you’re on the right bank and you build a very strong pillar and you reinforce it, and another group’s on the left bank, and they’re building a very strong pillar on that side, we cannot span that river or that chasm unless we come together and we think about our commonality. And so I’m encouraging my listeners to reject any type of division, wherever it comes from. The political parties have made great strides in gaining expertise in attacking the other side. We’ve seen them now begin to attack each other’s voters and drive further division. We’ve seen this fueled by a reporting industry that is intent on inflaming and twisting. And I think we can all take a step back. We had Sheriff Clayton on who was very articulate about law enforcement, and the people agree we have the right to redress grievances, that’s sacred in our constitution. We also believe that there’s a line that’s crossed about civil disobedience when it takes away the rights of another person, or indeed is dangerous or takes lives. Everyone, I think can understand that. And we do need to have those discussions. And that is what the Common Bridge is about. I do want to thank my good friend and colleague Chris Allen for lending his expertise. Chris, I would love to do 50 episodes with you. I think we’ve got a lot to talk about, but thank you for being on the Common Bridge.

Chris Allen:

Alright. Have a good one. Thank you.

Brian Kruger:

You have been listening to Richard Helppie’s Common Bridge podcast. Recording and post-production provided by Stunt Three Multimedia. All rights are reserved by Richard Helppie. For more information, visit RichardHelppie.com.