What Can Mississippi’s Health Care System Learn From Iran?
Read the whole thing here. It’s the New York Times Magazine’s feature article from last Sunday, so it’s long, well written, and well illustrated.
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Cox works for an agency called HealthConnect, whose purpose is to reduce admissions to the Central Mississippi Medical Center, a Jackson hospital where people routinely use the emergency room for primary care, sometimes multiple times in a month.
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One of the people responsible for HealthConnect’s holistic, intensely personal approach is Dr. Aaron Shirley, who three years ago found inspiration for health care reform in an unlikely place: the primary health care system created in the 1980s in the Islamic Republic of Iran. The main issue in Iran back then was “disparities in health between its urban and rural populations,” he told me recently. “In the U.S., these disparities exist. The Iranian model eliminated the geographic disparities, so why couldn’t this same approach be used for racial and geographic disparities in the U.S.?”
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Shirley is a civil rights-era hero who for a long time was the only black pediatrician in the state, the type of activist who, he says, wasn’t necessarily of the “nonviolent persuasion” and who, upon hearing that the local Klan was headed to his home, would warn the Police Department that both his boys knew how to shoot. He was the first black resident at the University of Mississippi Medical Center and, in the 1960s, worked at the state’s first community health center, in the Mississippi Delta. He did things that don’t end up in history books, too, like build wells for poor blacks when they didn’t have clean drinking water and travel through the countryside treating malnourished babies. In 1993, the MacArthur Foundation identified him as a “health care leader” when it gave him one of its “genius” awards.
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In 2008, Shirley was introduced to a consultant named James Miller by a public health professor at Jackson State University, Mohammad Shahbazi. Miller and his wife live in Oxford, Miss., where they and other family members run a consulting firm and other businesses. In 2004, Miller learned about Iran’s primary-care health system during a meeting in Germany with a delegation from the Iranian government. But it wasn’t until 2007, when a struggling hospital hired Miller’s firm to conduct an assessment of its operations, that Miller fully grasped the extent of Mississippi’s health care crisis — and recognized how much it resembled prerevolutionary Iran.
‘When the Iranian system was developed in the 1980s, there were no doctors in rural Iran,’ Miller says. ‘And this is similar to the problem in the delta today.’
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Shahbazi suggested that he and Miller approach Shirley. He arranged for the two men to visit Shiraz, Iran, and meet some of the people responsible for creating and administering the country’s health houses. The two groups decided to establish an official academic partnership between Shiraz University and Jackson State, and Shirley returned to Mississippi a convert. Later that year, several Iranian doctors and administrators and their wives made their own trip to Mississippi. They were surprised by what they saw: ‘This is America?’ they asked.
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Emphasis added, because when I re-read that yesterday, I had an article about Mitt Romney’s assertions on culture open in another tab, and it struck me that when he said this:
… I noted that part of my interest when I used to be in the world of business is I would travel to different countries was to understand why there were such enormous disparities in the economic success of various countries. I read a number of books on the topic.
…he could have been looking at the US and seeing disparities, but he wasn’t. And I wondered how his life might have been different if he had served his two year mission in Mississippi instead of in France.