CDC Director Calls for Sweeping Health Reform

Though rising unemployment, falling stock prices and other economic woes are dominating the national news, the fiscal crisis must not overshadow the need for health system reform, according to one of the country’s most powerful health policy leaders. “This is exactly the time for fixing the health system,” said Julie Gerberding, MD, MPH, director of the federal Centers for Disease Control and Prevention (CDC) and an associate professor of medicine at UCSF. “Good solutions will be two-for-one, addressing both the health and economic crises.” Gerberding delivered a lecture in a crowded Cole Hall at UCSF on how to confront the “two-headed monster” of an ailing economy and a broken health system. The event was part of the Chancellor’s Health Policy Lecture Series, which UCSF Chancellor J. Michael Bishop, MD, initiated in 2006. During her talk and in a subsequent interview on Tuesday, Gerberding noted that while the United States spends more than any other nation on health, it is not the healthiest nation. Far from it: The country ranks 72nd in the world in overall health investment performance, according to the World Health Organization. Gerberding stressed the importance of creating lasting solutions to this problem, rather than relying on quick fixes. For example, she said, in addressing the nation’s widespread health shortages and unaffordable health benefits, the quick fix would be changing the health care payment structure. But that Band-Aid solution wouldn’t offer nearly the same long-term benefits as investing in Americans’ overall health. “We need to realize the downstream benefits of health investments, and that health reform goes beyond the health care system,” she said. In an effort to promote large-scale health reform, the CDC and other national, state and local health advocacy groups have formed the Alliance for the Healthiest Nation, which aims to promote healthy lifestyle choices, prevent poor health and prepare Americans for new health threats, in addition to making health care more accessible and affordable. “Health doesn’t happen here,” Gerberding said of UCSF and other hospitals and patient care facilities. “Health happens at home. We need to support and restore health where it happens.” Looking ahead to the incoming presidential administration and Congress, Gerberding said she hopes to see universal health coverage become a reality — something President-elect Barack Obama in his campaign promised to pursue. “I pray we’ll get universal access, so we can stop talking as though that’s the only thing we have to change” about the health system, Gerberding said. In addition, noting Obama’s recently announced plan to invest billions of dollars in public works projects to jolt the economy, Gerberding said it was important to change the public’s thinking to include health infrastructure — such as state-of-the-art laboratories and biomedical research — under the larger umbrella of national infrastructure. “There is no more valuable infrastructure than health, even more than roads and bridges,” she said. “We have to appeal to people’s emotions, so they don’t lose sight of that at a time when the focus is on the economy.” In addition to politicians and policymakers, members of the UCSF community have an equally important role to play in the health reform process and must “lead by example,” Gerberding added. “UCSF is a health leader,” she said. “The power that we have as representatives for health care organizations is tremendous.” Prior to joining the CDC in 1998, Gerberding spent 17 years at UCSF, first as an intern and resident in internal medicine and later as a faculty member. She directed the University’s Prevention Epicenter, a multidisciplinary research, training and clinical service program that focused on preventing infections in patients and their health care providers. In addition to her associate professorship at UCSF, she is a clinical professor of medicine at Emory University in Atlanta, where she lives with her husband. It is unclear whether Gerberding, who became head of the CDC in 2002, will continue in her current role under the new Obama administration. The CDC director is appointed by the secretary of health and human services, a position that will change hands in January.