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Keeping People at the Center of Health Policy

February 14, 2018

At its heart, health policy is about people. That might seem obvious, but high-level policies don’t always translate into measurable improvements for real people in the real world.

I’ve always been drawn to this intersection of policy and people. Two experiences in my life have been the most influential. The first is professional, the second is personal.

Seeing Long-term Services in a New Light

While working in Virginia state government, I was part of a research team that conducted a study on Medicaid. My focus was on long-term services and supports. In time, I learned the ins and outs of this complex policy, including how to access the system, relevant laws and performance metrics, and payment methods. But it was not until I met Mary that I fully understood Medicaid’s value.

I began visiting Mary every week as part of a volunteer program, talking with her and just enjoying each other’s company. Each Wednesday, we talked about life, from the mundane to the memorable. Occasionally, health came up. Mary became blind in her seventies. Despite leading an independent and full life, her support network was the same age as she was, which meant that they were limited in how much they could help her.

She shared her experiences navigating health insurance, interpreting prescriptions, making it to doctor appointments and buying groceries. She was sharp and resourceful, but even so she relied tremendously on others to get by.

My friendship with Mary brought my research full circle. In this new light, I saw just how much she —and people like her — depend on in-home help and long-term services to maintain their quality of life.

Navigating the Health Care System

CHI's Liana Major on a hike.
A challenging health experience gave CHI's
newest policy analyst Liana Major (left, with
husband Charlie Major) a new perspective
on her work - and a new appreciation for
hikes like this one.

My second experience is from several years ago, when I suddenly and mysteriously lost a significant amount of my hearing. Months later, I developed an even worse symptom: chronic and severe vertigo. I went from being the healthiest in my life to being barely functional at times. It took me a year to get back to health. The trials of navigating our fragmented health care system to understand why I was sick and how to get well could easily fill a book, though one that would never sell because this is altogether too common.

I had a decent knowledge of health care, health insurance, a support system, a flexible job with sick leave, and resources to throw at my illness, but I still struggled mightily to get well. This made me even more attuned to how our health policies and systems sometimes create hurdles for people who are sick and who may not have the energy or resources to clear every one of them.

Both experiences reinforced for me that good policy always takes into account the human experience. People impacted by health problems should be engaged to help shape and change policy or improve implementation.

As a new member of the team at the Colorado Health Institute, I’m looking forward to becoming acquainted with the health community here at all levels and being a part of the important work happening in this state.

This post is an introduction to CHI's newest policy analyst, Liana Major. Find her on Twitter @CHI_LianaM

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