Rebecca Onie: What if our healthcare system kept us healthy?

Translator: Timothy Covell
Reviewer: Morton Bast So my freshman year of college I signed up for an internship in the housing unit at Greater Boston Legal Services. Showed up the first day ready to make coffee and photocopies, but was paired with this righteous, deeply inspired attorney named Jeff Purcell, who thrust me onto the front lines from the very first day. And over the course of nine months I had the chance to have dozens of conversations with low-income families in Boston who would come in presenting with housing issues, but always had an underlying health issue. So I had a client who came in, about to be evicted because he hasn’t paid his rent. But he hasn’t paid his rent, of course, because he’s paying for his HIV medication and just can’t afford both. We had moms who would come in, daughter has asthma, wakes up covered in cockroaches every morning. And one of our litigation strategies was actually to send me into the home of these clients with these large glass bottles. And I would collect the cockroaches, hot glue-gun them to this poster board that we’d bring to court for our cases. And we always won because the judges were just so grossed out. Far more effective, I have to say, than anything I later learned in law school. But over the course of these nine months, I grew frustrated with feeling like we were intervening too far downstream in the lives of our clients — that by the time they came to us, they were already in crisis. And at the end of my freshman year of college, I read an article about the work that Dr. Barry Zuckerman was doing as Chair of Pediatrics at Boston Medical Center. And his first hire was a legal services attorney to represent the patients. So I called Barry, and with his blessing, in October 1995 walked into the waiting room of the pediatrics clinic at Boston Medical Center. I’ll never forget, the TVs played this endless reel of cartoons. And the exhaustion of mothers who had taken two, three, sometimes four buses to bring their child to the doctor was just palpable. The doctors, it seemed, never really had enough time for all the patients, try as they might. And over the course of six months, I would corner them in the hallway and ask them a sort of naive but fundamental question: “If you had unlimited resources, what’s the one thing you would give your patients?” And I heard the same story again and again, a story we’ve heard hundreds of times since then. They said, “Every day we have patients that come into the clinic — child has an ear infection, I prescribe antibiotics. But the real issue is there’s no food at home. The real issue is that child is living with 12 other people in a two-bedroom apartment. And I don’t even ask about those issues because there’s nothing I can do. I have 13 minutes with each patient. Patients are piling up in the clinic waiting room. I have no idea where the nearest food pantry is. And I don’t even have any help.” In that clinic, even today, there are two social workers for 24,000 pediatric patients, which is better than a lot of the clinics out there. So Health Leads was born of these conversations — a simple model where doctors and nurses can prescribe nutritious food, heat in the winter and other basic resources for their patients the same way they prescribe medication. Patients then take their prescriptions to our desk in the clinic waiting room where we have a core of well-trained college student advocates who work side by side with these families to connect them out to the existing landscape of community resources. So we began with a card table in the clinic waiting room — totally lemonade stand style. But today we have a thousand college student advocates who are working to connect nearly 9,000 patients and their families with the resources that they need to be healthy. So 18 months ago I got this email that changed my life. And the email was from Dr. Jack Geiger, who had written to congratulate me on Health Leads and to share, as he said, a bit of historical context. In 1965 Dr. Geiger founded one of the first two community health centers in this country, in a brutally poor area in the Mississippi Delta. And so many of his patients came in presenting with malnutrition that be began prescribing food for them. And they would take these prescriptions to the local supermarket, which would fill them and then charge the pharmacy budget of the clinic. And when the Office of Economic Opportunity in Washington, D.C. — which was funding Geiger’s clinic — found out about this, they were furious. And they sent this bureaucrat down to tell Geiger that he was expected to use their dollars for medical care — to which Geiger famously and logically responded, “The last time I checked my textbooks, the specific therapy for malnutrition was food.” (Laughter) So when I got this email from Dr. Geiger, I knew I was supposed to be proud to be part of this history. But the truth is I was devastated. Here we are, 45 years after Geiger has prescribed food for his patients, and I have doctors telling me, “On those issues, we practice a ‘don’t ask, don’t tell’ policy.” Forty-five years after Geiger, Health Leads has to reinvent the prescription for basic resources. So I have spent hours upon hours trying to make sense of this weird Groundhog Day. How is it that if for decades we had a pretty straightforward tool for keeping patients, and especially low-income patients, healthy, that we didn’t use it? If we know what it takes to have a healthcare system rather than a sick-care system, why don’t we just do it? These questions, in my mind, are not hard because the answers are complicated, they are hard because they require that we be honest with ourselves. My belief is that it’s almost too painful to articulate our aspirations for our healthcare system, or even admit that we have any at all. Because if we did, they would be so removed from our current reality. But that doesn’t change my belief that all of us, deep inside, here in this room and across this country, share a similar set of desires. That if we are honest with ourselves and listen quietly, that we all harbor one fiercely held aspiration for our healthcare: that it keep us healthy. This aspiration that our healthcare keep us healthy is an enormously powerful one. And the way I think about this is that healthcare is like any other system. It’s just a set of choices that people make. What if we decided to make a different set of choices? What if we decided to take all the parts of healthcare that have drifted away from us and stand firm and say, “No. These things are ours. They will be used for our purposes. They will be used to realize our aspiration”? What if everything we needed to realize our aspiration for healthcare was right there in front of us just waiting to be claimed? So that’s where Health Leads began. We started with the prescription pad — a very ordinary piece of paper — and we asked, not what do patients need to get healthy — antibiotics, an inhaler, medication — but what do patients need to be healthy, to not get sick in the first place? And we chose to use the prescription for that purpose. So just a few miles from here at Children’s National Medical Center, when patients come into the doctor’s office, they’re asked a few questions. They’re asked, “Are you running out of food at the end of the month? Do you have safe housing?” And when the doctor begins the visit, she knows height, weight, is there food at home, is the family living in a shelter. And that not only leads to a better set of clinical choices, but the doctor can also prescribe those resources for the patient, using Health Leads like any other sub-specialty referral. The problem is, once you get a taste of what it’s like to realize your aspiration for healthcare, you want more. So we thought, if we can get individual doctors to prescribe these basic resources for their patients, could we get an entire healthcare system to shift its presumption? And we gave it a shot. So now at Harlem Hospital Center when patients come in with an elevated body mass index, the electronic medical record automatically generates a prescription for Health Leads. And our volunteers can then work with them to connect patients to healthy food and excercise programs in their communities. We’ve created a presumption that if you’re a patient at that hospital with an elevated BMI, the four walls of the doctor’s office probably aren’t going to give you everything you need to be healthy. You need more. So on the one hand, this is just a basic recoding of the electronic medical record. And on the other hand, it’s a radical transformation of the electronic medical record from a static repository of diagnostic information to a health promotion tool. In the private sector, when you squeeze that kind of additional value out of a fixed-cost investment, it’s called a billion-dollar company. But in my world, it’s called reduced obesity and diabetes. It’s called healthcare — a system where doctors can prescribe solutions to improve health, not just manage disease. Same thing in the clinic waiting room. So every day in this country three million patients pass through about 150,000 clinic waiting rooms in this country. And what do they do when they’re there? They sit, they watch the goldfish in the fish tank, they read extremely old copies of Good Housekeeping magazine. But mostly we all just sit there forever, waiting. How did we get here where we devote hundreds of acres and thousands of hours to waiting? What if we had a waiting room where you don’t just sit when you’re sick, but where you go to get healthy. If airports can become shopping malls and McDonald’s can become playgrounds, surely we can reinvent the clinic waiting room. And that’s what Health Leads has tried to do, to reclaim that real estate and that time and to use it as a gateway to connect patients to the resources they need to be healthy. So it’s a brutal winter in the Northeast, your kid has asthma, your heat just got turned off, and of course you’re in the waiting room of the ER, because the cold air triggered your child’s asthma. But what if instead of waiting for hours anxiously, the waiting room became the place where Health Leads turned your heat back on? And of course all of this requires a broader workforce. But if we’re creative, we already have that too. We know that our doctors and nurses and even social workers aren’t enough, that the ticking minutes of health care are too constraining. Health just takes more time. It requires a non-clinical army of community health workers and case managers and many others. What if a small part of that next healthcare workforce were the 11 million college students in this country? Unencumbered by clinical responsibilities, unwilling to take no for an answer from those bureaucracies that tend to crush patients, and with an unparalleled ability for information retrieval honed through years of using Google. Now lest you think it improbable that a college volunteer can make this kind of commitment, I have two words for you: March Madness. The average NCAA Division I men’s basketball player dedicates 39 hours a week to his sport. Now we may think that’s good or bad, but in either case it’s real. And Health Leads is based on the presumption that for too long we have asked too little of our college students when it comes to real impact in vulnerable communities. College sports teams say, “We’re going to take dozens of hours at some field across campus at some ungodly hour of the morning and we’re going to measure your performance, and your team’s performance, and if you don’t measure up or you don’t show up, we’re going to cut you off the team. But we’ll make huge investments in your training and development, and we’ll give you an extraordinary community of peers.” And people line up out the door just for the chance to be part of it. So our feeling is, if it’s good enough for the rugby team, it’s good enough for health and poverty. Health Leads too recruits competitively, trains intensively, coaches professionally, demands significant time, builds a cohesive team and measures results — a kind of Teach for America for healthcare. Now in the top 10 cities in the U.S. with the largest number of Medicaid patients, each of those has at least 20,000 college students. New York alone has half a million college students. And this isn’t just a sort of short-term workforce to connect patients to basic resources, it’s a next generation healthcare leadership pipeline who’ve spent two, three, four years in the clinic waiting room talking to patients about their most basic health needs. And they leave with the conviction, the ability and the efficacy to realize our most basic aspirations for health care. And the thing is, there’s thousands of these folks already out there. So Mia Lozada is Chief Resident of Internal Medicine at UCSF Medical Center, but for three years as an undergraduate she was a Health Leads volunteer in the clinic waiting room at Boston Medical Center. Mia says, “When my classmates write a prescription, they think their work is done. When I write a prescription, I think, can the family read the prescription? Do they have transportation to the pharmacy? Do they have food to take with the prescription? Do they have insurance to fill the prescription? Those are the questions I learned at Health Leads, not in medical school.” Now none of these solutions — the prescription pad, the electronic medical record, the waiting room, the army of college students — are perfect. But they are ours for the taking — simple examples of the vast under-utilized healthcare resources that, if we reclaimed and redeployed, could realize our most basic aspiration of healthcare. So I had been at Legal Services for about nine months when this idea of Health Leads started percolating in my mind. And I knew I had to tell Jeff Purcell, my attorney, that I needed to leave. And I was so nervous, because I thought he was going to be disappointed in me for abandoning our clients for some crazy idea. And I sat down with him and I said, “Jeff, I have this idea that we could mobilize college students to address patients’ most basic health needs.” And I’ll be honest, all I wanted was for him to not be angry at me. But he said this, “Rebecca, when you have a vision, you have an obligation to realize that vision. You must pursue that vision.” And I have to say, I was like “Whoa. That’s a lot of pressure.” I just wanted a blessing, I didn’t want some kind of mandate. But the truth is I’ve spent every waking minute nearly since then chasing that vision. I believe that we all have a vision for healthcare in this country. I believe that at the end of the day when we measure our healthcare, it will not be by the diseases cured, but by the diseases prevented. It will not be by the excellence of our technologies or the sophistication of our specialists, but by how rarely we needed them. And most of all, I believe that when we measure healthcare, it will be, not by what the system was, but by what we chose it to be. Thank you. (Applause) Thank you. (Applause)

100 comments on “Rebecca Onie: What if our healthcare system kept us healthy?”

  1. Leonidas GGG says:

    This is kind on disturbing. You have to have someone tell you what to eat? It's a big problem that public education, doesn't teach that and worse if there are corporations making money selling junk food, and other selling drugs to balance that out. You don't need doctors for this, volunters help, but in the end you need to inform the people.

  2. Paul G says:

    there is no prescription for stupidity and laziness. i love how this woman you could cut a prime slab of beef off of is preaching about responsible healthcare. healthcare begins with the individual, but sadly ends in the wallets of the taxpayer

  3. Eric Zhao says:

    Great talk. Really hits the point. The issue is even more devastating in regions of greater sociopolitical unrest and division. Consider Nancy Scheper-Hugh's account in "The Madness of Hunger."

  4. coopmuch56 says:

    There are many non-government ways that I can have security, fire protection.etc. Were suppose to have choice in a free country, what do we have?One police force that enforces its will on everybody else. The amount of police brutality,lies told by police, and just overall corruption in this one size fits all system is astonishing. If there was a security firm that would be less violent and coercive I would pick that but I have NO choice. "easiest slave to control is the one who thinks hes free"

  5. BBQPeanut says:

    Finding a job isn't luck. No one wants to hire an idiot.

  6. BBQPeanut says:

    Yeah, your mistakes you make are your own, and no one elses problem. Then stfu? Pretty simple.

  7. Roland Gridley says:

    Yep, you know everything! What a wonderful, understanding, and compassionate human being you are! That's probably why I can't find a job in the 3rd worst job area in the United States, I'm just an idiot. Thank you for showing me the light.

  8. Roland Gridley says:

    Do you have friends? It really doesn't seem like it. If you do, I'm sure they're all ass holes too.

  9. BBQPeanut says:

    I do. They're very nice people. They work hard to pay rent and pay for school and some of them never have any luxuries or get to party because they can't afford it, but they deal with it.

  10. BBQPeanut says:

    No one wants to hire someone that can't do anything but complain. Being desperate for a job doesn't mean you're a good employee.

  11. Roland Gridley says:

    And I'm sure that the difference between them and I is that I'm an idiot and deserve to starve, despite my lack of luxury and debauchery.

  12. viljamtheninja says:

    Don't be retarded. Talent is the smallest part of getting an employment when you're talking about odd jobs while studying. Luck, connections and of course ethnicity and all that nonsense is quite a bit more important.

  13. RutinaRottis says:

    USA healthcare systems biggest winner's appears to be insurance comppanies and lawyer offices.

  14. wakeupscreaming says:

    It almost appears that TED is a free-for-all now. It's become a victim of its own success.

  15. rbairos1 says:

    @wakeupscreaming Sigh, the sweeping generalization was your claim that the government prevents monopolies, when the fact is that all historical long lasting monopolies have relied in state intervention for their longevity, in the form of corporate status, indemnity from pollution and other private property laws and lobbying for regulation that prices out competition. Since you made the claim, show me an abusive example otherwise.

  16. rbairos1 says:

    @wakeupscreaming Here's something else for you to realize: Insulting and swearing at the person you disagree with greatly undermines your credibility. You might as well point out typos or how fat you think my momma is, makes you look just as irrelevant. Cheers

  17. rbairos1 says:

    @wakeupscreaming I never admitted collusion couldn't exist, only that's it's no more immoral than a group of consumers 'colluding' on how much to pay for a local service. Your demeanor is rude and your arguments betray a miscomprehension of what is actually being said. This is the part where you say 'nun-huh' , swear at me some more than hive five yourself on a job well done. Lol

  18. BBQPeanut says:

    Oil revenue. And density is a good thing because unlike the US and Canada, all physical goods have to travel a further distance, a lot of money is lost just transporting goods. And half of it going away in taxes or not, you're still earning double of the minimum wage of most other 1st world countries after taxes. There's a reason why you have the highest minimum wage earnings in international dollars. 3x more than Canada, 2x more than Australia. (the 2 nearest competitors)

  19. webkilla says:

    yes, there's a reason we got higher minimum wages – we've had some really good unions that organized their members into powerful voting blocks, which made them able to get laws passed that gave them good minimum working conditions. And denmark has jack shit oil, norway snagged all of that. They're loaded, we're not.

  20. Roland Gridley says:

    Doesn't change the fact that there are 3 times as many applicants as there are job openings here. Being a good employee means shit when you can't find work. When you can't find work because there is none, you have reason to complain.

  21. Miguel Chavez says:

    You said TED used to be about information? Is that all it used to be about?

  22. Miguel Chavez says:

    LOL. Im not even going to entertain your comment. Take it easy bro, its not that serious. Im glad that you agree with what is said in the video. The End.

  23. BBQPeanut says:

    Then make your own work.

  24. TheAbundantDuck says:

    Yes. Far better to hear about an amazing medicine for a disease, caused by social and economic factors, than it is to prevent the disease in the first place!

  25. Yu Lee Ahn says:

    she certainly has A LOT of food at home 😀

  26. reinl7 says:

    This is genius!

  27. 52111centrumcz says:

    Sorry…was after night shift (employed in the hospital sector) so was not thinking clearly. My apologies.

  28. TheAbundantDuck says:

    Non sequitur? How is this mundane and banal? Medicine only treats the disease – a much smarter idea is to prevent it. It may lack that "wow" factor you crave so much, but the problem she is talking about is by far the biggest failing of the health sector (and therefore of much greater significance than a new fringe drug). I loved it when she mentioned the doctor telling the bureaucrat why he shouldn't get in trouble for prescribing food! Really sorry that it didn't excite you in the right way.

  29. TheAbundantDuck says:

    That would be you: who's a moron?


  30. me says:

    well,if what they now inapropriately call alternative/complimentary care were mainstream,acupuncture,herbal therapy,nondrug,chiropractic,and reserve "modern meds"for emergency only,we might not need so much "HEALTH"care,and hey,heres and idea,stop injecting babies with mercury alumunim and formaldehyde 30 times before theyre grown making them return customers for life.mercury fillings as aint rocket science

  31. TheAbundantDuck says:

    Thanks to the link to an old "Whose Line is it anyway?" sketch. I used to love that show.

    But this: "The two are not codependent". How are they NOT co-dependent?

  32. TheAbundantDuck says:

    You really can't see the connections? Yes, we need them all, but sadly, there is no money to be made in prevention: very little spent on research, program development, or evaluation. Some money goes to research for cures to diseases that could be prevented. A great deal more is spent on research that offers symptom relief – because that's where the big bucks are to be made. Why would you want to cure someone when them popping a pill (or preferably more) every day prod
    ces a much better earner?

  33. TheAbundantDuck says:

    Yet what you really want is more of the old model, curative health, which could also be described as rather obvious. Preventative health care might seem obvious to you, but its potential has been rather lost on our policy-makers. You want TED to spend more time on a model that has limited potential, and less time on a model that is really yet to be explored (health promotion is the new stuff of health research). Just because curative medicine excites you more.

  34. TheAbundantDuck says:

    I would prefer it if you would refrain from abuse. Respectfully, I am not trying to tell you what you are thinking. You said you want more curative health breakthroughs on TED. Forgive me, but that is itself a political statement. When you choose one model over another in health, you are being political. When you say where resources go or what should be promoted, you are being political. In this sense, EVERY presentation on TED is inherently political.

  35. Filecreator says:

    Apologies accepted :3

  36. TheMontanaDave says:

    You are jealous, she ha a good job, a degree and actually helps people. You need to not breed. You do not help. I'd say keep learning but you are one sided it seems.

  37. Yu Lee Ahn says:

    oh shut up her being a fat and grossly out of shape wasnt the only thing i got out of this

  38. Danni Feveile Börm says:

    American views on Health Care is warped. I can't believe you could even remotely classify this talk as political. There's nothing in her idea that anyone in their right mind would object to, no matter their political conviction. She's saying: Peoples health issues is better prevented than treated and that you have to look at the whole picture. I wish for all americans to live with us for a time in a free health care system (not perfect, but still). They would go: Oh, silly us, and never go back.

  39. Keyholder says:

    Wow, glad to be Norwegian. This just sounds like bullshit.

  40. alastermyst says:

    My wife refuses to move out of the country but I want to move to Norway or Sweden or etc. America isn't just sliding downhill fast, it has already jumped off the cliff and is free-falling. Horrible and inhumane conditions for poor, profiting from child/slave/forced labor both abroad and domestic, continuous degradation of civil/constitutional rights, religious oppression…. and it goes on. And worst of all most Americans refuse to believe any of it, regardless of the proof.

  41. Eduardo Arroyo says:

    Excellent points

  42. Colonel Panda says:

    Clearly the entire rest of the first world has horrible, bankruptcy-inducing healthcare and only America "gets it".

  43. Wilfried de Jong says:

    Passion for care. Fantastic story

  44. MrElektrolyt says:

    " There's nothing in her idea that anyone in their right mind would object to," yes there is. It means the state has to take care of people like a mother takes care of a child. This does not enpower people but limit them to a system where they have no freedom!

  45. Dark Eternal says:

    Yes. We all need the freedom to die from easily preventable medical conditions.

    If people are not free to starve to death or succumb to simple infections and end up dead in the streets, then you don't live in a free society.

    Freedom is the corpses of starved children dotting the roads with vultures feasting upon their carcasses. If you don't see that, then you have to ask yourself where freedom went.

    Look at Liberia for an excellent example. It's pure, unadulterated freedom.

  46. Shannon Koob says:

    The health care system has to keep us sick to keep them $

  47. anotherdrummer23 says:

    How do you feel about immigrants over there in Norway? Because I've seriously been considering becoming one….

  48. Keyholder says:

    We need immigrants! We're only 4,5 million people and get 1,2 kids pr citizen so we can't grow at all without people coming from different places. Come to visit and see if you like it. I recommend Tromsø and Bergen. Do a bit of reachers and look into it! 🙂

  49. Syeal7 says:

    Come to Sweden instead! xD
    Free education, even paying you to study at college and university, and great health-care, well that if you are a citizen.

  50. Blodreina says:

    "Healthcare keeping individuals healthy? Oh, how preposterous."


  51. Munchegod says:

    oh that's funny don't Norway and Sweden have some of the highest citizen happiness ratings, must be a coincidence.

  52. Munchegod says:

    sorry I don't understand, are you saying free healthcare is wrong? or were you being sarcastic?

  53. Colonel Panda says:

    It was sarcasm. A lot of conservatives think America is the only place in the world with healthcare that doesn't suck, because it's the only country that doesn't have socialized medicine (at least other than third world countries).

    It's absurd.

  54. Munchegod says:

    Oh thank god I was really worried about that for a moment, at least I'm not the only one who tries to use sarcasm through text.

  55. amorphusensanity says:

    Sarcasm: does not come across well in text only formats.

  56. amorphusensanity says:

    While I agree that a lot can be done with disease prevention over curing, I think some of the numbers she threw out were highly over estimated. For the number of college students: limit it to (nearly) medically oriented. For student hours: volunteer is out, D1 Bball players compete (motivator) are paid for their time: $ + prestige. Compared to sports, the level of active followers drops drastically for nonathletics.
    Refining the waiting room is still quite worth pursuing. Even a gym would help.

  57. The John A. Hartford Foundation says:

    The Health Leads model is an inspiration. The same kinds of interventions that Health Leads volunteers offer to disadvantaged children would be outstanding services for vulnerable older adults.

  58. Jack Price says:

    I can't believe how the "greatest county in the world" is so far behind on simple stuff like this.

    Makes me realise how lucky I am living in Australia where health care isn't free, but the government pays for most of it. Of course, that comes from taxes, but the tax we pay isn't that high compared to most countries, and with our above average minimum wage, you NEVER hear of sick people going untreated.

  59. Kathleen Sciacca says:

    Can collaborative communication between health care providers and clients/patients yield more efficient/effective health care and outcomes"
    Watch Six video clips "Motivational Interviewing In Primary Health Care" for a detailed description of a communication style, including skills and strategies that engage clients in their health care decisions and participation.
    Right here on you tube: expand17

  60. 2009rogera says:

    Even if you're a troll, and the lowest common denominator morally, getting a free lunch is a stupidly attractive quality in terms of survival of the fittest.

  61. 2009rogera says:

    ultimately, they aren't already well though. They're in a situation where they're more likely to encounter disease. The clinics treat the disease (or sometimes, worse, the symptoms of the disease) not the causes of the disease's propagation (lack of sanitation, food, water, education, money). This is attempting to rectify an imbalance in the distribution of resources in society through making social welfare services available and attractive to people.

  62. TheShorterboy says:

    You can't get low wages if people aren't starving and afraid, feeding the poor endangers the capitalist system.

  63. Alix Farley says:

    If your idea of getting medical care is only in emergency situations then you need to visit the ER yourself.

  64. Spaceisprettybig says:

    The irony of America is, for a country that hold creationism with such high regard, we have a very darwinistic method for dealing with the needy…

  65. Austin Clark says:

    Anyone here for RHS?

  66. ivoteforpedrosanchez says:

    The law says they have to be stabilized. They do not have to be treated pased stabilization. That's EMTALA. And the hospital has to be receiving Medicaid funding. IF they do not, then they do not have to treat people.

  67. Glitter says:

    She's hot!

  68. Shana Kuehn says:

    Yes, yes, yes! What a wonderful young lady! I commend her action 🙂

  69. Виктор Скрягин says:

    Hi! I'm Matthew.I did -15 lbs last one week.Open

  70. AssessPatients says:

    Great talk which shows the close correlation between the social/living context for a patient and their health. Also shows great innovation by blending #ehr software solutions and processes to actively trigger an appropriate response to get people eating healthy (as in this example) and the use of the 'waiting room' time for people to learn to be healthy.

  71. walter veneau says:


  72. Sam Auciello says:

    No that is an idea worth spreading!

  73. Natalie Spa says:

    One of the keys to managing chronic health problems is for the patient to be educated and self-sufficient in their own disease management.

  74. pipsqueek89 says:

    i dislike her voice, it's like she's gonna start crying

  75. Emma Eames says:

    Amazing talk, truly inspiring!

  76. Sustainable Tips says:

    I would love to help out, I am certified as a Group Fitness Instructor, and I looking for a full time position.

  77. Richard Long says:

    Then they wouldn't be able to make a bunch of money off people's suffering.

  78. Emily Nichols says:

    There is a lot that can be done with disease prevention over curing a disease once it has started to take its progression even though these numbers are grossly over estimated. however, this video is simply just victim blaming. Not helping someone because they have HIV because the either made a mistake or were born with it is absolutely disgusting. Anyways, if a disease can't be prevented it is smart and safe to have the option to cure (or simply help symptoms). There are several regulations on health care that can be changed. Regulations that cause costs to be far to high with the quality of care being far too low. Change these and we an have costs drop and the quality of care vastly improve. Having regulations that cause these things are not right, and in fact should be changed. I feel like this is more of a political debate than an informative presentation of health care systems keeping us healthy. Stop victim blaming, and leave your politics out of this.

  79. Kaitlyn Lipinski says:

    Prescribing food is definitely something I've never heard of, but it is a good idea. The patients going to this clinic can't get better if they can't get healthy. To avoid getting sick thee patients need a clean home, unlike the family she mentioned living in a home overrun by cockroaches. That family can't afford to keep their home clean, so it is highly unlikely they would be able to afford medication. Yes, as she said managing disease is important, but if the doctors could do more sure as improve their overall quality of life some how that would be even more beneficial to the patients. If the patient is unable to afford food or housing treating them from disease will not do much, since they will be going back to the unhealthy lifestyle.

  80. Armani garrison says:

    then the question would be, where do we start? and who would determine how much food each person would get? what is the cut off for how much food a malnourished person can get? and how would we keep track of it? because there are places like food pantries and whatnot that that can help so would it be the same basic principle?

  81. Mickey Sutton says:

    I feel as though this is all good in theory, however the actual capital one would need to carry out prescribing food and prescribing exercise would be nearly impossible to obtain. We would also need much larger facilities and more staff to keep up on their patients. She even mentions in the beginning how the doctor already had too many patients to handle. Also, decent healthcare today is already costly, and with providing this new aspect of prescribing a "healthy diet" as a preventative manner to obtaining future diseases would only increase that and make it even more less available. Morally this is a great idea, but actually carrying it out proves troublesome in todays society. This idea must have fair and equal opportunity for every individual in the country, and when considering costs and benefits, the costs just do out-weight the benefits. Certain questions arise such as how do we start a program like this, and who is going to look over these people? Lastly, who do we prioritize if there is not enough room in such a program and how would you choose?

  82. Heather Hill says:

    You are an amazing presenter! I inspire to be like you! Thank you very much for your work Rebecca!!!

  83. Abigail Lanczak says:

    Never did I think about this perspective of health care. People usually get sick because of the fact that they do not have a healthy environment in the home. For insurance purposes though, I don't know how that kind of billing would work. This seems like more of a job of social workers, therapist, etc. I think the doctor's role should still be with disease and sickness treatment and prevention. They did not go to school for 8 plus years just to prescribe heat for your home. Not at all am I bashing this idea. I do believe that she is correct when saying a lot of times people are sick because of the fact that live in terrible situations. But instead of putting another task on a doctor's shoulders, lets better make known the resources that are out there. She is very valid on the idea that health care does not always keep us healthy. Pretty much you use your health care when you are already sick. I think this preventative form needs to be an added branch of the health care system already in place. But where do we start this? What's the best way to get this information out to those who need it the best? Also, maybe this is something that can be put into place in schools. I think this is something that could be beneficial to our health care system. As well as it would keep people out of clinics and ER's because it was preventable. Good ideas, but implementation needs tweaked. However, I supportive the concept.

  84. Metazoxan Dexall says:

    One of the problems I can see with a system that allows perscribing and paying for things like food is there will be plenty who will try to exploit that so that they can get free food and such.

    I'm not saying a system that aims more to "keep us healthy" rather that treating sickness is bad. But you do have to keep in mind the exploit ability of such a system.

  85. Tyler Kwapis says:

    Rebecca brings up an idea that is innovative and new. However, I do not believe that it is the duty of a doctor to provide families things like nutritious food and housing. Yes, I understand that some people are better off than others, while others are struggling behind. However, I believe there are some questions that must be answered when looking at a model like Ms Onie suggests. First, who pays for this new health system? Is it the doctors that dig into their pockets to provide heat and food to their patients. No, of course not. Doctors need to be payed well for their job, or else we will not have good doctors. Taxpayers will have to bear the load of this new cost. Although I agree that a preventative health system is a brilliant idea, and a model that we should move towards some day, but at what cost and to who. Should we penalize the normal, healthy, taxpayer because their neighbor cannot feed themselves?

    Also, if we delve into prescribing housing, heat, and nutritious food to student, what other patients suffer due to increased time and spending on these new patients? Doctors have a duty to help people who are sick, who are dying due to terminal illnesses. Resources that could be used to help develop cures to these diseases or treat patients with them, are instead being used to redistribute the nation's wealth for those who can not work hard enough to prevent their own illnesses.

    Again, I think that Rebecca's story is significant and inspiring, and that it should be where we head in healthcare. However, I believe at the end of the day there are still many questions that need to be answered in order to create a system that is fair to all.

  86. Maria Lynn says:

    What's so great about the Health Leads program is it not only provides patients with the services the need, but it educates them as well. Education is what is so desperately needed to be given to these individuals who are living in squalor, or are malnurished in some way. With education, individuals aren't just given a perscription or a new diet plan, they are given a new LIFE plan that they can use for many different areas of their life. Education really is the greatest tool. But one thought that I had while watching this lecture was that this crisis she was describing that occured in the 1960s is happening again RIGHT NOW. With all of the new legislation being put into place about heathcare, and the repeal of the Affordable Health Care Act, people are suffering! There are people starving, people dying, people living an awful quality of life because now, they have no healthcare; it's been stripped from them. Of course, unfortunately, there are always people who are living this way, it's not an old or new concept. But it is espscially apparent in the current times because of what is happening with healthcare. And it is just going to get worse until systems such as Health Leads prevail and allow healthcare to acutally help patients get well.

  87. zaburashaid abdullah says:

    There is a saying that “ An Apple a day Keeps a doctor away”, it is the basic thing for everyone. In this video I have found everything related to a good and healthy food. These days people are busy in visiting the doctor for diseases they have generated by themselves. What if we get the healthy food or a food that has nutrition’s and other things which is good for our health. We don’t have to go the doctor, and yes it is a reality that doctors are curing the diseases and they are giving the medicines which also have the side effects. What it means that you have to take a good care of your health. When you take a healthy diet, your health will be better. One side you are paying for the medicines and on their side, you are also paying for the food. Why not you just pay for the healthy food and save the money.

  88. Michael Mallal says:

    Is the real problem over-population, that is to say, lack of contraception? The right to plan one's family is also in UDHR I think.

  89. Michael Mallal says:

    Yes, although food may be unavailable there is always plenty of money for alcohol, tobacco and poker machines..

  90. Michael Mallal says:

    Emperor Ashoka of India apparently built hospitals for sick animals. Beat that.

  91. Michael Mallal says:

    Patients in the waiting room can brink their own books, laptops and rosaries to keep themselves productive. Maybe they want to sit around and have a rest before having their BP taken?

  92. Kathy says:

    Brilliant, – impassioned, rational and inspirational! The only thing missing was a call for patients to share the responsibility for their own health. Part of the system that Rebecca identifies as problematic is the traditional role of the doctor as expert who takes responsibility for health outcomes and the role of the patient who has been trained to be passive and compliant, but not proactively responsible for making healthy choices

  93. Patricio Cabrera says:

    Great speech and kudos to following your vision.

  94. walter makokha says:

    "When you have a vision, you have an obligation to realize that vision." I couldn't agree more

  95. Pat Allen says:

    So can I bill my insurance for my vacation I need for my mental health??

  96. Not A Government Agent says:

    Hard to listen to someone that's obese talk about health issues. Like, you can't keep yourself at a healthy weight, you have nothing to offer on this subject. Go for a run instead.

  97. Lily White says:

    A ham planet talking about health?
    These obeasts deserve nothing but contempt and disgust.
    Fat shaming needs to become not only acceptable but encouraged as the only form of communication with tats.

  98. Rollz7272 says:

    We need minds like this in government if we ever want real change. And not just one or two, a majority.

  99. Benjamin Down says:

    What if the public ate REAL FOOD and not processed garbage and didn’t expect the healthcare system to fix their follies??

  100. Joshua VanVleet says:

    Pretty damn inspired.

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