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November 18, 2016

Healthy Communities are Good Policy

With Election Day in the rearview mirror, attention is turning to what a Trump presidency will bring. We’re watching the changes closely.

With Election Day in the rearview mirror, attention is turning to what a Trump presidency will bring. We’re watching the changes closely. After all, the current administration ushered in big healthcare shifts such as the Affordable Care Act, value-based pricing and Medicaid expansion. Will the future bring similar change? Potentially.

A recent New England Journal of Medicine article ranked healthcare as the third highest issue for voters this election cycle, with only 16 percent naming it the most important factor. Issues like the economy and national security dominated instead. This tells me that while important items remain to be fixed—access, cost of care, drug pricing—it also means we as a country and healthcare system are doing some things right.

Increased momentum around value-based payment, for example, has worked. Medicare is viewed by both Republicans and Democrats as a working solution. Expect continued support or incremental change here. We’ll also likely see a theme of increased state flexibility for Medicaid programs. Other aspects of the Affordable Care Act, however—especially the structure of the exchanges—came into question prior to the election and will remain under scrutiny.

From a Wisconsin healthcare perspective, it will be interesting to see how Speaker Paul Ryan’s ideas play a role in conservative strategies such as allowing consumers to buy insurance across state lines or the creation of state high-risk pools.

One issue that seems to have bipartisan support is pharmaceutical industry reform. The Epi Pen example has captured headlines lately, and when you watch the evening news you see one expensive drug ad after another. In most developed countries, such decisions are left to patients and their doctors, not advertising. Can we afford to continue down this path? I’m optimistic leaders will come together to say, “Let’s do something that makes sense as the pricing state of pharmaceuticals isn’t working so well.”

Recently, I heard an observation that if your candidate wins, it’s rarely as good as you expect. Likewise, if your candidate loses, it’s rarely as bad. A good reminder for all of us. While it’s impossible to see the future, it’s not impossible to see where we need to improve.

According to the Robert Wood Johnson Foundation, lifestyle and behavior choices make up 30 percent of health, and socioeconomics and environment make up 50 percent. That means that when employers and public officials invest in a healthy community and a good working environment, it greatly impacts overall well-being. Let me share a few local examples that give me hope we’re on the right track.

  • Fox Valley Voices of Men – More than 1,000 area men are engaged in building a culture of Healthy Manhood. The rate of domestic violence and assault has gone down as a result, and not only is our environment safer and more productive, it’s more vibrant as well.
  • United Way Fox Cities, the Community Foundation, POINT and many others – When we’re focused on creating a healthy community and lasting positive change, it comes back to help us too. Together, we create a more fun, joyful community in which to live.

So, during the next four years, I encourage us to focus on what we can agree on. A healthy community is good business, good policy and good for each of us individually too.

— Dr. Dean Gruner is president and CEO of Appleton-based ThedaCare. To send your thoughts to him, email