01
KHPA is facing some challenges in advancing its 2009 legislative agenda. What part of the agenda are you most eager to get passed?
KHPA’s agenda focuses on three items that are closely connected: implementing a statewide indoor smoking ban; increasing tobacco taxes by 75 cents per pack; and using that revenue to expand access to affordable insurance for small businesses, young adults, and poor parents. Reducing tobacco use among smokers and limiting the exposure of non-smokers to harmful second-hand smoke will improve public health overall and help control future growth in health care costs.

02
Critics of blanket smoking bans say that such actions represent unwarranted government intrusion into private enterprise. How do you respond to that?
Many suggest that what’s intrusive is a public policy that exposes children and adults to unhealthy second-hand smoke. Public establishments like bars and restaurants must provide an environment that is safe for their customers. Restaurants can’t serve spoiled food and must be clean. Why should the air be any different?

03
What’s the most important thing Kansans can do to improve their health?

Just remember what your mother told you. Eat a healthy diet. Get plenty of exercise. Get enough sleep. Don’t smoke. Don’t drink alcohol in excess. Look both ways before you cross the street, and always buckle up in the car..

04
Insurance coverage for the poorest Kansans has been a primary focus of KHPA’s work. What’s the best and most efficient way to provide coverage for this population?
The poorest children in Kansas already have coverage through HealthWave, our joint Medicaid/State Children’s Health Insurance Program. Medicaid also covers poor adults who are low-income and disabled, elderly, or pregnant. The challenge facing Kansas is covering “working poor” adults. It is KHPA’s position that the most efficient way of extending coverage to those who are poor is through the existing publicly funded insurance program, Medicaid.

05
The KHPA speaks of promoting personal responsibility in health care, both in behavior and sharing financial obligations. How do we convince sometimes reluctant taxpayers to share financial responsibility?
Some would say that we are already paying for universal health care because anyone can show up at an emergency room in America and get care. That is a federal law. When you look across the world and examine health care systems in other countries, you find that we’re paying more than we should, but we’re not getting good results. Investing in better health and more accessible health care is both a moral responsibility and an economic necessity.

06
There’s been a marked shift in recent years away from an emphasis on treatment and toward one of prevention. What kind of motivation can be used to help persuade people to make changes in their daily lives to improve their health?
Incentives have proven very effective in helping people to change their health behaviors. For example, in the state employee health plan, we have significantly improved our health and wellness benefits and offer a $50 gift card for employees and dependents who take a personal risk assessment. We are also providing a non-smokers discount on health insurance premiums for those who don’t smoke or those who smoke but have enrolled in a smoking cessation program.

07
One problem facing many rural Kansans is a dearth of primary care physicians. How can we solve this?
There are some terrific programs in Kansas that are intended to address this shortage of rural physicians – like the Medical Student Loan Program administered by KU. We are also developing and adopting a medical home model for Kansas that will increase reimbursement for primary care. But we need national leadership on the issue, particularly when it comes to low Medicaid reimbursements that are paid to rural primary care physicians.

08
How will defining a medical home benefit Kansans?
We believe the medical home model of care will lead to better, more efficient and more cost-effective health care for Kansans. The idea is that every patient should have coordinated, comprehensive, culturally sensitive care so that, in the end, we’re treating the whole patient, rather than a disjointed collection of symptoms or conditions.

09
You have a very diverse professional background…you spent time in the Peace Corps, you were in the military, and you were an aide to former Nebraska Senator Bob Kerrey. How has this wide range of experience shaped your views of health policy?
During my professional career, I have been blessed to know a lot of people with differing points of view. I have learned that there is more than one way to solve a problem, and that alternative views don’t have to lead to an impasse. Working closely with Dr. Barbara Atkinson and her team at KU Medical Center helped me to see the importance of developing a vision, and then having patience and resolve to make it come to fruition.

10
What are the best and worst parts of your job?
The best is having a job that allows me to impact public policy on issues that I have a tremendous passion for. The worst is that I find it hard to unwind and unplug. Fortunately, I have very entertaining seven-year-old twin daughters, and they inspire me to get back to reality. Nothing is more fun than seeing the world through their eyes. +