Donald Trump signed a series of executive orders, including the “Global Gag Rule,” on January 23, 2017.
By Diana Bowser and Monica Jordan
The last few weeks of health policy changes in the United States have demonstrated that now, more than ever, we need socially conscious students with a deep understanding of these issues to strengthen health systems in the United States and around the world.
President Trump campaigned on the promise of undoing the Affordable Care Act (ACA), and by January 12, the Senate approved a budget that would allow its repeal. This was a first step in the process of dramatically decreasing both health care coverage and individual health care rights. Medicaid expansions are associated with significant reductions in mortality, and an estimated 29.8 million people will be without coverage if the ACA is repealed. People with pre-existing conditions who are currently protected under the ACA may lose coverage and face large out-of-pocket costs for services. Repealing the ACA would also impact Medicare, increasing premiums and prescription drug costs for seniors. In order to take action, it is imperative we understand the current system and all the possible fallout from these policy changes.
Starting with a global view of health systems can give students a broader understanding of system weaknesses and how to improve them. Health systems around the world are facing the demographic shock of rapidly aging populations and the parallel increase of chronic illness such as heart disease, cancer, and diabetes.
Consider the Middle East, a region with one of the highest breast cancer mortality rates for women under 60. Some of the richest countries in the world are located in this region, yet they are struggling to adapt their health systems to these changes. Our Master’s Program in Global Health Policy and Management teaches students how health systems are designed around the world and how to use lessons from other countries to improve your own system.
Over the next four years, we will need individuals capable of combating the notion of “alternative facts.” A Global Health Policy and Management degree teaches students to responsibly consume and interpret scientific research and data to build and defend an argument. They graduate with an arsenal of facts: For example, despite spending more on health care than any other country in the world, the U.S. maternal mortality rate has increased in the last 15 years to 28 per 100,000 live births, higher than most other high-income countries who spend much less on health care. Around the world, approximately 830 women die every day from preventable causes related to pregnancy and childbirth. Ischemic heart disease and stroke are responsible for 15 million deaths worldwide in 2015. Our students know these facts well, and can use them to protect marginalized communities around the world.
Finally, the Global Health Policy and Management degree at the Heller School attracts students from across the world, with typically 80 percent of each cohort from outside the U.S. During their year of study, they build networks with colleagues and faculty members, resulting in collaborations that often last beyond graduation.
We refuse to let policies based in fear, rather than facts, affect the work we are doing. We will continue to collaborate and build ties with graduates who are agents of change for healthcare systems globally. Many of the issues currently facing healthcare systems, such as the rise of chronic diseases, span countries and continents. It is imperative that we continue working together, and bringing diverse perspectives to tackle serious threats to human health.
Diana Bowser is an associate professor and director of the MS in Global Health Policy and Management program at the Heller School for Social Policy and Management at Brandeis University.
Monica Jordan is the assistant director for the MS in Global Health Policy and Management program at the Heller School for Social Policy and Management at Brandeis University.