Although billed as a discussion of the health care reform effort, College President Jim Yong Kim's interview with PBS' Bill Moyers, which aired Friday night, was also a discourse on Kim's rise to the Dartmouth presidency and hopes for his coming tenure.
Kim, who took office as College president July 1, will be officially inaugurated on Sept. 22.
Moyers, who began the interview by recounting Kim's previous successes in the realm of global health, asked the College's new president to explain why he had decided to assume Dartmouth's helm.
Kim said he was motivated to take the positon, in part, because it affords him the opportunity to "train a group of young people who would leave the College energized and inspired," and who will go on to tackle global issues like health care.
"A lot of young people don't think they can make a difference," he said, later invoking the words of anthropologist Margaret Mead, "Never doubt that a small group of thoughtful, committed people can change the world. Indeed, it is the only thing that ever has."
The interview was taped on Thursday, just one day after President Barack Obama addressed a joint session of Congress in an attempt to move health care reform efforts away from the current quagmire.
"I thought, as a speech, it was really stunning and masterful," Kim said of Obama's address.
Kim said it was clear from the Republican response to the speech that members of both parties recognize the need for better quality health care at a lower cost.
The challenge now, he said, is to get the best and the brightest involved in reinventing the current system.
"There's no simple solution to this problem," Kim said.
Kim argued that the U.S. health care reform effort needs to particularly address the issue of health care delivery, specifically how care is provided.
"There is not a single medical school that I know of that teaches how we deliver health care," he said.
He cited Native American communities in New Mexico, where life expectancies are significantly lower than those in developing countries, as one of the great moral crises the country faces.
"We've been working under the fantasy that if we come up with medicines and new drugs, we're done, the rest of the system will take care of itself," he said.
Kim proposed that reformers focus on promoting "evaluative clinical sciences" analysis of variations in doctors' practices and how those variations impact patient care.Understanding why certain hospitals spend large amounts of money without delivering high-quality care will help to improve medical efficiency, Kim said.
"We need to rethink fundamentally the kind of research we do and the kind of people we educate what we need now is a whole new kind of people who understand the science, but also know how to make human systems work effectively," Kim said.
This analysis may also lead to the implementation of programs domestically that have shown promise in less-developed nations.
For example, Kim said that aid organizations such as Partners in Health, a non-profit organization he cofounded with Harvard University professor Paul Farmer, have found that better health outcomes are often assured when community health workers are engaged in the treatment process, visiting patients at home.
Kim referred to a recent study of an HIV program in Roxbury, Mass., that included home visits by community health workers. The study found that, with these visits, the cost of care and number of emergency room visits in the patient group decreased significantly.
Kim also discussed a need to maintain market incentives for pharmaceutical companies to develop new drugs and to lower the cost of treatment. He cited his work to make tuberculosis drugs available in third-world countries through cooperation with Doctors Without Borders and Eli Lilly as an example of an approach that could be applied in the United States.
Improving health care in third-world countries is in America's interest because of the potential that diseases like drug-resistant tuberculosis and bird flu could spread across the globe, Kim said.
"There's no question that in terms of infectious diseases, we are one planet," he said.
