Research Activities, January 2014
From the Director
I very much look forward in the New Year to working on AHRQ's revamped mission and priorities. A number of my experiences have shaped my views of health care and my vision for AHRQ.
In 1989, Alain Enthoven and I wrote an article that characterized health care in the United States as a paradox of excess and deprivation. At the time, we had approximately 30 million people without health insurance and a health care economy that spent more on health care than any other country in the world. It was clear then, as it is now, that making progress on both of those problems would make us collectively much better off. At a minimum, universal coverage is part of the bedrock of living in a decent society.
In 1993, when I worked in the Clinton Administration, my fourth-grade daughter opened her first AOL account and her password was 37mill, shorthand for 37 million, which then was the number of uninsured. I worked on increasing access to care in 1993-94, as I had worked on it in Massachusetts State government in the 1980s and, unfortunately, am still working on it now. I very much hope and expect not to be working on it 10 years from now.
We have the prospect of making great progress over the coming years in reducing the number of uninsured. The Affordable Care Act has also served as a catalyst for delivery system reform efforts, designed to increase the quality and value of the health care we receive. In the medium to long run, these efforts are likely to have as large or larger effect on the health of Americans as the coverage expansion, which understandably is receiving most of the media attention at this point.
We are making significant progress in reducing growth in health care costs, and in focusing on increasing quality and efficiency. But I'm sure we'll be struggling for decades with figuring out how to deliver high-quality, safe, accessible, equitable, and affordable care. The opportunity to work on creating the evidence base on how to achieve these outcomes, and to work with HHS and other partners on making sure the evidence is understood and used is incredibly exciting, and drew me to AHRQ.
Richard Kronick, Ph.D.