Life and Death Matter

Ask the average person on the street for their view of the federal government’s involvement in the health care system, and you’re likely to get a wide variety of responses—most of them less than positive.

For some, Uncle Sam is simply a heavy-handed meddler. Remember, for example, the “keep the government out of my Medicare” shouts during the Affordable Care Act debate. And after the highly contentious legislation was passed, the disastrous rollout of the HealthCare.gov website led to the widespread view that government was out of its depth in attempting to set up such a complex network.

Then came the patient scheduling scandal at the Veterans Affairs Department, in which officials were alleged to have put bureaucratic interests ahead of providing quality, timely medical care to veterans. In one fell swoop, years of efforts to improve VA health systems and care delivery—which earned the agency high marks from veterans—were replaced in the public mind with horror stories of falsified patient waiting lists.

There are other stories, though, that aren’t told as often. For many people across the country, government- supported health care efforts are literally a lifesaver. And innovation in health-related systems and activities is making a genuine difference in the lives of some whose physical and mental health is at serious risk. 

We focus on two such efforts in this issue of the magazine. First, Frank Konkel explores the collaboration between the Army and the National Institute of Mental Health, starting in 2009, on the Study to Assess Risk and Resilience in Servicemembers. It grew out of deepening concern about the rising rate of suicides among soldiers. 

The officials involved in the study weren’t exactly shocked by the increase in suicides, given the increasing rate and frequency of deployments of military personnel to combat zones. But what did surprise them was finding that the suicide rate of soldiers who had not deployed grew even faster. 

A team of researchers began combing through hundreds of terabytes of data from Army personnel and administrative records and subjecting it to predictive analytics. As a result, they identified 5,000 service members who could be at risk of suicide. Now comes the tough part: figuring out—very carefully—exactly what to do with the data. That does not mean rushing to target soldiers who algorithms suggest are at risk of taking their own lives. But it does mean gaining a deeper understanding of the root causes of suicides. 

Also in this issue, Katherine McIntire Peters takes a look at a collaborative effort involving the Health and Human Services Department, the Centers for Medicare and Medicaid Services and the National Oceanic and Atmospheric Administration. They’ve created an interactive online map showing the locations of Americans who are dependent on dialysis machines and other electricity-powered medical equipment.

The project involves meshing Medicare claims reports with weather-tracking data to populate a geographic information system. That allows everyone from first responders to utility executives to identify vulnerable residents during an emergency. The system grew directly out of officials’ determination not to see a repeat of the health care horror stories that emerged in the aftermath of Hurricane Katrina 10 years ago.

These are just a couple of examples of government applying a dose of quiet innovation in the health sector. The results could be as extraordinary as they are unheralded.