Lessons From Home
health care system. That’s good news. The better news
is his intimate knowledge of the reasons that reform
is so necessary. Perhaps no president has taken office
with such personal exposure to the critical aspects of
American health care—
especially the challenges we
face in restructuring a fractured system and bringing
costs and services into bal-
COVER: NEJM; COVER INSET: COURTESY MAT TEL; THIS PAGE: FROM LEF T, OBAMA PRESIDENTIAL CAMPAIGN/AP PHOTO; HO NE W/REU TERS; EMMANUEL DUNNAND/GE T T Y IMAGES
OBAMA’S MOTHER IN THE 1970S, AND GRANDMOTHER IN THE 1980S.
ance with needs. ; Lessons
from home, namely the experiences of his mother and
grandmother, will come into sharp focus
as Obama proposes his first federal bud-
get. His administration and Congress must
wrestle with the conflicting dynamics of a
soaring national debt, lagging revenue and
a $2 trillion annual health care bill that still
leaves 45 million Americans uninsured
and consumes one-quarter of the federal
budget—even as U. S. infant mortality rates are higher, and longevity
lower, than in the rest of the industrial world.
“My mother died very suddenly and very young,” Obama told the
AARP Bulletin last fall. [Read the complete interview at bulletin.aarp
.org.] Ann Dunham died in 1995 at age 52 after working as a consul-
tant for the U.S. Agency for International Development, the Ford
Foundation and Women’s World Banking. She taught her son an im-
portant lesson about access to health care. “She’d go from contract
to contract and would be able to buy health insurance [only] when
she got a new contract,” Obama said. “When she got sick, she had
just signed up for a new job, a new contract, and she had a lot of
arguments of whether this was a preexisting condition of which she
had no knowledge whatsoever.” Later he added, “As someone who
watched my mother argue with insurance companies while she lay in
bed dying of cancer, I will make sure those companies stop discrimi-
nating against those who are sick and who need care the most.”
From his grandmother, Madelyn Dunham, who continued living
in the same Honolulu apartment where he had been raised, Obama
learned important social and economics lessons about long-term care.
“What I’ve learned from watching my grandmother is
that with some modest help she’s able to remain indepen-
dent,” he told the Bulletin shortly before she died. “And
that costs the system much less than if she’d gone into a
long-term care facility. The problem we have is that so
much of our system is built around institutional care that
we end up spending more money than we need to and
probably with worse outcomes in a lot of cases.”
“These are not abstractions for me,” he said frequently
during the campaign. Nor are they abstractions for mil-
lions of Americans. As AARP’s leaders write in a letter to
the White House [see page 10], this is an important mo-
ment for the nation. With the approaching retirement
of 78 million boomers, reining in health care costs and
strengthening the core safety net are crucial to stabiliz-
ing the nation’s finances and establishing an upgraded
and rational system of health care. Starting points are
the leadership of the president and the firsthand lessons
he learned from his mother and grandmother. His first
book was titled Dreams From My Father. His next must
be “Lessons Learned.” —Jim Toedtman
Perhap no
president has
taken office
with such
personal
exposure to
the critical
aspects of
American
health care.
AARP Bulletin March 2009, Volume 50, No. 2 (USPS Number 002-900; ISSN 1044-1123) is published monthly except February and August by AARP, 601 E St. N. W., Washington, DC 20049 (telephone: 1-888-687-2277). Internet site: bulletin.aarp.org. Sales and Marketing Offices: AARP Publications, 780
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