With one of the most dire healthcare situations in America, advocates for healthcare reform in Mississippi are turning to an unexpected source for inspiration: The Islamic Republic of Iran. Like Mississippi, pre-revolutionary Iran did little in terms of providing healthcare services to rural areas. But after the 1979 Islamist takeover, Iran installed a system of community health centers and workers who give primary care with a focus on preventative medicine.
In a fascinating story for the New York Times Magazine, journalist Suzy Hansen explored how advocates in Mississippi are drawing on lessons of the Iranian experience to improve rural healthcare in their own state. One such advocate, a consultant to the Mississippi project name James Miller, told Hansen:
When the Iranian system was developed in the 1980s, there were no doctors in rural Iran. And this is similar to the problem in the [Mississippi] delta today.
Hansen described an Iranian system of building “health houses” that served anyone within an hour’s walking distance. She wrote:
Today, 17,000 health houses serve 23 million rural Iranians. Health disparities between rural and urban Iranians have narrowed; the Iranians have reduced rural infant mortality by 75 percent and lowered the birthrate.
Health statistics reveal an abysmal situation in rural Mississippi, with high infant mortality and teen birth rates, little access to nutritional food, deaths due to AIDS at rates 64 percent higher than the U.S. average, and the lowest ratio of doctors to residents in the country. As with many of the nation’s poor, Mississippians without insurance go to emergency rooms for primary care when health problems arise — and many don’t pay, increasing the burden on taxpayers.
That’s why Dr. Aaron Shirley helped found HealthConnect, a community-based healthcare system inspired by Iran’s reforms, in 2010. The budding community centers — where trained staff administer primary care, make home visits and encourage patients to undertake crucial preventative steps toward more healthy lives — are an inexpensive to set-up and operate, but pay huge dividends in savings on health care costs.
Hansen noted that the Affordable Care Act (ACA) — commonly known as “Obamacare” — stands to benefit “8,300 centers serving 20 million” across the country, including in Mississippi:
[T]he Affordable Care Act will give $11 billion to community health centers, a sum that will double the numbers and capacity of centers nationwide….
The Affordable Care Act has created “accountable care organizations” that include doctors, social workers, nurses and pharmacists working together to serve patients. Since May, also as part of health care reform, the Centers for Medicare and Medicaid Services announced more than 100 multimillion-dollar grants to organizations that proposed new ways to prevent illness and save money. Its Innovation Center awarded grants to a large number of experimental programs that involve community health workers.
By harnessing these innovations in healthcare from abroad with a 30-year working track record, the ACA stands to both improve health care and reduce the costs of reactive care for the uninsured.