Health care is a social justice issue

Mark Secord has worked in health care for more than 30 years and seen a lot of change.

When I stopped by his office near Yesler Terrace, he'd been listening to President Obama speak about health-care overhaul.

Secord's eyes were glistening. He was moved by the speech and by the bill Obama signed Tuesday. "It's so easy to get lost in all of the complexity, and all the technical details ... " Secord said.

But, "Fundamentally our nation has taken a huge step forward in doing the socially just thing by providing coverage to 32 million Americans who don't have it now."

Secord is the executive director of Neighborcare Health, a nonprofit that provides mental, dental and medical care to about 50,000 people a year in Seattle.

Most of its patients are poor, and 40 percent of them have no medical insurance.

Community health centers like the ones he supervises have been plugging health-care gaps since the 1960s.

Health care as a social-justice issue is at the root of community health care.

Secord said that about 45 years ago, the first two community health clinics in the U.S. were set up in rural Mississippi and in a poor area of Boston. They were inspired by clinics in South Africa that treated people whose options were limited because of apartheid.

Community clinics operate across the country now and share a common goal: to work toward 100 percent access and zero percent disparities in health care.

He impresses on new staff members that more than taking on a job, they are joining a movement.

Secord said he got from his father, who was an alderman in Madison, Wis., the belief that everyone should spend time serving their community. His father was also on the hospital board, and Secord chose health administration as his career path.

He first came to Seattle as an administrative resident at Virginia Mason when he was 25.

He joined the staff in the '70s and rose to the upper administrative ranks before leaving 13 years ago to lead Neighborcare (then called Puget Sound Neighborhood Health Centers).

Mainstream health care was drifting toward commercialization, toward health care as a commodity and not a service, and that bothered Secord.

Still, while at Virginia Mason he helped create partnerships with community clinics and helped build a relationship with Bailey-Boushay House, which provides residential care to people who have life-threatening diseases.

His mentor at Virginia Mason, former hospital vice president Austin Ross, was inducted into the Health Care Hall of Fame this week, along with the late Sen. Ted Kennedy.

Secord took a 50 percent pay cut to make the move to Neighborcare Health, but he said, "I have the best job in health care."

People have been asking him two opposite questions about the impact of the overhaul on Neighborcare. Does this mean the clinic won't be needed now? And does the law mean financial easy street for Neighborcare?

As to the first question, he said the newly insured will need doctors, which the clinic provides. And even though people will be required to get insurance, some just won't. That's been the experience in Massachusetts, which already requires coverage.

His answer to the second question: No, the clinic won't see a big windfall. But the bill will make things better. The new law provides $11 billion in new funding for organizations like Neighborcare, which gets about 10 percent of its funding from the federal government.

Secord doesn't think the new system is perfect. He agrees with Rep. Jim McDermott, a Seattle Democrat, that we'll be tinkering with the law for years to come.

Secord said the law is more about insurance changes than overhauling the health-care system. He'd like to see more emphasis on primary care and prevention, and on waste reduction.

But he said the change is a big step in the right direction.

By adopting the law, "We've said we're in this boat together, and that eclipses everything else," Secord said.

That unity is what it means to be one nation.

Jerry Large's column appears Monday and Thursday. Reach him at 206-464-3346 or jlarge@seattletimes.com.