Dr. Nicholas Andreadis, though now retired, has worn many hats in his twenty-year Kalamazoo residency, tempering his perspective of the Affordable Care Actâ€™s adoption in this community. Prior to his service at Western Michigan University and his ultimate position as Dean of the Universityâ€™s Lee Honors College, he trained and, consequently, practiced as a medical physician. I met with Dr. Andreadis at Oakland Driveâ€™s Water Street Coffee Jointâ€”a space of diverse, morning coffee-drinkers that likely reflects a portion of the community affected by Enroll Kalamazooâ€™s efforts. In reflecting upon his motivations to partner with this coalition as an independent volunteer, Dr. Andreadis noted that the most rewarding dimension of his contribution was engaging with Kalamazoo residents such as these. He remarked that despite early â€œuncertaintyâ€ that accompanied the novelty of the legislationâ€™s reforms, â€œ[the newly enrolled] were uniformly thrilled. I mean, they were a little scaredâ€¦ they had to express some of their vulnerabilities. But, some of them were moved to tears. Others were just thankful that there were people there who care about themâ€¦So you had this surrounding rhetoric from politicians on all sides and then you had the real people.â€ A sense of security and â€œdignityâ€ that accompanies this elation in possessing health insurance, he believes, indicates a successful beginning in a changing health care landscape.
Yet, Dr. Andreadis conceded that the advent of more equitable access to care must be supplemented with educational measures aimed to â€œempowerâ€ the newly insured â€œto take care of themselves.â€ These efforts to engage the community with its health, he asserted, will likely function in three ways: â€œâ€¦you have this passive education, which has a placeâ€”a small place in my mindâ€”, then you have an active participation by people mentoring,…and then you have to have some policy and systems changes.â€ The alliance of these tiered educational efforts, he purports, can not only improve the ease in which newly insured residents navigate the current health system, but will, furthermore, better the circumstances determining community-wide ability to live in health. Yet, languageâ€”and, more broadly, communicationâ€”will certainly be a barrier in conducting these changes in public sentiment and structure. Indeed, Dr. Andreadis articulated, that consideration of both â€œlanguage translationâ€ and â€œcultural translation,â€ in conjunction with an effort of care providers to â€œunderstand what motivates their patient to changeâ€ will result in fairer, higher-quality health care.
However, most fundamentally, Dr. Andreadis emphasized the necessity of collective action and participationâ€”much like that which is occurring in the Enroll Kalamazoo coalitionâ€”to enhance access to and equitability of health care. Indeed, he notes that the Kalamazoo communityâ€” and certainly its healthâ€”will benefit from the engagement of all, diverse residents: â€œ…if we begin to create systems that marginalize or reinforce marginalization, then weâ€™re losing assets. So, from a perspective of…complex problem solvingâ€”problem solving that needs everyone engagedâ€”we have to move forward.â€