0:00:00.500,0:00:01.944
So my freshman year of college

0:00:01.944,0:00:04.694
I signed up for an internship in the housing unit

0:00:04.694,0:00:06.894
at Greater Boston Legal Services.

0:00:06.894,0:00:08.547
Showed up the first day

0:00:08.547,0:00:10.863
ready to make coffee and photocopies,

0:00:10.863,0:00:15.445
but was paired with this righteous, deeply inspired attorney

0:00:15.445,0:00:16.914
named Jeff Purcell,

0:00:16.914,0:00:19.379
who thrust me onto the front lines

0:00:19.379,0:00:21.379
from the very first day.

0:00:21.379,0:00:23.144
And over the course of nine months

0:00:23.144,0:00:24.157
I had the chance

0:00:24.157,0:00:25.929
to have dozens of conversations

0:00:25.929,0:00:28.713
with low-income families in Boston

0:00:28.713,0:00:31.829
who would come in presenting with housing issues,

0:00:31.829,0:00:35.113
but always had an underlying health issue.

0:00:35.113,0:00:37.345
So I had a client who came in,

0:00:37.345,0:00:39.663
about to be evicted because he hasn't paid his rent.

0:00:39.663,0:00:41.951
But he hasn't paid his rent, of course,

0:00:41.951,0:00:44.445
because he's paying for his HIV medication

0:00:44.445,0:00:46.645
and just can't afford both.

0:00:46.645,0:00:47.996
We had moms who would come in,

0:00:47.996,0:00:49.379
daughter has asthma,

0:00:49.379,0:00:52.264
wakes up covered in cockroaches every morning.

0:00:52.264,0:00:54.237
And one of our litigation strategies

0:00:54.237,0:00:57.012
was actually to send me into the home of these clients

0:00:57.012,0:00:59.145
with these large glass bottles.

0:00:59.145,0:01:01.145
And I would collect the cockroaches,

0:01:01.145,0:01:04.163
hot glue-gun them to this poster board

0:01:04.163,0:01:06.195
that we'd bring to court for our cases.

0:01:06.195,0:01:07.473
And we always won

0:01:07.473,0:01:10.195
because the judges were just so grossed out.

0:01:10.195,0:01:12.344
Far more effective, I have to say,

0:01:12.344,0:01:15.195
than anything I later learned in law school.

0:01:15.195,0:01:17.745
But over the course of these nine months,

0:01:17.745,0:01:19.596
I grew frustrated with feeling

0:01:19.596,0:01:22.562
like we were intervening too far downstream

0:01:22.562,0:01:25.079
in the lives of our clients --

0:01:25.079,0:01:26.611
that by the time they came to us,

0:01:26.611,0:01:28.779
they were already in crisis.

0:01:28.779,0:01:31.595
And at the end of my freshman year of college,

0:01:31.595,0:01:33.279
I read an article about the work

0:01:33.279,0:01:35.061
that Dr. Barry Zuckerman was doing

0:01:35.061,0:01:37.197
as Chair of Pediatrics

0:01:37.197,0:01:38.597
at Boston Medical Center.

0:01:38.597,0:01:41.664
And his first hire was a legal services attorney

0:01:41.664,0:01:43.546
to represent the patients.

0:01:43.546,0:01:45.061
So I called Barry,

0:01:45.061,0:01:47.664
and with his blessing, in October 1995

0:01:47.664,0:01:49.729
walked into the waiting room

0:01:49.729,0:01:52.595
of the pediatrics clinic at Boston Medical Center.

0:01:52.595,0:01:53.928
I'll never forget,

0:01:53.928,0:01:56.812
the TVs played this endless reel of cartoons.

0:01:56.812,0:01:59.746
And the exhaustion of mothers

0:01:59.746,0:02:03.278
who had taken two, three, sometimes four buses

0:02:03.278,0:02:05.210
to bring their child to the doctor

0:02:05.210,0:02:07.094
was just palpable.

0:02:07.094,0:02:08.342
The doctors, it seemed,

0:02:08.342,0:02:09.861
never really had enough time for all the patients,

0:02:09.861,0:02:11.111
try as they might.

0:02:11.111,0:02:12.329
And over the course of six months,

0:02:12.329,0:02:14.010
I would corner them in the hallway

0:02:14.010,0:02:17.911
and ask them a sort of naive but fundamental question:

0:02:17.911,0:02:20.396
"If you had unlimited resources,

0:02:20.396,0:02:23.711
what's the one thing you would give your patients?"

0:02:23.711,0:02:26.411
And I heard the same story again and again,

0:02:26.411,0:02:29.361
a story we've heard hundreds of times since then.

0:02:29.361,0:02:32.926
They said, "Every day we have patients that come into the clinic --

0:02:32.926,0:02:34.627
child has an ear infection,

0:02:34.627,0:02:36.560
I prescribe antibiotics.

0:02:36.560,0:02:39.393
But the real issue is there's no food at home.

0:02:39.393,0:02:40.894
The real issue

0:02:40.894,0:02:43.128
is that child is living with 12 other people

0:02:43.128,0:02:44.626
in a two-bedroom apartment.

0:02:44.626,0:02:46.476
And I don't even ask about those issues

0:02:46.476,0:02:49.227
because there's nothing I can do.

0:02:49.227,0:02:51.065
I have 13 minutes with each patient.

0:02:51.065,0:02:53.634
Patients are piling up in the clinic waiting room.

0:02:53.634,0:02:56.319
I have no idea where the nearest food pantry is.

0:02:56.319,0:02:58.667
And I don't even have any help."

0:02:58.667,0:02:59.867
In that clinic, even today,

0:02:59.867,0:03:01.553
there are two social workers

0:03:01.553,0:03:04.284
for 24,000 pediatric patients,

0:03:04.284,0:03:07.136
which is better than a lot of the clinics out there.

0:03:07.136,0:03:10.167
So Health Leads was born of these conversations --

0:03:10.167,0:03:11.351
a simple model

0:03:11.351,0:03:12.866
where doctors and nurses

0:03:12.866,0:03:15.084
can prescribe nutritious food,

0:03:15.084,0:03:16.386
heat in the winter

0:03:16.386,0:03:18.968
and other basic resources for their patients

0:03:18.968,0:03:21.519
the same way they prescribe medication.

0:03:21.519,0:03:23.500
Patients then take their prescriptions

0:03:23.500,0:03:25.967
to our desk in the clinic waiting room

0:03:25.967,0:03:29.784
where we have a core of well-trained college student advocates

0:03:29.784,0:03:32.236
who work side by side with these families

0:03:32.236,0:03:33.535
to connect them out

0:03:33.535,0:03:36.751
to the existing landscape of community resources.

0:03:36.751,0:03:40.300
So we began with a card table in the clinic waiting room --

0:03:40.300,0:03:42.450
totally lemonade stand style.

0:03:42.450,0:03:45.770
But today we have a thousand college student advocates

0:03:45.770,0:03:50.070
who are working to connect nearly 9,000 patients and their families

0:03:50.070,0:03:53.271
with the resources that they need to be healthy.

0:03:53.271,0:03:54.787
So 18 months ago

0:03:54.787,0:03:57.572
I got this email that changed my life.

0:03:57.572,0:03:59.987
And the email was from Dr. Jack Geiger,

0:03:59.987,0:04:02.971
who had written to congratulate me on Health Leads

0:04:02.971,0:04:04.270
and to share, as he said,

0:04:04.270,0:04:06.906
a bit of historical context.

0:04:06.906,0:04:09.856
In 1965 Dr. Geiger founded

0:04:09.856,0:04:12.870
one of the first two community health centers in this country,

0:04:12.870,0:04:16.021
in a brutally poor area in the Mississippi Delta.

0:04:16.021,0:04:18.537
And so many of his patients came in

0:04:18.537,0:04:20.687
presenting with malnutrition

0:04:20.687,0:04:23.171
that be began prescribing food for them.

0:04:23.171,0:04:26.422
And they would take these prescriptions to the local supermarket,

0:04:26.422,0:04:27.520
which would fill them

0:04:27.520,0:04:30.338
and then charge the pharmacy budget of the clinic.

0:04:30.338,0:04:33.221
And when the Office of Economic Opportunity in Washington, D.C. --

0:04:33.221,0:04:35.056
which was funding Geiger's clinic --

0:04:35.056,0:04:36.255
found out about this,

0:04:36.255,0:04:37.455
they were furious.

0:04:37.455,0:04:39.204
And they sent this bureaucrat down

0:04:39.204,0:04:42.155
to tell Geiger that he was expected to use their dollars

0:04:42.155,0:04:43.621
for medical care --

0:04:43.621,0:04:47.021
to which Geiger famously and logically responded,

0:04:47.021,0:04:49.446
"The last time I checked my textbooks,

0:04:49.446,0:04:53.805
the specific therapy for malnutrition was food."

0:04:53.805,0:04:55.089
(Laughter)

0:04:55.089,0:04:57.788
So when I got this email from Dr. Geiger,

0:04:57.788,0:05:00.154
I knew I was supposed to be proud

0:05:00.154,0:05:01.821
to be part of this history.

0:05:01.821,0:05:03.037
But the truth is

0:05:03.037,0:05:05.029
I was devastated.

0:05:05.029,0:05:06.370
Here we are,

0:05:06.370,0:05:10.355
45 years after Geiger has prescribed food for his patients,

0:05:10.355,0:05:12.370
and I have doctors telling me,

0:05:12.370,0:05:16.437
"On those issues, we practice a 'don't ask, don't tell' policy."

0:05:16.437,0:05:18.870
Forty-five years after Geiger,

0:05:18.870,0:05:20.421
Health Leads has to reinvent

0:05:20.421,0:05:23.256
the prescription for basic resources.

0:05:23.256,0:05:26.421
So I have spent hours upon hours

0:05:26.421,0:05:29.755
trying to make sense of this weird Groundhog Day.

0:05:29.755,0:05:32.289
How is it that if for decades

0:05:32.289,0:05:35.058
we had a pretty straightforward tool for keeping patients,

0:05:35.058,0:05:37.655
and especially low-income patients, healthy,

0:05:37.655,0:05:39.556
that we didn't use it?

0:05:39.556,0:05:42.655
If we know what it takes to have a healthcare system

0:05:42.655,0:05:45.154
rather than a sick-care system,

0:05:45.154,0:05:47.187
why don't we just do it?

0:05:47.187,0:05:49.421
These questions, in my mind,

0:05:49.421,0:05:52.487
are not hard because the answers are complicated,

0:05:52.487,0:05:57.621
they are hard because they require that we be honest with ourselves.

0:05:57.621,0:06:00.721
My belief is that it's almost too painful

0:06:00.721,0:06:03.950
to articulate our aspirations for our healthcare system,

0:06:03.950,0:06:06.688
or even admit that we have any at all.

0:06:06.688,0:06:07.855
Because if we did,

0:06:07.855,0:06:09.471
they would be so removed

0:06:09.471,0:06:11.657
from our current reality.

0:06:11.657,0:06:14.620
But that doesn't change my belief

0:06:14.620,0:06:17.538
that all of us, deep inside,

0:06:17.538,0:06:21.105
here in this room and across this country,

0:06:21.105,0:06:24.021
share a similar set of desires.

0:06:24.021,0:06:26.154
That if we are honest with ourselves

0:06:26.154,0:06:28.455
and listen quietly,

0:06:28.455,0:06:30.271
that we all harbor

0:06:30.271,0:06:34.471
one fiercely held aspiration for our healthcare:

0:06:34.471,0:06:36.571
that it keep us healthy.

0:06:36.571,0:06:39.888
This aspiration that our healthcare keep us healthy

0:06:39.888,0:06:42.288
is an enormously powerful one.

0:06:42.288,0:06:44.905
And the way I think about this

0:06:44.905,0:06:47.089
is that healthcare is like any other system.

0:06:47.089,0:06:49.655
It's just a set of choices that people make.

0:06:49.655,0:06:51.456
What if we decided

0:06:51.456,0:06:53.872
to make a different set of choices?

0:06:53.872,0:06:56.904
What if we decided to take all the parts of healthcare

0:06:56.904,0:06:58.706
that have drifted away from us

0:06:58.706,0:07:01.172
and stand firm and say, "No.

0:07:01.172,0:07:03.139
These things are ours.

0:07:03.139,0:07:05.138
They will be used for our purposes.

0:07:05.138,0:07:07.162
They will be used to realize

0:07:07.162,0:07:09.093
our aspiration"?

0:07:09.093,0:07:10.843
What if everything we needed

0:07:10.843,0:07:12.988
to realize our aspiration for healthcare

0:07:12.988,0:07:14.571
was right there in front of us

0:07:14.571,0:07:16.455
just waiting to be claimed?

0:07:16.455,0:07:18.505
So that's where Health Leads began.

0:07:18.505,0:07:20.189
We started with the prescription pad --

0:07:20.189,0:07:22.588
a very ordinary piece of paper --

0:07:22.588,0:07:26.556
and we asked, not what do patients need to get healthy --

0:07:26.556,0:07:29.574
antibiotics, an inhaler, medication --

0:07:29.574,0:07:32.357
but what do patients need to be healthy,

0:07:32.357,0:07:34.904
to not get sick in the first place?

0:07:34.904,0:07:36.755
And we chose to use the prescription

0:07:36.755,0:07:38.537
for that purpose.

0:07:38.537,0:07:39.739
So just a few miles from here

0:07:39.739,0:07:41.523
at Children's National Medical Center,

0:07:41.523,0:07:43.789
when patients come into the doctor's office,

0:07:43.789,0:07:45.474
they're asked a few questions.

0:07:45.474,0:07:48.138
They're asked, "Are you running out of food at the end of the month?

0:07:48.138,0:07:49.704
Do you have safe housing?"

0:07:49.704,0:07:51.773
And when the doctor begins the visit,

0:07:51.773,0:07:54.606
she knows height, weight, is there food at home,

0:07:54.606,0:07:56.222
is the family living in a shelter.

0:07:56.222,0:07:59.106
And that not only leads to a better set of clinical choices,

0:07:59.106,0:08:03.156
but the doctor can also prescribe those resources for the patient,

0:08:03.156,0:08:06.822
using Health Leads like any other sub-specialty referral.

0:08:06.822,0:08:09.055
The problem is,

0:08:09.055,0:08:11.254
once you get a taste of what it's like

0:08:11.254,0:08:13.489
to realize your aspiration for healthcare,

0:08:13.489,0:08:15.007
you want more.

0:08:15.007,0:08:15.770
So we thought,

0:08:15.770,0:08:17.371
if we can get individual doctors

0:08:17.371,0:08:20.588
to prescribe these basic resources for their patients,

0:08:20.588,0:08:23.305
could we get an entire healthcare system

0:08:23.305,0:08:26.057
to shift its presumption?

0:08:26.057,0:08:27.304
And we gave it a shot.

0:08:27.304,0:08:28.739
So now at Harlem Hospital Center

0:08:28.739,0:08:32.525
when patients come in with an elevated body mass index,

0:08:32.525,0:08:34.389
the electronic medical record

0:08:34.389,0:08:38.189
automatically generates a prescription for Health Leads.

0:08:38.189,0:08:39.655
And our volunteers can then work with them

0:08:39.655,0:08:42.872
to connect patients to healthy food and excercise programs

0:08:42.872,0:08:44.304
in their communities.

0:08:44.304,0:08:45.438
We've created a presumption

0:08:45.438,0:08:47.005
that if you're a patient at that hospital

0:08:47.005,0:08:48.555
with an elevated BMI,

0:08:48.555,0:08:50.789
the four walls of the doctor's office

0:08:50.789,0:08:52.641
probably aren't going to give you everything

0:08:52.641,0:08:53.823
you need to be healthy.

0:08:53.823,0:08:55.223
You need more.

0:08:55.223,0:08:55.904
So on the one hand,

0:08:55.904,0:08:57.601
this is just a basic recoding

0:08:57.601,0:08:59.306
of the electronic medical record.

0:08:59.306,0:09:01.024
And on the other hand,

0:09:01.024,0:09:02.673
it's a radical transformation

0:09:02.673,0:09:04.841
of the electronic medical record

0:09:04.841,0:09:08.723
from a static repository of diagnostic information

0:09:08.723,0:09:11.557
to a health promotion tool.

0:09:11.557,0:09:12.674
In the private sector,

0:09:12.674,0:09:15.294
when you squeeze that kind of additional value

0:09:15.294,0:09:17.041
out of a fixed-cost investment,

0:09:17.041,0:09:19.641
it's called a billion-dollar company.

0:09:19.641,0:09:21.022
But in my world,

0:09:21.022,0:09:24.423
it's called reduced obesity and diabetes.

0:09:24.423,0:09:26.306
It's called healthcare --

0:09:26.306,0:09:29.289
a system where doctors can prescribe solutions

0:09:29.289,0:09:30.839
to improve health,

0:09:30.839,0:09:32.988
not just manage disease.

0:09:32.988,0:09:34.522
Same thing in the clinic waiting room.

0:09:34.522,0:09:36.139
So every day in this country

0:09:36.139,0:09:37.639
three million patients

0:09:37.639,0:09:42.133
pass through about 150,000 clinic waiting rooms in this country.

0:09:42.144,0:09:44.117
And what do they do when they're there?

0:09:44.117,0:09:47.567
They sit, they watch the goldfish in the fish tank,

0:09:47.567,0:09:50.050
they read extremely old copies

0:09:50.050,0:09:52.333
of Good Housekeeping magazine.

0:09:52.333,0:09:55.566
But mostly we all just sit there forever, waiting.

0:09:55.566,0:09:56.917
How did we get here

0:09:56.917,0:10:00.266
where we devote hundreds of acres and thousands of hours

0:10:00.266,0:10:02.049
to waiting?

0:10:02.049,0:10:03.266
What if we had a waiting room

0:10:03.266,0:10:05.367
where you don't just sit when you're sick,

0:10:05.367,0:10:07.233
but where you go to get healthy.

0:10:07.233,0:10:09.750
If airports can become shopping malls

0:10:09.750,0:10:12.716
and McDonald's can become playgrounds,

0:10:12.716,0:10:16.149
surely we can reinvent the clinic waiting room.

0:10:16.149,0:10:18.183
And that's what Health Leads has tried to do,

0:10:18.183,0:10:20.466
to reclaim that real estate and that time

0:10:20.466,0:10:21.898
and to use it as a gateway

0:10:21.898,0:10:22.950
to connect patients

0:10:22.950,0:10:25.717
to the resources they need to be healthy.

0:10:25.717,0:10:27.233
So it's a brutal winter in the Northeast,

0:10:27.233,0:10:29.700
your kid has asthma, your heat just got turned off,

0:10:29.700,0:10:31.867
and of course you're in the waiting room of the ER,

0:10:31.867,0:10:34.399
because the cold air triggered your child's asthma.

0:10:34.399,0:10:37.316
But what if instead of waiting for hours anxiously,

0:10:37.316,0:10:39.516
the waiting room became the place

0:10:39.516,0:10:42.000
where Health Leads turned your heat back on?

0:10:42.000,0:10:43.618
And of course all of this requires

0:10:43.618,0:10:45.566
a broader workforce.

0:10:45.566,0:10:48.733
But if we're creative, we already have that too.

0:10:48.733,0:10:51.119
We know that our doctors and nurses

0:10:51.119,0:10:52.466
and even social workers

0:10:52.466,0:10:53.934
aren't enough,

0:10:53.934,0:10:55.583
that the ticking minutes of health care

0:10:55.583,0:10:57.001
are too constraining.

0:10:57.001,0:10:59.050
Health just takes more time.

0:10:59.050,0:11:01.849
It requires a non-clinical army

0:11:01.849,0:11:04.533
of community health workers and case managers

0:11:04.533,0:11:06.149
and many others.

0:11:06.149,0:11:09.299
What if a small part of that next healthcare workforce

0:11:09.299,0:11:13.000
were the 11 million college students in this country?

0:11:13.000,0:11:15.766
Unencumbered by clinical responsibilities,

0:11:15.766,0:11:18.368
unwilling to take no for an answer

0:11:18.368,0:11:19.950
from those bureaucracies

0:11:19.950,0:11:21.883
that tend to crush patients,

0:11:21.883,0:11:23.833
and with an unparalleled ability

0:11:23.833,0:11:25.285
for information retrieval

0:11:25.285,0:11:28.266
honed through years of using Google.

0:11:28.266,0:11:30.799
Now lest you think it improbable

0:11:30.799,0:11:32.416
that a college volunteer

0:11:32.416,0:11:34.199
can make this kind of commitment,

0:11:34.199,0:11:35.766
I have two words for you:

0:11:35.766,0:11:38.117
March Madness.

0:11:38.117,0:11:42.084
The average NCAA Division I men's basketball player

0:11:42.084,0:11:45.349
dedicates 39 hours a week to his sport.

0:11:45.349,0:11:47.501
Now we may think that's good or bad,

0:11:47.501,0:11:50.183
but in either case it's real.

0:11:50.183,0:11:52.368
And Health Leads is based on the presumption

0:11:52.368,0:11:53.750
that for too long

0:11:53.750,0:11:56.300
we have asked too little of our college students

0:11:56.300,0:12:00.065
when it comes to real impact in vulnerable communities.

0:12:00.065,0:12:01.418
College sports teams say,

0:12:01.418,0:12:03.483
"We're going to take dozens of hours

0:12:03.483,0:12:07.367
at some field across campus at some ungodly hour of the morning

0:12:07.367,0:12:10.183
and we're going to measure your performance, and your team's performance,

0:12:10.183,0:12:12.349
and if you don't measure up or you don't show up,

0:12:12.349,0:12:13.799
we're going to cut you off the team.

0:12:13.799,0:12:15.687
But we'll make huge investments

0:12:15.687,0:12:16.899
in your training and development,

0:12:16.899,0:12:20.317
and we'll give you an extraordinary community of peers."

0:12:20.317,0:12:22.132
And people line up out the door

0:12:22.132,0:12:24.917
just for the chance to be part of it.

0:12:24.917,0:12:26.134
So our feeling is,

0:12:26.134,0:12:27.617
if it's good enough for the rugby team,

0:12:27.617,0:12:29.732
it's good enough for health and poverty.

0:12:29.732,0:12:33.000
Health Leads too recruits competitively,

0:12:33.000,0:12:34.481
trains intensively,

0:12:34.481,0:12:36.450
coaches professionally,

0:12:36.450,0:12:38.399
demands significant time,

0:12:38.399,0:12:39.766
builds a cohesive team

0:12:39.766,0:12:41.250
and measures results --

0:12:41.250,0:12:43.933
a kind of Teach for America for healthcare.

0:12:43.933,0:12:46.033
Now in the top 10 cities in the U.S.

0:12:46.033,0:12:48.352
with the largest number of Medicaid patients,

0:12:48.352,0:12:51.566
each of those has at least 20,000 college students.

0:12:51.566,0:12:54.767
New York alone has half a million college students.

0:12:54.767,0:12:57.816
And this isn't just a sort of short-term workforce

0:12:57.816,0:13:00.066
to connect patients to basic resources,

0:13:00.066,0:13:03.667
it's a next generation healthcare leadership pipeline

0:13:03.667,0:13:06.117
who've spent two, three, four years

0:13:06.117,0:13:07.618
in the clinic waiting room

0:13:07.618,0:13:11.602
talking to patients about their most basic health needs.

0:13:11.602,0:13:13.351
And they leave with the conviction,

0:13:13.351,0:13:15.183
the ability and the efficacy

0:13:15.183,0:13:18.966
to realize our most basic aspirations for health care.

0:13:18.966,0:13:21.984
And the thing is, there's thousands of these folks already out there.

0:13:21.984,0:13:25.801
So Mia Lozada is Chief Resident of Internal Medicine

0:13:25.801,0:13:27.216
at UCSF Medical Center,

0:13:27.216,0:13:29.549
but for three years as an undergraduate

0:13:29.549,0:13:31.182
she was a Health Leads volunteer

0:13:31.182,0:13:34.184
in the clinic waiting room at Boston Medical Center.

0:13:34.184,0:13:37.899
Mia says, "When my classmates write a prescription,

0:13:37.899,0:13:39.917
they think their work is done.

0:13:39.917,0:13:41.633
When I write a prescription,

0:13:41.633,0:13:43.900
I think, can the family read the prescription?

0:13:43.900,0:13:46.083
Do they have transportation to the pharmacy?

0:13:46.083,0:13:48.533
Do they have food to take with the prescription?

0:13:48.533,0:13:50.783
Do they have insurance to fill the prescription?

0:13:50.783,0:13:53.466
Those are the questions I learned at Health Leads,

0:13:53.466,0:13:55.216
not in medical school."

0:13:55.216,0:13:57.200
Now none of these solutions --

0:13:57.200,0:14:00.170
the prescription pad, the electronic medical record,

0:14:00.170,0:14:01.317
the waiting room,

0:14:01.317,0:14:02.485
the army of college students --

0:14:02.485,0:14:03.668
are perfect.

0:14:03.668,0:14:06.168
But they are ours for the taking --

0:14:06.168,0:14:07.500
simple examples

0:14:07.500,0:14:11.001
of the vast under-utilized healthcare resources

0:14:11.001,0:14:13.916
that, if we reclaimed and redeployed,

0:14:13.916,0:14:17.333
could realize our most basic aspiration

0:14:17.333,0:14:19.117
of healthcare.

0:14:19.117,0:14:22.333
So I had been at Legal Services for about nine months

0:14:22.333,0:14:25.066
when this idea of Health Leads started percolating in my mind.

0:14:25.066,0:14:28.000
And I knew I had to tell Jeff Purcell, my attorney,

0:14:28.000,0:14:29.419
that I needed to leave.

0:14:29.419,0:14:30.382
And I was so nervous,

0:14:30.382,0:14:32.916
because I thought he was going to be disappointed in me

0:14:32.916,0:14:35.966
for abandoning our clients for some crazy idea.

0:14:35.966,0:14:37.950
And I sat down with him and I said,

0:14:37.950,0:14:39.833
"Jeff, I have this idea

0:14:39.833,0:14:42.252
that we could mobilize college students

0:14:42.252,0:14:45.186
to address patients' most basic health needs."

0:14:45.186,0:14:46.767
And I'll be honest,

0:14:46.767,0:14:50.066
all I wanted was for him to not be angry at me.

0:14:50.066,0:14:51.533
But he said this,

0:14:51.533,0:14:54.881
"Rebecca, when you have a vision,

0:14:54.881,0:14:58.732
you have an obligation to realize that vision.

0:14:58.732,0:15:01.833
You must pursue that vision."

0:15:01.833,0:15:05.099
And I have to say, I was like "Whoa.

0:15:05.099,0:15:07.116
That's a lot of pressure."

0:15:07.116,0:15:08.515
I just wanted a blessing,

0:15:08.515,0:15:10.066
I didn't want some kind of mandate.

0:15:10.066,0:15:11.633
But the truth is

0:15:11.633,0:15:14.416
I've spent every waking minute nearly since then

0:15:14.416,0:15:16.200
chasing that vision.

0:15:16.200,0:15:19.382
I believe that we all have a vision

0:15:19.382,0:15:21.283
for healthcare in this country.

0:15:21.283,0:15:23.482
I believe that at the end of the day

0:15:23.482,0:15:25.316
when we measure our healthcare,

0:15:25.316,0:15:28.132
it will not be by the diseases cured,

0:15:28.132,0:15:30.650
but by the diseases prevented.

0:15:30.650,0:15:33.667
It will not be by the excellence of our technologies

0:15:33.667,0:15:36.167
or the sophistication of our specialists,

0:15:36.167,0:15:38.966
but by how rarely we needed them.

0:15:38.966,0:15:40.450
And most of all,

0:15:40.450,0:15:42.967
I believe that when we measure healthcare,

0:15:42.967,0:15:45.650
it will be, not by what the system was,

0:15:45.650,0:15:48.416
but by what we chose it to be.

0:15:48.416,0:15:49.483
Thank you.

0:15:49.483,0:15:59.733
(Applause)

0:15:59.733,0:16:01.000
Thank you.

0:16:01.008,0:16:10.331
(Applause)