This article first appeared in the St. Louis Beacon, Aug. 25, 2011 - The future of health care is hard to see, but Robert Hughes knows it's evolving.
"I think there is more of a receptivity to change but not in the sense of knowing how things are actually going to unfold; so it's a very interesting time right now," he said.
Whatever those changes may be, Hughes will get a front-row seat to their effect on the region. The visiting research professor at Rutgers University and 20-year-veteran of the Robert Wood Johnson Foundation was named Thursday morning as the next president and CEO of the Missouri Foundation for Health.
The 62-year-old succeeds Dr. James R. Kimmey who has led the non-profit since its creation a decade ago.
In an interview with the Beacon, Hughes said health care is in a time of transition nationally with the advent of the Affordable Care Act, the recent health care reform bill passed by a divided Congress and now implemented amid stormy court battles.
"It wasn't what I wanted in an ideal world but, certainly through the lens of the potential to do a lot of good, another 32 million people will have health insurance so the financial barriers for getting care to those folks will be reduced," he said. "There are also a number of other elements to the reform that I think were good."
Hughes said the picture gets murkier if the courts rule that the act's central provision, the requirement to buy health insurance, is unconstitutional. In the meantime, the outcome of the litigation wending its way to the Supreme Court remains a mystery.
"I'm no legal expert so I don't know," he said. "I do know that if the individual mandate is repealed, that may have an effect on some of the rest of the legislation because the logic of the legislation really depends on having everyone in the insurance pool."
Much like health care reform, Hughes said his own priorities as head of the foundation were still in formation.
"In some ways I think I need to understand Missouri a little bit better before I make those decisions because the work of the foundation really needs to take into account the communities here," he said. "Communities vary a lot and even the culture from one place to another can differ so what might be effective in one place might not work so well in another."
Hughes is no stranger to the Midwest, however. Born in Lincoln, Ill., he grew up in towns ranging from Kankakee to Peoria.
"I have to say I liked the Cubs back then," he admits with a laugh.
In a sense, Hughes said his passion for health care finds its roots early in his life.
"It stems more probably from my upbringing," he said. "I actually believed the stuff about equal opportunity and everyone having a fair chance. To me, that includes not only education but having a healthy start, too."
For him, it's a fundamental issue.
"It's just basic values," he said. "A society should have more equity in the provision of health services and the ability to get the care that people need. Unfortunately, that's not true right now. There is a lot of inequity in society."
But he makes it clear that the agency he heads isn't a base for advocacy but rather a non-profit designed to help others. He feels his experience with the larger Robert Wood Johnson organization will help him to take on his duties here.
"The foundation has a clear purpose, identify and fill gaps in service for the underserved and do that as effectively and efficiently as it can," he said. "To the extent that there are opportunities to advocate for things that promote that, that's a reasonable thing. We're not lobbyists so we don't advocate in a political sense."
In the end, Hughes said health care will need to roll with the punches to some extent. The big battle continues to be over how best to control the price tag for care, which has skyrocketed over time.
"I think it's very confused," he said. "Over the last two years, I'd say that one of the things that's happened is that the structure has loosened up and people throughout the health care system are thinking about the possibilities because the overriding concern of the inexorable rise of health care costs really is driving the public policy decisions and that is rippling down."
"People are beginning to see that things really have to change," he said.
Formed originally from the conversion of Blue Cross-Blue Shield of Missouri to a for-profit entity, the foundation is the biggest non-governmental funder of community health activities in the state issuing about $50 million in grants each year across 84 counties.
Hughes comes to the organization after an academic career that included stints at Arizona State University and the University of California-San Francisco. A philosophy and religion undergraduate from DePauw University, he did his masters work at Ohio State before earning a Ph.D. in behavioral health from Johns Hopkins University.
K. Beth Johnson, chair of the foundation's board, told attendees at a mid-morning press conference that she believes Hughes' experience in the health care field and in grant making will move the organization forward into a prosperous future.
"His peers call him an innovative thinker and expect him to challenge everyone around him to raise their passion for the mission," she said. "We look forward to that challenge."
Hughes, who is married and has three grown children, officially assumes his new position Nov. 1.
Editor's Note:
Funding for the Beacon's health reporting is provided in part by the Missouri Foundation for Health.
David Baugher is a freelance writer.