When I received the call to be an ACYPL delegate to Vietnam and Thailand, the two areas I knew would be top of mind for me would be leadership and health care policy, due in large measure to my current work at the nonpartisan Center for Health Care Strategies and my past work in Medicaid.  While in Vietnam, the delegation had the opportunity to engage with the Health Ministry.  The leaders there are in the midst of developing a long range plan for improving Vietnam’s health system, which is a constitutionally guaranteed right.  There’s no question that they have their work cut out for them due in large measure to the growing population– in a country of nearly 90 million people, 70 percent of them are workers between the ages of 15-64. In addition to attending to the needs of a health care delivery that will need to serve an aging population over the next 20-40 years, the Ministry of Health is tackling many public health challenges that are common to developing nations in southeast Asia – food and water safety, vaccine access, and communicable disease prevention. The biggest “ah-ha” moment for me in our meeting with  the minister and his leadership team is that in their research and planning to improve health care delivery and access they are considering embracing many US health cost containment or reform efforts including one that continues to drive ObamaCare implementation known as the “Triple Aim”. This effort, penned by former CMS Administrator Don Berwick, seeks to develop a system that embraces three key pinnacles – better health, better quality care at a lower cost – something we can surely all agree on, regardless of which side of the aisle or Pacific we are on.

Prior to the trip, I was very excited to learn more about Thailand’s relatively new system of universal health care coverage, and our delegation’s meeting with former Thai prime minister Abhisit Vejjajiva did not disappoint.  Mr. Abhisit, the current opposition leader in the Thai Parliament, spent an hour with our delegation amid more flashing cameras and TV and radio microphones I have ever seen in a press briefing.  Shortly after meeting with the ACYPL group, Mr. Abhisit reported to the Department of Special Investigation (Thailand’s FBI), to face murder charges – heavy stuff regardless of your political leanings, and certainly the key reason for the intensity of the press coverage.  Throughout out meeting, Mr. Abhisit, one of the youngest political officials every elected in Thailand, deftly rolled through deep topics ranging from his own fate as a politician and an individual, the future of Thailand’s constitution, to the nuance of developing a sustainable benefit scheme for Thailand’s current universal access health system developed under his leadership. Mr. Abhisit understood in great detail the technical happenings here in the US around ObamaCare, and acknowledged that the hardest part of developing a system of care and coverage is to decide what health services are considered essential, a debate that continues today in US health policy.  My  mental vignettes from our meeting with Mr. Abhisit will not soon be forgotten, and the front page news story the day after our meeting with him will remain in my office as a source of inspiration for years to come.