Sunday, January 23, 2011

A Great Debate

NPR's Intelligence Squared US |

Should The Obama Health Care Law Be Repealed?

A great debate which begins to frame the conversation:

First Posting - Setting the Goals

For the whole of my architectural career I was drawn to one mission: to be in the art of place-making.  However, after graduating w/ Honors from Georgia Tech and finding myself jobless, I decided to wholeheartedly pursue an A/E firm instead of boutique design firm.  My idea was that such a firm would teach me about construction and I would "do my time."  After 1 enjoyable year at Michael Brady Inc and living in Knoxville, Tennessee, I knew I had to return to my home in Atlanta and refocus my career.

A small healthcare architecture firm, Stegenga + PARTNERS, would help me refocus on place-making.  I was and continue to feel pride when I tell others I specialize in healthcare.  I use it almost as a shield because if not, I will undoubtedly be bombarded w/ questions about how to remodel one's kitchen, or what is the best tile compound or worse: can you draw me a floor plan...

So I am now into my 6th year of my healthcare specialization and I have not yet fully understood why healthcare architects need to be "healthcare" architects.  With the help of this blog, I will try to understand the intersection of   healthcare, architecture and policy.  In short, my new mission is still place-making, but I now see place-making as the resultant of vectors.  Invisible forces like costs and access are impacting the practice of healthcare architecture.  We, architects, are part of the high costs of healthcare.  Our solutions to any programming problem is: a bigger space.  When clients want more program, we add more space.  We point to our healthcare guidelines as justification.

On this note, I would like to spend the next few months following healthcare reform and the impact on public health.  Here are the questions I must ask:

1.  How will The Affordable Care Act reduce healthcare spending/costs? 
2.  How will The Affordable Care Act promote healthy living?
3.  How will The Affordable Care Act impact urban/rural/regional hospitals?
4.  How will The Affordable Care Act constrain/expand hospital budgets?

I will explore these answers in the next few weeks by posting radio links, news articles, and opinions from all sides.  I will try to act as a filter and sift through elements which address these 4 questions.  My larger goal is to posit this simple idea: Policy impacts programming.  Architects must understand policy if they are to devise creative solutions.  Healthcare architects are too far removed from healthcare policy to understand the system in which they profit/operate.  This is a bridge - a first step.