Hein’s quest for social justice in medicine leads to Vermont

Dr. Karen Hein.

Dr. Karen Hein. VTD/Josh Larkin

Editor’s note: This is the second in a five-part series profiling members of Gov. Peter Shumlin’s Green Mountain Care Board, a panel tasked with designing a universal health care plan for Vermont.

After Dr. Karen Hein finished her medical residency, she went to jail.

She worked there with some of the most abused and neglected kids in the Bronx at the Spofford Juvenile Center. Hein would make rounds with a lawyer and an ethicist and provide medical care for incarcerated youth. The experience provided a window into a demographic that most doctors never see, and Hein started to see trends in health problems facing under served youth. This experience was one of many that led Hein to found the nation’s first comprehensive adolescent HIV/AIDS program and work on international health projects throughout Africa and Asia. Most recently, she landed a position on the Green Mountain Care Board.

Hein, 67, is one of the five members of the board that will lay the groundwork for a universal health care system in the state. She and her husband have been homeowners in southern Vermont for more than 40 years. They have lived in the state full time since 2003.

Hein’s desire to go places where most doctors would not, and sometimes could not, led her all over the world and allowed her to spot trends before they were on anyone else’s radar.

“I’ve always been drawn to areas that people haven’t figured out yet,” Hein said.

She calls them “vacuum areas.” Whether it means working at a rural bush hospital in Liberia during medical school, providing service in refugee camps around the Thai-Burma border, or tackling a health care benefits package in the U.S. Senate Finance Committee, Hein finds a way to stay on the cutting edge of medical trends. This might explain why she wanted to be part of an experiment that could result in Vermont becoming the first state in the country to adopt a single-payer health care system.

This is a bold experiment. We need to learn from it and modify it as we go along.”
- Karen Hein

Hein’s renown in the medical field started slowly. Her father was a general practitioner in Long Island. His office was connected to the family home by a ramp, and she would pore over medical books and inspect models as a child. She attended Dartmouth Medical School when it was a two-year school and then finished her medical education at Columbia University. After her residency in pediatrics, Hein began to notice patterns of HIV/AIDs-related symptoms among teenagers in the youth detention center in the Bronx.

Serving the under served

“In the detention center, we saw things that were going to be happening next in general society,” Hein said. “We saw epidemics early because kids were presenting signs and symptoms.”

In 1987, she founded the nation’s first comprehensive adolescent HIV/AIDS program, which, Hein says, is still the largest facility in the country for youth with HIV. Shedding light on such a contentious issue was not easy, Hein said. She received death threats, and her treatment of adolescents with AIDs was viewed with skepticism from others in the medical community. The work, however, paid off, she said.

“I think we helped to decrease the stigma and the denial by being out there,” she said.

Karen Hein

Karen Hein with one of the cashmere goats she keeps at her Southern Vermont home. Courtesy photo.

Hein has also worked at refugee camps in countries throughout Africa and Asia. In that realm, also, she focused on the places where the general public was not allowed. Often camps would be closed except for refugees.

“I’ve focused on connecting people on the outside with places that aren’t transparent,” Hein said.

When asked how her work with under served people and issues applies to her new position in Vermont, Hein said this time it applies not so much to people who are hidden. This time it is about the legislation she will be helping implement.

She said many Vermonters aren’t aware of the new health care bill, which passed during the last legislative session. Perhaps that is why she is focusing on public engagement for the board. One of the main issues Hein wants to inform people about are the problems in the health care system that will affect them. She wants Vermonters to understand how over-utilization—repeating tests because of lack of communication between hospitals, for example—and underutilization—avoiding office visits and exams – impact the medical system as a whole.

No stranger to politics and health reform

Hein is no stranger to politics, she says. She was a staffer in the 1990s for the U.S. Senate Finance Committee when Sen. Patrick Moynihan was chair. She was the only doctor on the committee, and she created a benefits package for the proposed national health care bill. The federal effort failed, but Hein said she took away some valuable lessons that she believes will apply to Vermont. Now she is charged with creating a benefits package for Vermont’s universal health care system.

Hein has held many prominent positions, including as president of the William T. Grant Foundation from 1998 to 2003. After five years in that high-profile position, and shortly after the attacks on the World Trade Center and the United States’ involvement in two wars, she relinquished her prestigious role and narrowed her focus to international health and youth development, focusing on Asia and Africa.

When she read the principles outlined in Act 48, which starts with ensuring universal high-quality coverage for Vermonters, she said “everything I’d ever done my whole life seemed relevant.”

Hein said she finds ways to bring things to the forefront, and she hopes to do that here. Like her work with HIV/AIDS and refugee camps, Hein said she hopes the idea of quality universal health care will catch on and show the country a way forward.

“This is a bold experiment,” she said. “We need to learn from it and modify it as we go along.”

Jim Strickler, former dean of Dartmouth Medical School, has known Hein since she was a medical student. “She likes being on the cutting edge,” he said.

Strickler appointed her to the first board of overseers for the school. While Hein has a real interest in the big picture, he said, “she’s not just a philosopher.”

Alan Panebaker

Comments

  1. Jim Silbert :

    What a breath of fresh air. The people of Vermont are so fortunate to have Dr. Hein play such a vital role in the implementation of this ambitious, forward-looking legislation.

  2. Leslie Teicholz :

    Karen Hein is one of the most unique people I have ever met. She is the only one I know who can get a room of politicians and/or doctors to hold hands, form a circle, and sing, “This land is our land.”
    I want to come back as Karen or at least, one of her goats! :)

    Congratulations Vermont. You made a great choice.

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