April 1, 2026 Forum

Jack

There is a high correlation, I think, for lots of different reasons. I think disintegrated communities do lead to food deserts, and less good produce to eat, poor housing prices, and lower educational standards. So, those do cluster. However, there are places in the suburbs and in the gated communities. As Bill G pointed out, all the money in the world doesn’t necessarily mitigate a life of poor health, poor connections, and poor outcomes.

Gay

I wanted to challenge the data a little bit or at least try to expand our view.

Because as I always come from sort of this non-allopathic, or non-medicine sort of perspective, I wonder what the data would look like if we were able to capture those super users that are using alternative care types of models, not just medicine, to see whether we would see the same trend in terms of where they live, or whether or not they were in cold areas. Because once again, we still have this non-parity about looking at medication users versus those people that are health-promoting. And even people who are health-promoting use functional medicine, or they’re using behavioral medicine that might qualify them as super users. They might not be considered the same sort of hot spot that they are in the medical community.

Bill B 

In fact, we had psychologists, physiologists, expert community outreach workers. We had all the people involved that promoted alternative care, and none of that seemed to work.

Jeremy

And the other thing, Gay, is to recognize that if I’m a health system, and I’m interested in reduction of hot spotters using my system, as soon as they stop using my system, I don’t really care how that happened. My research is done. And so, I think what Jack is bringing up is that if we look at it as what’s in a community that makes the community healthier, it’s a different focus, because you may be right. In certain communities, it might be an alternative provider that’s providing great care, or a psychologist, or it could be there’s a coach of a football team, or something. I don’t know. None of those things get looked at right now, because the framework is based on the assumption that  this individual is overusing the system. Whatever reduces that is the right result, end of study. And if it’s not working, or what we’re spending money on isn’t any better than what’s going on in the ambient environment. Then we’re going to stop paying for that. And that sounds like billions.

Jack

We have laws in the United States that require us to take care of people who show up at the emergency room. But we don’t have laws saying those same people should have clean air, clean water, a park, access to food, access to behavioral health, access to those things that we also know improve care. And fixing bills. A1C, is probably only part of the issue.

It takes care of the ER visit, but doesn’t necessarily raise the community up in a way that Bill G now is connected with lots of other people in a positive manner. And I think we just have spent so much time blaming individuals rather than taking accountability from a society standpoint.

Bill B

So, Jo, I know Los Angeles is this lovely beautiful area with no healthcare problems. There’s no Comptons. Everything is just lovely. It’s all the San Fernando Valley, which actually itself now, I guess, has hotspots.