Dede de Percin
The executive director of the Colorado Consumer Health Initiative (CCHI) on Obamacare, doing the right thing, and speaking up for yourself. Interview by Jessica Farmwald
What were your influences growing up?
I was raised Catholic, and those essential values—with privilege comes responsibility, those pieces around social justice—were actually a really good framework for the work that I do now. The piece I didn’t like as much about the Catholic faith, that had maybe an anti-influence, was that I don’t like other people making choices for me. If you don’t speak up and aren’t engaged, then somebody else is going to make that decision for you.
Any especially formative moments?
I grew up just outside Washington, D.C., in the suburbs of Maryland, and we had a maid, a woman of color, who came out to clean our house once a week. This is back in the ’60s, right around the time of the riots in downtown D.C. My father came home from work one day, and my mother said, “I co-signed a loan for Mrs. Mitchell so they could buy a house.” My father said, “What?” And she said, “She couldn’t get a loan because she’s African-American, and that was just wrong.” I’m sure there was a lot more conversation about it, but my mother was just like, That’s it. I’m going downtown, and I’m fixing this.
Of all the causes you’ve championed over the years, which is closest to your heart?
The one I’m immersed in right now is the most important and urgent to me. I’ve done systems change before in other arenas, but the health system is not one system. It’s about a dozen different systems that were all going in different directions, not working together. And the brilliance and challenge of the Affordable Care Act was to put a framework around virtually all those systems and try to turn them all in a single direction.
What role does CCHI play for the state?
We’re a coalition of about 50 members [for example, the Autism Society of Colorado and the Rocky Mountain Farmers Union]. And our policy committee operates by consensus. So while sometimes finding that consensus is difficult, when we get there, having the majority of 50 member organizations behind something is incredibly strong.
What’s unique about Colorado’s health-care situation?
We had already done a lot of things before the Affordable Care Act that were in the Affordable Care Act, so we were well positioned to take advantage of it. We have also moved forward in a bipartisan way; Colorado is the only state, to date, that has passed a bipartisan exchange bill. That makes us a model for a lot of other states.
Does anyone lose when it comes to the Affordable Care Act?
There aren’t a lot of losers. The insurance companies supported it. The doctors supported it. Nobody liked everything in it; but everybody liked something in it. What I will say for almost everybody is that their business model is going to have to change. Maybe the very bad actors in every sector lose, but I’m OK with that.
You say putting patients first is a revolution that needs to happen in health care.
It’s a changing of the model when you talk about patient-centered care. There’s a great quote that I stole: For too long in health care, patients have been the football, and they ought to be the quarterback. I like to use this example. The several times I’ve had surgery, on the way out the door, when I’m groggy, they’re like, “And here’s your prescription, go get that filled, but stay off your feet for three days.” The assumption that someone is going to do that for me and walk my dog and bring me groceries—they haven’t asked those questions. If we have shared decision-making, we have more patient empowerment.
Shouldn’t people take responsibility for their own health?
Part of it is individual responsibility. But people need to be in a stable and reasonable situation—not working three jobs and raising two kids—in order to make life changes. We need systems that work with us and not against us. And right now the systems work against us a lot of the time.