CURING THE HEALTH SYSTEM

At Schwab Rehabilitation Hospital, Kristi Kirschner helps people dealing with the aftereffects of spina bifida, cerebral palsy, and other neurologic conditions. But the more she works with those patients, the more Kirschner feels her focus shifting. “Every day I was dealing with issues that I felt to be moral issues,” she says. “As an example, a shocking number of people [in their 50s] have had strokes. They had hypertension and high cholesterol, but they never had access to the health care system. Because of that lack of early intervention, now they have a significant disability.”

Kirschner, 51, aims to correct what she describes as that “great disparity in health care between the haves and have-nots.” There is a special urgency to her mission, she insists, since an Illinois law passed last January will shift half of the state’s Medicaid recipients to managed care by 2015. Working with medical and psychosocial experts from around the country, Kirschner has submitted a proposal to the state for a pilot program that provides an improved coordinated approach to treating patients. “We know we have to rein in costs,” she says. “But we can still try to produce better alternatives to traditional managed care.”

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Photograph: Anna Knott