WASHINGTON — The start of the new year marks a new beginning for Joshua Sharfstein. Maryland’s top health official has left his government job, and Monday morning, he will walk into his new office at the Johns Hopkins University.
There were more than a few accomplishments during his tenure at the Department of Health of Mental Hygiene, which began in 2011 and ended with the dawn of 2015.
But there was also one big frustration that for a time, eclipsed everything else.
“The first launch of Maryland Health Connection — the state based exchange — was incredibly frustrating,” says Sharfstein, remembering the disastrous late 2013 debut of the state’s health insurance website.
“People wanted access to quality and affordable care — who can blame them for being frustrated that the website wasn’t working.” he says.
The health insurance website crashed on take-off, and Sharfstein took a lot of the blame for a software system that just didn’t deliver as promised. There were calls for him to resign, but he stayed on and worked with officials at the largely successful Connecticut health exchange to bring their technology to Maryland.
Now in its second open season, Maryland Health Connection is working well, and sign-ups for insurance have surpassed expectations — a development that enabled Sharfstein to leave his state office on a high note.
In an interview with WTOP summing up his stint as Secretary of the Department of Health and Human Hygiene, he spoke with pride about Maryland’s efforts to cut health costs without sacrificing quality. They give health care providers incentives to keep people healthy.
Sharfstein’s favorite example is a program in Washington County, where a local hospital took over the school health program. As more children were treated proactively for asthma and other problems, and access to top-notch preventative care increased, the number of emergency room visits declined.
“It’s an example of how when you change the incentives in health care, you really can get actual benefits for child health and others,” he says.
Sharfstein — a Harvard-trained pediatrician who still helps out at clinics in the Baltimore area — says the state of pediatric health in Maryland is good but not good enough. He says the child mortality rate has come way down in recent years, though the decline has stalled a bit recently.
Still the overall trend is in the right direction, in large part because of a successful ad campaign urging parents to put their babies to sleep alone in a crib on their backs, not in a bed or couch with others.
But in his final days in office, another issue occupied a lot of his time — and it is one he sees as a huge threat to public health now and moving forward.
“We now have overdose deaths exceeding suicides, homicides, motor vehicle accidents,” Sharfstein top WTOP, noting that a problem which was once largely confined to inner cities is now all over the state.
“Part of it is, I think, related to the fact there are a lot more people at risk for heroin addiction because of the significant expansion in the use of pain medications,” he explains, noting the state has responded by stepping up training for doctors prescribing pain meds, and by expanding the availability of a powerful overdose antidote Naloxone, commonly known by the brand name Narcan.
The OD “epidemic” is just one of the issues he will continue to focus on in his new job with the Johns Hopkins University Bloomberg School of Public Health, where he will be a faculty member and an associate dean.
It’s an opportunity to expand his national reputation as an expert in public health policy. But Sharfstein says what excites him the most is that he will have the opportunity to help train the next generation of public health officials at one of the best public health schools in the world.