A role in better health
Reforms go beyond cost and care
We’ve heard how health-care reform will or will not work, what it will or will not cost and how it will or will not impact us as individuals. We’ve also heard from people who sincerely believe we should simply leave it alone.
But, few talk about whether reform will improve health, particularly public health.
Considering how much we spend on health insurance, gyms, organic food and vitamins, we should be a very healthy nation. Apparently, there’s room for improvement:
1. We have the highest rate of preventable deaths among (19) industrialized nations.
2. We came in 37th on the World Health Report 2000 for overall health.
3. More than half of U.S. adults are overweight.
4. Almost 2 million a year die in the U.S. from chronic, treatable diseases.
According to Assistant Secretary for Health Howard K. Koh, all five health-care reform bills before Congress contain components that “absolutely” will improve those numbers. Koh was Massachusetts health commissioner from 1997-2003. Today he is America’s top doc, overseeing the U.S. Public Health Service, the CDC, Surgeon General’s office and many related agencies.
Reform will bring quality, affordable care to most Americans, with the operative term “affordable,” since everyone will pay toward their care.
Right now, millions of Americans cannot get coverage at any cost and 14,000 more lose their insurance every day, Koh said in a recent interview. “When Americans go without health insurance, they suffer,” he added.
According to Koh, one in six Americans with employer- sponsored insurance coverage in 2006 lost it by 2008, leaving many children and adults without preventive care, immunizations, basic dental services and prescription medicine. “When sick, (the uninsured) are more likely to experience poorer health outcomes” than the insured.
Insured or not, low-income Americans — including racial and ethnic minorities as well as people living in rural areas — are less likely to receive preventive care than others.
“We are the only advanced democracy that allows this hardship on millions of its people,” according to Koh.
Once insured under reform, there will be little financial reason for anyone to go without basic health care. We will be leveling the field, reducing health disparities, in terms of access to care.
As shocking as it may seem, with reform, millions will have the opportunity to see primary-care physicians — and even dentists — for the first time. Children and adults who previously saw doctors only in emergency rooms will be screened for and, if necessary, treated for chronic diseases. And, they will be called back for check-ups.
“We’re developing a wellness care system that protects health, promotes healthy behaviors and strengthens community prevention,” Koh said.
“A national report recently found that 100,000 lives could be saved each year by investing in five basic preventive services that are available through a doctor’s office,” Koh said. “We can’t eliminate all disease, but … we can reduce chronic disease by ensuring Americans have the care they need to prevent and treat these diseases so that if they do get sick and need care, they have the best possible chance of getting better.”
To accomplish this, the 2009 Recovery Act already has pumped millions into the health-care infrastructure to build work force. Reform measures will expand on that base. Big investments in medical training should boost resources in underserved areas — such as rural New England — which otherwise might not attract enough health-care workers to make reform work.
Of course, reform really begins with each one of us. Whether health-care reform succeeds or fails, individuals will share some responsibility with physicians, hospitals and drug companies.
It won’t be painless, or easy. There are no quick fixes. And, no one will chase us around to “make us” healthy.
If we haven’t already done so, we should start to build our own healthy lives based on knowledge, responsibility and respect. It’s time to make healthy choices, as in “yes” to salads, “no” to cigarettes and binge drinking, etc. We must vaccinate our kids, encourage loved ones to exercise, make sure our young people get enough sleep and our elders are seen by doctors when they need to. We should wash our hands, flu season or not. If sick, stay out of the workplace.
In other words, we need to get our collective act together to start taking proactive responsibility for our health, because the Band-Aid approach to health care is coming to a very expensive end.
But, whatever it takes should be worth the effort, making a big difference in the lives of our children and grandchildren, by making a big difference in public health.
When it comes to closing the gap on health disparities, Koh said, “we should remember that this isn’t a partisan issue. It’s a moral issue.”
Greenfield resident Paula Hartman Cohen writes about health care and other issues for The Recorder publications, Harvard Public Health Review, Dartmouth Medicine Magazine, and KevinMD.com, among other media. She blogs at www.birdsonawireblog.com.