Monday, May 25, 2015

The Pursuit of Health

Every American needs health insurance. As the glitches on Healthcare.gov are repaired, it appears that all those who are eligible for new insurance options will be able to enroll.

The Pursuit of Health

Every American needs health insurance.  As the glitches on Healthcare.gov are repaired, it appears that all those who are eligible for new insurance options will be able to enroll. 

But when that happens, what will happen to the health of Philadelphians?  The Affordable Care Act (ACA) creates a structure not only to improve access, but it also strives to create a way to improve health as a way to reduce the costs of healthcare in America.  These pieces are outlined in Title IV of the Act. 

The Act authorizes a strong new investment aimed at preventing chronic illnesses as a way of saving billions of health care dollars.  Part of cost reduction is derived from improving Americans’ access to preventive services by removing all copayments. 

Additional savings, though, are created through investment in the nation’s public health infrastructure.  This includes

  • funds to improve how we monitor and understand the occurrence of conditions like asthma, hypertension, obesity, diabetes, and others;
  • support for long-term investments in interventions to prevent or delay chronic illnesses and assure that those with chronic illnesses are identified early and linked to good care;
  • dollars for research  into health disparities and on the delivery of public health services;
  • support for training more primary care providers who will be needed to help patients use the ACA and its “medical homes.” 

In addition, broad preventive interventions are endorsed, like more school-based health centers, support for healthier corner stores and bodegas, smoking cessation resources and media campaigns, and labeling chain restaurant menus to provide people with information about calorie contents of food items.

All of these interventions and innovations were to have been funded by a large pool of dollars called the Prevention and Public Health Fund. 

What we have seen, instead, is the persistent whittling away at the Fund by Congress as it seeks to fill gaps in other parts of the ACA:  dollars from the Fund have been used to stop cuts in physician payments mandated by the ACA (more than one-third of the fund); dollars have been used to fund the development of the on-line federal Exchange (reportedly nearly half of the Fund for this year).  What remains is a small fund that is not going to be able to launch the prevention work that is needed to promote the health of Americans. 

Yes, health insurance is critical to improving American’s health, and yes, healthcare is expensive.  It is critical to realize, though, that healthy people consume fewer health care dollars.  Adequate support for healthier lives is key to making a healthier nation at an affordable cost.


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About this blog

The Field Clinic reports and analyzes health care laws, government policies, and political trends that are transforming the care we receive and the way we pay for it. Read more about our panel of bloggers here.

This blog is produced in partnership with Kaiser Health News, an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health-policy research and communication organization not affiliated with Kaiser Permanente. Portions of this blog may also be found on Inquirer.com and in the Inquirer's Sunday Health Section.

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Robert I. Field, Ph.D., J.D., M.P.H. Professor, School of Law & Drexel School of Public Health
Jeffrey Brenner, MD Founder of the Camden Coalition of Healthcare Providers, Medical Director of the Urban Health Institute at Cooper University Healthcare
Andy Carter President & CEO, The Hospital & Healthsystem Assoc. of Pa.
Robert B. Doherty Senior Vice President of Governmental Affairs & Public Policy American College of Physicians
David Grande, MD, MPA Assistant Professor of Medicine at the University of Pennsylvania
Tine Hansen-Turton Chief Strategy Officer of Public Health Management Corporation
Drew A. Harris, DPM, MPH Director of Health Policy Program at the Jefferson School of Population Health
Antoinette Kraus Director of the Pennsylvania Health Access Network
Laval Miller-Wilson Executive Director of the Pennsylvania Health Law Project
David B. Nash, MD, MBA Founding Dean of the Jefferson School of Population Health
Mark V. Pauly, Ph.D. Professor of Health Care Management, Business Economics and Public Policy at The Wharton School
Howard J. Peterson, MHA Managing Partner of TRG Healthcare, a national healthcare consulting firm
Paula L. Stillman, MD, MBA Healthcare consultant with special expertise in population health and disease management
Elizabeth A. W. Williams Senior Vice President & Chief Communications Officer for Independence Blue Cross
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