Sara Gardner, MPH
Last week, I listened to President Obama’s address to the nation following one of the most contentious and divisive election seasons in modern history. Whatever your political persuasion, I think most Americans are ready to move on from the election and get down to the business of trying to heal our very divided nation. President Obama rightfully reminded us that we are all on the same team, that first and foremost we are Americans and committed to some pretty basic rights for all people, the right to life, liberty and the pursuit of happiness for starters. As a public health professional, I know that good health, and the pursuit of health equity, is fundamental to all of it.
Health transcends party politics. Everybody wants to be healthy. Our ability to be productive, achieve our goals and be happy in life depends on it. Being unwell is not something anyone aspires to. As a parent, my hopes for my children include a good education, a successful and stimulating career, a home and a happy union. We raise our kids with these goals in mind and we plan and save to support our children to achieve them. We all hope our kids will grow up healthy, but when we’re planning for our kids’ future, we don’t necessarily make specific plans to avert diabetes or alcoholism or avoid gun violence. Despite spending $3 trillion on health care we are becoming a society of sick people, and instead of planning for health we try and buy it back when we become sick.
In the US we have a two-part health system with a treatment side and a public health side. Recently, we have begun to recognize that the two sides should be working together. This shift in thinking is playing out across the country and was articulated within the Affordable Care Act (ACA) by the inclusion of a number of provisions that support total population health. Provisions that might surprise many Americans.
When most people think of the ACA (better known as “Obamacare”) they think of health insurance and expansion of coverage to more people — a good thing. They also think of rising premiums, which was a major issue during this presidential campaign. Many people are not aware that the ACA includes a vast array of reforms, multiple and complementary initiatives to transform our entire health care system with the aim of better health at lower cost. For example, the Prevention and Public Health Fund was established to provide funding to test new ways of preventing disease and encourage healthy behaviors to keep Americans well and out of the hospital.
Coming out of the election, it is pretty clear that the ACA is in for some changes, although a clear vision for what will replace the current law is yet unknown. Will there be a complete repeal or a rollback of some provisions? What we do know is that it took more than a century to create our current health system – one in which “sick care” is emphasized far more than wellness. The ACA has allowed our country to take some meaningful steps toward promoting prevention and population health. It would be tragic not to keep at it, and it will require ongoing investment from federal, state, and local governments, as well as the philanthropic community and the private sector.
Across the country there are many excellent efforts underway to improve population health. The movement to integrate our two-part health system, improve outcomes and reduce costs is just getting started, and it affects all of us regardless of politics and party affiliation. This movement must continue if we are to create and nurture a healthy society.