BLOOMINGTON, Ind. - The new Affordable Care Act provides both short- and long-term plans for health improvement. Its success depends on full implementation of short-term health insurance access and long-term public-health elements.
Public health is the act's long-term game plan to improve health and reduce cost, because it addresses those conditions that make us well or sick.
Without public-health systems and programs, our sick-care system will continue to grow in size and cost. This point should not be lost during our current debate on the impact of budget cuts.
ACA's short-term game plan expands health-insurance access using public and market mechanisms. Important patient protections and incentives for preventive health screenings will identify leading causes of illness and death. This will lead to early and manageable treatment, resulting in healthier populations and reduced health system costs associated with late diagnosis.
ACA's public-health system investments bolster the safety net to assure access for those estimated 24 million people who will not be granted insurance access under ACA. Examples include community health centers, mental-health centers, local health departments, family-planning clinics and migrant-health centers.
While health-care access is an important determinant of health, it is not the only one.
Reducing our weight, eating well, stopping smoking and increasing activity would significantly reduce our chronic health conditions, lead to more productive lives and reduce the need for sick care.
The public-health system will make these life changes easier. It is the only reform component focusing on reducing demand for health care.
This public-health game plan, however, is less certain because of our long, tenuous relationship with public-health investment.
Congress threatens to eliminate the Prevention and Public Health Fund that provides grants to reduce chronic disease, improve nutrition and increase physical activity.
The fund also strengthens the primary-care safety net, prevention-research centers, public-health workforce, laboratory infrastructure, breast- and cervical-cancer screening and all the other safety-net and preventive activities that sustain population health and reduce system cost. We lose the Prevention and Public Health Fund, and we lose the health game in the long run.
Health-insurance access is part of our health, but it alone cannot go the distance to assure health for all populations. Public health's preventive, systems approach to health determinants will help us win the long race toward health.
The vision of ACA - with both short- and long-term game plans - will usher in the reforms America needs. We must fully invest to benefit.
Yes: But only if we aid public health
Every Monday we offer pro/con pieces from the McClatchy-Tribune News Service to give readers a broad view of issues.
Beth Myerson is an assistant professor at the Indiana University School of Public Health and national policy director of Cervical Cancer-Free America.