Friday, May 16, 2008
Erza Klein points out an interesting article by Neal Halfon discussing health reform and its costs. He notes the power of preventive health and positive public health efforts and how small changes add up to quite a bit of savings not to mention better health for the entire population. Ezra Klein writes,
Reading Neal Halfon's article on "The Primacy of Prevention" reminded me of a point that I don't make enough. Health
reform, which is what we mainly talk about, is about economic security more than it's about health improvement. It's about ensuring people don't go bankrupt when they need care, and ensuring the country doesn't go bankrupt in 30 years beneath the burden of health costs.
Conversely, the real gains to be made in population-health (the term researchers use for the aggregate health of the country) will come from public-health efforts. That's a broad category. It can include everything from vaccinations to stripping lead from walls to encouraging better nutrition to making educational interventions. A better integrated health system would encourage this as it would make it far easier to reach the relevant populations, but it would not, on its own, radically change the health outcomes of anyone but the uninsured or severely underinsured, and it would not necessarily be reliant on individual medical care. Rather, it'll probably require broader policy changes that make it easier for whole populations to live healthier lives almost without meaning to. That means more walkable, bikable cities. It means less pollution and lead in the walls and water. It means more access to fresh, affordable, fruits and vegetables in poor and urban areas. It means food subsidies targeted towards healthy foods rather than foods with powerful interest groups. It means more anti-smoking programs. . . . .