Healthcare Politics and Policy in America by Kant Patel & Mark E. Rushefsky

Author:Kant Patel & Mark E. Rushefsky [Patel, Kant & Rushefsky, Mark E.]
Language: eng
Format: epub
Tags: Medical, Health Policy, Political Science, Public Affairs & Administration
ISBN: 9780765626042
Google: FJv2ngEACAAJ
Publisher: M.E. Sharpe
Published: 2014-01-15T09:50:29+00:00

IMPORTANT CONSIDERATIONS

Before we do that, there are several other factors to consider. One is that having access to healthcare, including insurance coverage, is important, but not the only factor that affects the health of the individual and the community. The United Health Foundation (2017) employs a model of the factors that impact health outcomes, similar to the discussion below: behaviors, community and environment, policy, and clinical care.

One such factor is public health. Public health focuses on the health of the larger community, whether it is a municipality, such as the lead in water problem in Flint, Michigan, or the larger nation (such as the flu epidemic in 2017 or the obesity epidemic or the opioid epidemic or the health effects of tobacco), or the global community (such as the AIDS or Zika epidemics). Its focus is on prevention and understanding of disease/sickness patterns and the cause(s) of those patterns. Public health is also concerned about assessing and mitigating problems, such as the possibility of biological attack by terrorists (see Institute of Medicine 2008; Patel and Rushefsky 2005; Schneider 2000). In the aftermath of the September 11, 2001 attacks by Al Qaeda on the United States, public health, at least for a while, gained some prominence.

Public health has had dramatic achievements that have led to increases in human longevity. These include sanitation services, the development of vaccines, clean drinking water, development of antibiotics, safe automobiles, and so forth. There is a massive public health infrastructure (Patel and Rushefsky 2005), particularly at the local level (county health departments), up to federal agencies such as the Centers for Disease Control and Prevention (CDC). But much of the work and achievements of public health are overlooked and funding for public health by all sectors is dwarfed by funding for medically related services. Medical care is estimated to prevent between 10 and 50 percent of premature deaths (Woolf and Aron 2013). Public health is responsible for some portion of the remainder, though estimates vary widely.

A second consideration is personal responsibility. The basic idea here is the health of a person is at least partly a result of decisions that the person makes. This would include, for example, taking appropriate medications and following a doctor’s recommendations. There are also lifestyle factors that affect a person’s health. These include smoking, diet, drinking, use of drugs, extent of exercise, and so forth (see, for example, Li et al. 2018). The ability to follow directions, such as taking medications, may be a function of the cost of the medication. Similarly, eating a healthy diet is affected by advertising and the availability of healthy alternatives. Nevertheless, Li et al. (2018) find that not smoking, a heathy diet, moderate amounts of exercise, and a low body mass index (BMI) leads to fewer premature deaths and greater life expectancy.

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