Health Care Reform 2010: Where is the prevention?
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NWHF Staff
| Posted on: March 24th, 2010
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During the lead up to the passage of the Patient Protection and Affordable Care Act on March 23, 2010, many health advocates fought tirelessly to ensure that true disease prevention would make it into this law.
Were these efforts successful?
Will this new law actually help keep people healthy?
According to colleagues here in Oregon, and in Washington, the answer is largely yes.
As Mary Lou Hennrich, CEO, of Community Health Partnership: Oregon’s Public Health Institute said, “while they did not get much ‘air time,’ there are many provisions that will help keep Americans healthier and reduce the need for health care services.”
Mary Lou cites the national chain restaurant menu labeling and workplace accommodations for breastfeeding mothers to express milk, both of which, she says, follow Oregon’s leadership in passing state laws for these two issues.
“I think we can all be proud of having been a part of getting them the national recognition needed,” she said.
Trust for America’s Health, a prevention advocacy group in Washington, D.C., also applauded the new law, and pointed to the creation of a Public Health Investment Fund.
A Trust for America’s Health press release said the fund “will support core public health functions, community prevention initiatives, an increased public health workforce, and public health prevention and research activities.”
Jeffrey Levi, Executive Director of Trust for America’s Health, said that the bill “includes the ingredients needed to ensure we get the returns that prevention offers, including a focused national prevention strategy, a reliable public health funding stream, and evidence-based programs that will be held accountable for improving health outcomes.”
A detailed list of these prevention activities is included in this pdf file.
If you’re satisfied, or unsatisfied with this new historic legislation, please feel free to leave a comment.
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Prevention of causes or risks of diseases will keep people healthy in the new law
The definition of “prevention” and “preventive care” suffers of lack of clarity and seems widely misunderstood. The muddle is among both consumers and professionals. The confusion about the prevailing conception (definition) of “preventive care” and “wellness” became acutely evident with the latest, new guidelines for routine mammography screening, elaborated by the USPSTF (U.S. Preventive Services Task Force) experts for early detection of breast cancer.
Definition of primary prevention is not easily found in the modern medical textbook. The best practical definition is to be found in older literature, from the mid-19th Century, of the period of Cholera epidemics in London. In this regard, the British Parliament Select Committee on the Health of Towns, declared in 1840 that: “Primary prevention is about eliminating the causes of a disease before it can affect people. It is historically based on common sense and recognition of the proven or suspected cause and effect of diseases…” The working definition by the perplexed members of the Parliament Select Committee of more than 150 years ago fitted exactly and practically solved the uncertain nature they faced of the epidemic of fatal contagious disease, as the members of the U.S. Congress Task Force are facing today, in terms of both the same situation of an epidemic of deadly malignant disease(s), and the assumed lack of knowledge for primary prevention of the current breast cancer epidemic.
Screening for early detection of breast cancer is not prevention of the epidemic disease. A campaign for breast-cancer awareness (for compliance to use mammography screening programs) is as effective for prevention of breast cancer in epidemic form as the awareness of earthquake is effective for prevention of an eventual earthquake disaster.
In order to return to the traditional meaning and philosophy of preventive actions, a primary prevention policy seem unavoidable. American courts have reportedly ruled exactly the opposite of the prejudiced, non-defined approach of the USPSTF experts, by suggesting to some environmental protection agencies the liberty “to use theories, models and estimates to prevent harm” from the diseases in the “War on Cancer 1970.”
Arne N. Gjorgov, M.D., Ph.D. (UNC-SPH, Epidemiology, Chapel Hill, NC)
Author of “Barrier Contraception and Breast Cancer,” 1980: x+164