I had the great opportunity to participate in the Association of Public Health's (APHA) Health Policy Summit this past weekend as part of the build up to APHA's annual meeting this week.
The Summit was a dramatic reminder of the breadth of opportunities and challenges facing public health in the months and years ahead as the Affordable Care Act is implemented. The sessions highlighted four key aspects of the Act that are going to be essential for the implementation of the prevention and public health sections of the legislation:
First, public health has a stake in every aspect of the reform effort - from what insurance benefits look like and how health networks are constructed to community prevention and quality assurance. Massachusetts Health Commissioner John Auerbach gave an important talk highlighting lessons from implementation of health reform in the Bay State, which showed that when public health is at the table, the outcomes are different (and better).
Second, the work of the newly-created Public Health Council, chaired by Surgeon General Benjamin and responsible for releasing a National Prevention Strategy by March 23, 2011, provides an incredible opportunity to bring together all the key federal agencies (all of whom sit on the Council) to embrace a Health in All Policies approach that recognizes that the work of almost every federal agency contributes in some way to longer, healthier lives. Dr. Benjamin reminded us that this is not just wishful thinking on the part of the public health community - but reflects the perspective of those at the top levels of domestic policy leadership. She quoted a speech by Melody Barnes, the President's domestic policy advisor, at a Healthy Communities Conference cosponsored by RWJF and the Federal Research where Ms. Barnes said:
"We're putting our focus in the White House on people and places in a way that we believe strengthens neighborhoods and improves health outcomes. We're using a multidisciplinary approach and strategy because, after all, every aspect of life includes health, it includes education, it includes housing and energy and transportation. People don't wake up in the morning and say 'I'm going to have an education day today and tomorrow I'm going to have a transportation day.' For families, all of these pieces are integrated so we have to start thinking about our policies and our approach in that same integrated fashion. So, for us, what we're trying to insure, is that the days of thinking and working and talking in silos is, in fact, over."
Third, successful implementation of health reform will require interconnecting roles of state and local public health departments, community based organizations, insurance companies, and the medical provider community. The workshop I moderated focused on community prevention, and showcased some of the amazing innovative and collaborative work done in Minnesota as part of their State Health Improvement Project, the Tricounty Colorado Communities Putting Prevention to Work projects, and the work of YMCAs across the country doing Healthy Communities projects and diabetes prevention.
Fourth, and hardly least, the new Prevention and Public Health Fund, which assures a mandatory appropriation of $15 billion over 10 years for public health programs demonstrates an unprecedented investment in non-clinical activities; this new mandatory appropriation becomes even more important after the mid-term elections as Congress may severely limit any increases in discretionary spending. There was a general consensus at this summit that now, in addition to the very real and very difficult tasks associated with fully implementing this reform legislation by 2014, we all must come together to make visible and defend the value of the public health investments in the Affordable Care Act. Visit here to see the latest work of lots of organizations on public health and health reform.
Parts of the above were featured in part of the Robert Wood Johnson's Coverage of the American Public Health Association (APHA)'s annual meeting. You can follow all of the coverage of APHA's annual meeting at: http://rwjfapha.com/.