Watch any segment of the evening news and you realize hot button public health issues continue to stir debate. A few examples of current public health issues include; the continuing obesity epidemic, disparities in the healthcare delivery system, rising costs for medical prescriptions, inaccessible rural health care>, as well as environmental issues. These public health issues are a major part of the greater issue of health care reform currently under debate. While the political system remains deadlocked in reaching a workable solution, the dilemmas these current public health issues are creating for millions of Americans unable to afford expensive health insurance, copayments, or prescription medications not covered by their health plans continues to affect availability and affordability of health care for communities across the nation.
There seems to be no end to the debate concerning the cost of health care reform. By 2014, Americans will be required to have health insurance with penalties imposed on those without health care coverage. Estimates for insurance costs, as well as the proposed sliding scale premiums or federal subsidies to low-income families remain confusing. Insurance coverage alone will not address the issue of the rising cost of medical care or the shortage of quality health care services in many rural areas. Key issues sure to influence nearly any public health policy issue include:
- Constitutionality of Health Care Reform
- Implementation of Health Insurance Exchange and Accountable Care Organizations
- Electronic Medical Records and Patient Privacy
- Health Information Exchange
- Freedom of Speech to Market: Drugs, Medical Devices, products or services
- Maintaining a Public Health Infrastructure
- Enforcement of Health Care Insurance requirements
- Cost of Obesity Related Health issues
- Loss of Worker Productivity
- Drug costs and availability
- Long-term health care for the elderly
- The affect cultural differences have on health care
Constitutionality of Health Care Reform
Among many points of conflict, surrounding the health care crisis is the constitutionality of health care reform. At issue is wither the Commerce Clause gives the federal government the right to mandate the expansion of state Medicaid coverage or face the possibility of losing matching funds. More importantly, for individual consumers, does the Commerce Clause grant the federal government the right to require individuals to purchase insurance coverage? The hazards of forcing an individual health care mandate involves defining minimum compliance, limits in benefit packages, assisting those who cannot afford to purchase insurance, and noncompliance enforcement. Who would be responsible in addressing noncompliance issues? Will it be the responsibility of state, federal, or local governments? No public health policy issue can be resolved without cooperation and support at all levels. The continued debate surrounding basic constitutionality issues adds even more confusion to an overwhelming problem.
With the implementation of a new health care reform system, there will be challenges regarding the handling of vast amounts of health care data. Individual privacy must be safeguarded and there must be a health care infrastructure in place capable of handling efficient, dependable transfer of health information from agency to agency and between medical health care providers. The formation and organization of such an infrastructure is yet another public health policy issue that needs to be adequately addressed. Current public health issues have only begun to scratch the surface in dealing with the Pandora’s Box of public health issues that will no doubt prove to be interconnected with health care reform.
With a new health care reform plan in place, there will still be other public health issues to consider. The public health issue regarding obesity is a good example of how one issue can affect other aspects of health care in both cost and treatment options. It is estimated that obesity related concerns cost Americans over $270 billion dollars a year. With federal insurance mandates, will insurance companies be required to cover a larger percentage of health care costs? If costs are not covered by insurance and the costs of medications and treatment continues to rise, how will the additional costs be covered? It would seem a public health issue seeking solutions to both affordable insurance coverage as well as affordable health care treatment will be a major focus for several years as health care reform continues to be put into place. The new health care law will change the way health care is provided and paid for in our country. How and where these changes impact individual, and public health is yet to be determined. Even with a best-case scenario, there is always going to be yet another public health issue that requires a solution. Hot button issues in public health will continue to affect communities large and small. Public understanding of these major issues is the key to positive change.