As the nation faces a change in leadership, UC Berkeley School of Public Health professor Stephen Shortell and UCSF School of Medicine associate professor Dr. Diane Rittenhouse highlight the most critical health policy issues and offer recommendations for the next administration in a commentary published November 1 in the journal Annals of Internal Medicine.
Shortell and Rittenhouse call for “creating a nationwide ‘culture of health.’” They challenge the next president to present a vision that emphasizes the physical, social, and behavioral determinants of health with policies that encourage cross-sector collaboration and innovation.
To articulate this vision, the next president should emphasize a few core principles: American citizens dually have the right to health care and the obligation to engage in healthy behavior; the private and public sectors have a joint commitment to community health; resources should be distributed on a need-based gradient; and the health care system must eliminate the estimated 30 percent of wasteful activities that not only does not add value to patients but, at times, can be harmful to their health.
The authors recommend that the next administration promote these principles through specific actions, such as federal/state funding to create Accountable Communities for Health (ACHs), providing federal matching funds for schools that implement a “health in all things” curriculum or giving tax breaks to companies that meet “healthy workplace” criteria. They also advocate raising the minimum wage, so more people will be able to afford healthier lifestyles.
They also call for a major reform of the health care industry by stabilizing health insurance markets, creating incentives for all states to expand Medicaid coverage, and creating a Public Option in states with little competition between insurers. In addition, they highlight the need to accelerate the transition to value-based payment models, make performance data more focused and transparent, and for the Office of the National Coordinator for Health Information Technology to work with vendors to develop common platform standards that facilitate the sharing of medical records and related health information.
Unless we change, Shortell and Rittenhouse argue, future biomedical advances may become inaccessible. “Too many Americans will not be able to afford them,” they warn, “and the health care delivery system will not be able to incorporate them efficiently or effectively.”