Prevention Matters

The passage of a health reform bill that emphasizes prevention and wellness was named the “Best Prevention Idea of the Week,” while reduced life expectancy due to preventable risk factors was named the “Worst Prevention Idea of the Week."

The “Best/Worst” awards are announced each week in “Prevention Matters,” the blog of Partnership for Prevention. Nominees are submitted by Partnership staff as well as the general public, and are voted on by the staff. Partnership for Prevention is a nonpartisan organization of business, nonprofit and government leaders who are working to make evidence-based disease prevention and health promotion a national priority. More information is available at http://www.prevent.org/.

BEST

Obama Signs Historic Health Reform Law, Steps Up Focus on Prevention and Wellness

On March 23, 2010, President Barack Obama signed the health care bill into law. The new federal health reform law (HR 3590) includes many provisions aimed at disease prevention and promoting healthy lifestyles. The law creates a $15 billion fund for programs designed to promote prevention and wellness, such as efforts to address obesity and to help patients manage chronic diseases. The law also establishes a National Prevention, Health Promotion and Public Health Council to coordinate federal efforts to promote healthy living. In addition, the health care reform law:

• Eliminates copayments for Medicare and Medicaid beneficiaries receiving preventive services;
• Increases reimbursement rates for physicians who offer certain preventive services;
• Provides grants to small business for establishing wellness programs and incentives for employers to offer workers as much as 50% off their premiums for participating in such programs; and
• Requires chain restaurants and vending machines to disclose nutritional information.

WORST

Four Preventable Risk Factors Reduce Life Expectancy in U.S. and Lead to Health Disparities

A new study led by researchers from the Harvard School of Public Health (HSPH) in collaboration with researchers from the Institute for Health Metrics and Evaluation at the University of Washington estimates that smoking, high blood pressure, elevated blood glucose and overweight and obesity currently reduce life expectancy in the U.S. by 4.9 years in men and 4.1 years in women. It is the first study to look at the effects of those four preventable risk factors on life expectancy in the whole nation.

Writer Sarah Wildman suggests that one asset President Obama has yet to use in getting health reform over the goal line would be to enlist help from the First Lady. In an engaging piece of “what if” writing, Wildman argues that Mrs. Obama’s enormous popularity gives her a potentially powerful platform to show Americans that health reform is an “apolitical” problem that affects us all.

Wildman is disappointed that the Mrs. Obama stayed in the family garden focusing her time on the important but “safe” First Lady-like issue of childhood obesity.

“At a moment when an entire year's worth of bickering over health care reform has unraveled into a partisan wrestling match, and the very word "reform" has nearly ceased to be meaningful, tackling obesity is cheerfully unobjectionable. Laudable even. But it's not the most important thing on the agenda right now… As a concept it vaguely brushes up against the health care reform debate but without, in reality, getting anywhere close.”

Wildman argues that the First Lady should use her popularity “to get America to understand how very nonpartisan health care reform might be? … The First Lady could have gathered together a task force comprised of a clutch of women -- moms, mostly -- and presented their stories, simply and without fanfare, to highlight how un-family friendly our current insurance policies are. How anti-woman. How anti-mother."

She might have brought in, say, a widow who lost health insurance after her husband died, therefore leaving the family uninsured. Women, she would have pointed out, are more likely to be on their husband's insurance than vice versa, leaving them vulnerable in the event of divorce, or death, or job loss. She might have invited a young, entrepreneurial would-be mother who desperately sought health insurance to cover a potential future pregnancy, but discovered there was no way to sufficiently cover maternity on the individual insurance market. She might have shown America a mother who owns her own business and discovered, happily, she was pregnant and that, unhappily, she could not find health insurance to cover the prenatal care, labor, and delivery.”

Wildman writes that the First Lady could have told the country that “On the individual market, pregnancy … is a pre-existing condition. Most insurance companies will not allow a woman to purchase insurance once she is already with child. Worrisome, the First Lady would have said, because this woman now has to decide between caring for her fetus and going into debt. Maternity benefits, she would have explained to the cameras, are never a guarantee.”

At the moment health reform appears stuck between a partisan divide. Although many of us are rightfully focused on the important nuances of prevention coverage and policy, the larger context of health reform – coverage, fairness, quality -- is fundamental to our national character. The First Lady can do much to remind us of this even as we are called to become more physically active and less attracted to junk food.

As we enter the final quarter of play lets remember that health reform is a team sport and no one should be left on the bench.

Posted by:
Ripley Forbes
Director, Government Affairs
Partnership for Prevention

President Obama today released his proposal for resolving the impasse with Congress over health reform. The proposal is summarized in an 11 page document released this morning by the White House. Initially prevention advocates were shocked to discover that the words “prevention” and “wellness” were not included in the summary draft. Fortunately, these concerns were premature as the release of additional information highlighted the key role that prevention plays in the Administration’s plan for reform.

We have since discovered that the 11 page summary was intended primarily to highlight proposed changes in the Senate passed health reform bill; HR 3590, the “Patient Protection and Affordable Care Act.”

The White House has developed a detailed web site which discusses the President’s proposal in greater detail. Most encouraging to those of us who believe REAL Health Reform Starts with Prevention, the President has made crystal clear his Administration’s continued support for the key prevention, public health and wellness provisions contained in Title IV of the Senate passed health reform bill. By retaining the Senate proposal for the prevention trust fund, the proposal “provides for unprecedented investments in prevention, public health, disease research, and screening. The national investment in preventing disease and finding cures will save lives and money in the long run for American families, small businesses, and the Nation.”

The President’s commitment to prevention is reflected in the following description of the Prevention and Public Health provisions of Title IV.

“If we want to truly reform health care to benefit American families, we need to transition from a system focused primarily on treating the sick to one that helps keep people well throughout their lives…It directs the creation of a national prevention and health promotion strategy that incorporates the most effective and achievable methods to improve the health status of Americans and reduce the incidence of preventable illness and disability in the United States. The Act relies on the innovation of small businesses and state and local governments to find the best ways to improve wellness in the workplace and in our communities. And it strengthens America’s capacity to respond to public health emergencies. The Act empowers families by giving them tools to find the best science-based nutrition information, and it makes prevention and screenings a priority by waiving co-payments for America’s seniors on Medicare. By attacking disease before it hits, the Act helps to improve health, save lives, and avoid more costly complications down the road.”

Additional details about the President’s health reform proposal are summarized on a white house web site that has been developed in preparation for the bipartisan health summit scheduled for February 25. The summit will begin at 10am and will be broadcast live at whitehouse.gov/live.

Posted by:
Ripley Forbes
Director, Government Affairs, Partnership for Prevention