A DASH OF PUBLIC HEALTH WITH MY HEALTHCARE REFORM, PLEASE?

by Harold Pollack

“Health reform” was the key domestic policy issue of the Democratic primaries. It may yet become a central issue of the fall campaign. Everyone favors it, partly because we are all talking about different things. I could shingle my roof with the various proposals, webcast invitations, and advocacy group briefs that reach my inbox every day. As I open the attachments, it becomes clear that health reform includes at least seven really important things:

1. Protecting everyone from the financial consequences of illness and medical care itself.
2. Expanding social provision in America.
3. Using healthcare to transfer in-kind resources down the income scale.
4. Controlling public and private health expenditures.
5. Improving care quality and cost-effectiveness.

Less often, someone sends an email about two other, readily neglected subjects intimately affected by health reform:

6. Providing stable financing for state and local governments now reeling under Medicaid and safety-net expenditures.
7. Improving population health.

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