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People With Disabilities in National Health Care Reform

Policy Date: 1/1/1993
Policy Number: 9307

9307: People With Disabilities in National Health Care Reform

The American Public Health Association,
Being aware of the health care needs of all people regardless of age, gender, ethnicity, sexual orientation, ability, or disability; and
Recognizing that the term disablement embraces experiences and consequences of disease, injury, congenital anomaly, or disorder and their expression at all levels from the organ level to the interaction with the environment level;1,2,3 and
Having previously addressed issues related to disablement in more than 100 policy statements;4 and
Having supported efforts to prevent disablement and to equalize opportunities for people with mental and physical disabilities in all facets of life;5 and
Noting that between 24 and 46 million Americans have one or more physical or mental disabilities; and
Recognizing that the Americans with Disabilities Act6 should be reinforced by national health care reform that includes all people with disabilities; and
Recognizing that, at some point in their lives, all members of society will experience issues related to disablement, either directly or indirectly;3 and
Being concerned that people with disabling conditions sometimes have been denied access to health services and programs;7,8 and
Being alarmed that annual disablement-related expenditures are escalating and that in 1980 per capita medical expenditures were five times higher for people with two or more disabling conditions than for people without disabilities;9 and
Recognizing that a national health program must address the full spectrum of health related disablement issues, including prevention of causes of a disablement as well as secondary conditions, rehabilitation, long-term care, full community participation, and independent living for all people with disabilities to the maximum feasible degree, leading to enhancement of individual dignity, respect, and economic self-sufficiency;3,10,11 therefore
1. Encourages development of national health care reform to address the health experiences of people with disabilities at the levels of impairment, disability, and disadvantages (ie, organ level, functional activity level, and societal level);1,2,3,12
2. Encourages inclusion of disablement issues in national, state, and local health care reform efforts; and
3. Encourages inclusion of disablement issues in public health functions, especially surveillance needs assessment, outreach, provider education access, and policy development.

References:


  1. The International Classification of Impairments, Disabilities and Handicaps. Geneva: World Health Organization; 1980.

  2. Berg RL, Cassells JS. The Second Fifty Years Promoting Health and Preventing Disability. Washington, DC: National Academy Press; 1990.

  3. Pope AM, Tarlov AR. Disability in America: Toward a National Agenda for Prevention. Washington, DC: National Academy Press; 1991.

  4. American Public Health Association. APHA public policy statements, 1948-present. Cumulative. Washington, DC: APHA, current volume.

  5. American Public Health Association. Public Policy Statement 8320: Decade of Disabled Persons. Washington, DC: APHA, current volume.

  6. The Americans with Disabilities Act (ADA). Public Law 102-336 July 26, 1990 104 STAT. 327, Sec. 2.

  7. American Public Health Association. Public Policy Statement 8811: Discrimination Against the Disabled in the Health Care Field. Washington, DC: APHA, current volume.

  8. Watson SD. An alliance at risk: The disability movement and health care reform. American Prospect 1993;61-67.

  9. Rice DP, Laplante MP. Medical expenditures for disability and disabling comorbidity. Am J Public Health. 1992; 82(5):739-741.

  10. DeJong G, Batavia AZ, Bouscaren McKnew L. The independent living model of personal assistance in national long-term-care policy. Generations. J Am Society of Aging. 1992;89-95.

  11. Batavia AZ, DeJong G, McKnew LB. Toward a national personal assistant program: The independent living model of long-term care for persons with disabilities. J Health Politics Policy and Law. 1991;16(3):523-545.

  12. Batavia AZ. Assessing the function of functional assessment: a consumer perspective. Disability and Rehabilitation. 1992;14(3):156-160.

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