A Taste of the APHA Midyear Meeting – June 2011

Implementing Health Reform – A Public Health Approach

By Kathye Gorosh, CEO New Age Services; APHA ATOD Section Councilor; Coordinator of ATOD Health Reform Work Group

The Affordable Care Act will transform our nation's health system once it is fully implemented. There are implications for all disciplines within public health as well as many cross-cutting issues that span the full continuum of our field – such as prevention, communication, fiscal and access to care. 

Over the course of the three day meeting, we heard from leaders in our field that highlighted the impact of ACA on public health – both opportunities and challenges that lie ahead of us. If you attended the meeting, you can use your personal subscription ID to listen to access the online program for the sessions you missed (http://apha.confex.com/apha/mid2011/webprogram/meeting.html). 

If you did not attend the meeting itself – you can get a sense of it by going to: http://www.youtube.com/aphadc.

Here are a few takeaways from the meeting provided by some of our ATOD members:

·         One goal of the ACA is to reduce health disparities and expand health care coverage and to serve underserved populations who are currently uninsured or underinsured. 

§  The federal law follows the experience of Massachusetts, where health insurance for the overall population was expanded from 88 percent of the population prior to passage of their reform bill, to 95 percent after five years.  Massachusetts had even better improvements for non-white residents, increasing coverage from only 78 percent to 95 percent.   

§  We need to make the business case that what we do is cost effective and leads to better outcomes.

§  Three-part Aim (formerly Triple Aim) is key: improve individual experience of care; improve the health of populations; and decrease cost of care.

·         Challenges: 

§  Implementation of the ACA will require expansion of the public health workforce and development of new skills in many cases. 

§  Coordination of care necessitates better information sharing. The potential for these improvements means better care, better health outcomes and reduced costs in the long run as more patients receive care earlier.

§  We must weave the data into the stories we tell (or vice versa) and the stories we tell must be compelling. Be strategic when telling your stories.  Talking “visually” and avoiding jargon helps to uncomplicate our stories and reduce confusion especially when it comes to talking to policymakers or to the news media.

§  Creating traditional and nontraditional funding initiatives to support the training of public health workforce, including curriculum which reflect new dimensions of public health infrastructure named above.

·         The benefits of the ACA are largely misunderstood, and it is important for us to change the tone of the discussion. The midyear meeting was a valuable learning experienced to increase the knowledge base of APHA members no matter what section we are part of. Those opposed to the ACA continue to call for the repeal of the legislation, and the arguments are often based on misinformation. As closing speaker Larry Wallack, Dean, College of Urban and Public Affairs, Portland, pointed out, “If your opponents can get you asking the wrong questions, it doesn’t matter what the answers are.”  Health reform has often been attacked for the role of government in people’s lives, largely obscuring the cost saving and life saving measures in the bill. As public health advocates and professionals, it is important for us to help get the word out about the ACA’s benefits and potential.

From an advocacy perspective – it's important to remember to keep the vision alive for a single payer/universal access program. Health care coverage doesn't guarantee access to care. Millions will remain uninsured at a time when the fiscal health of our states has decreased at a time of increased need for safety net services. The ACA helps us to move in that direction – we all need to do what we can to implement these system changes in the coming years and to increase the health and wellness for our nation.