Don't Confuse Health Care Reform with Public Health | George Avery | Cato Institute: Commentary

Don't Confuse Health Care Reform with Public Health | George Avery | Cato Institute: Commentary: "In fact, federal 'reform' often hurts the public health system. Both public health and health care experts have criticized Medicare and Medicaid, enacted by Congress in 1965, for changing the focus of health care practitioners from prevention to treatment. Infectious disease mortality rates rose 22 percent in the 1980s (even after discounting for AIDS deaths), despite rising public and private spending on health insurance and medical care. In 1988, the Institute of Medicine warned of a deteriorating public health system. Inadequate vaccine supplies, such as the recent shortages of the measles-mumps-rubella vaccine or influenza vaccines, are at least in part the result of federal attempts to control the production and distribution of the vaccines.

Requiring all Americans purchase health insurance, which the current bills hope to do, would not address the underlying socio-economic issues at the root of most public health problems. Income, social capital, employment status, and other factors have a stronger impact on population health than access to health care. People with more education and higher incomes are better able to avoid health risks."

"Indeed, access to health care can help individual patients, but can also aggravate some public health problems. Healthcare, like everything else in life, involves risk tradeoffs. Hospitals can help cure disease, but by their very nature can also help spread infections. Most of Toronto's 2002 SARS cases were infected, for example, were health care workers and visitors infected by exposure to the virus in a hospital. High rates of surgical intervention increase the risk and spread of drug resistant infections like MRSA."