Global Health Weekly News Round-Up

UNICEF celebrated its 65^th anniversary on December 11, 2011 (Source: http://www.unicefusa.org/news/news-from-the-field/unicef-at-65-looking-back.html).

Politics and Policies

• The US Department of Health and Human Services announced that, beginning in 2014, states will be allowed a basic set of essential health benefits for millions of Americans who would qualify for coverage through state based insurance exchanges (Source: http://www.politicalnewsnow.com/2011/12/17/states-to-weigh-in-on-basic-health-coverage-reuters/).
• The US National Transportation and Safety Board (NTSB) called for the first ever nation-wide ban on drive use of portable electronic devices (PEDs) while operating a motor vehicle (Source: http://www.ntsb.gov/news/2011/111213.html).
• The Association of American Physicians and Surgeons (AAPS) have opposed a rule that required the health care facilities workers to have an annual influenza vaccine or they lose their jobs (Source: http://www.reuters.com/article/2011/12/14/idUS205180+14-Dec-2011+GNW20111214).
• First United Nations (UN) report on human rights, sexual orientation and gender identity, titled, “Discriminatory laws and practices and acts of violence against individuals based on their sexual orientation and gender identity, A.HRC.19.41.” was released on Wednesday, December 15^th, 2011 (Source: http://www.windycitymediagroup.com/gay/lesbian/news/ARTICLE.php?AID=35274).
• The United States Conference of Mayors issued a report indicating emergency food assistance increased over the past year by an average of 15%. This report, prepared by City Policy Associates, contains each city (29 cities) survey report with their individual profiles – median household income, the metro unemployment rate, the monthly foreclosure rate, percentage of people in city who fall below the poverty line and contact information for individual service providers (Source: http://www.usmayors.org/pressreleases/uploads/20111215-release-hhr-en.pdf).

Programs

• A drop of about 20% drop in obesity rates seen in New York obese school children from kinder garden to eight grade as a result of the programs which boost physical activity and healthier eating habits (Source: http://www.bloomberg.com/news/2011-12-15/school-obesity-rate-dips-in-new-york-from-healthy-habit-programs.html).
• A county program in Chula Vista, California has made fresh food accessible and is hoping to combat obesity and other health related issues (Source: http://www.cbs8.com/story/16344095/new-program-brings-fresh-produce-to-corner-stores).
• Texas’ request to run a family planning program which excludes certain providers has been turned down by the U.S. Department of Health and Human Services (Source: http://www.arcamax.com/politics/politicalnews/s-1008156).

Research

• The IMF has published a Staff Discussion Note on economic growth and income inequality. The note argues that while a certain degree of income inequality can help drive markets, excessive inequality can lead to unsustainable growth (Source: http://www.imf.org/external/pubs/ft/sdn/2011/sdn1108.pdf).
• Research shows link between smoking and skin cancer in women (Source: http://yourlife.usatoday.com/health/healthcare/studies/story/2011-12-16/Smoking-linked-to-skin-cancer-in-women/52010190/1).
• Key interventions to reduce maternal, newborn and child deaths identified in three year study “Essential interventions, commodities and guidelines for reproductive, maternal, newborn and child health” (Source: http://www.who.int/mediacentre/news/releases/2011/reduce_maternal_deaths_20111215/en/).
• A significant improvement in factors related to metabolism and heart health was seen in patients with  obstructive sleep apnea, when they wore face mask during their slumber hours, according to a research published in New England Journal of Medicine (Source: http://www.medicalnewstoday.com/articles/239280.php).
• Two out of three Americans fear of global disease out breaks, according to a study conducted by EcoHealth Alliance (Source: http://www.infectioncontroltoday.com/news/2011/12/survey-assesses-americans-fear-of-global-disease-outbreaks.aspx).
• Study published in Circulation: Journal of the American Heart Association, Chewing Chat, a natural plant-derived stimulant, increase risk of death and stroke in heart disease patients (Source: http://newsroom.heart.org/pr/aha/herbal-amphetamine-increases-risk-220305.aspx).
• A surveillance study from 2007-08 flu season indicates that people on statins (lipid control drug) protected against flu (Source: http://www.cidrap.umn.edu/cidrap/content/influenza/general/news/dec1511statin.html).

Diseases and Disasters

• More than 430 people died due to the flooding caused by tropical storm in Philippines (Source: http://latimesblogs.latimes.com/world_now/2011/12/typhoons-philippines-drowning-victims.html).
• Louisiana state officials issued a warning about dangers of using tap water of nasal irrigation using neti pot after two people died of infection by “brain eating amoeba”  (Source: http://www.medpagetoday.com/InfectiousDisease/InfectionControl/30283).
• According to the first National Diabetes audit (U.K.) about three-quarters of avoidable diabetes-related deaths occur in people over 65 years of age (Source: http://www.netdoctor.co.uk/interactive/news/up-to-24000-diabetes-related-deaths-are-avoidable-id801239169-t116.html).
• World Health Organization (WHO) report reveals 655,000 deaths in 2010 due to Malaria and Africa accounted for 91% of deaths. UN health agency claims to eradicate this deadly disease by the end of the year 2015 (Source: http://www.nydailynews.com/life-style/health/655-000-malaria-deaths-2010-africa-accounted-91-percent-deaths-article-1.991359).
• In his interview, Oliver Aubry, MSF head of mission in the Central African Republic, says Central Africais in a state of health emergency. Mortality rate reaches emergency levels (Sources: http://www.doctorswithoutborders.org/news/article.cfm?id=5665&cat=field-news, http://www.doctorswithoutborders.org/press/release.cfm?id=5669&cat=press-release).
• More than 100 people died of drinking contaminated liquor in the villages of West Bengal, India (Sources: http://www.washingtontimes.com/news/2011/dec/15/bootleg-booze-kills-143-in-eastern-india/, http://www.reuters.com/article/2011/12/15/india-hooch-idUSL3E7NF2SC20111215).
• Malaysia’s Fourth National Health and Morbidity survey report reveal the unhealthy lifestyle and dietary habits of Malaysian’s (Source: http://thestar.com.my/news/story.asp?file=/2011/12/16/nation/10109475&sec=nation).
• The International Diabetes Federation president-elect said by 2025, 380 million people will have diabetes, with the greatest burden falling on low and middle-income countries (Source: http://www.dailytimes.com.pk/default.asp?page=2011\12\12\story_12-12-2011_pg7_23).
• Pakistanfacing acute threat of bird flu infection, though no warnings have been issued yet (Source: http://www.dailytimes.com.pk/default.asp?page=2011\12\12\story_12-12-2011_pg7_2).

These headlines were compiled by Vani Nanda, MPH Candidate at West Chester University PA.

Global Health Weekly News Round-up

Politics and Policies

• The US federal government has awarded Iowa $7 million to prepare a computerized system that will help the small businesses and individuals to find affordable coverage. (Source: http://blogs.desmoinesregister.com/dmr/index.php/2011/11/29/feds-give-state-7-million-for-insurance-exchange-planning/ )
• US federal agency has rejected Indiana’s bid for an exemption from federal health care. (Source: http://www.cbsnews.com/8301-505245_162-57332830/feds-reject-ind-request-for-health-care-exemption/ )
• The House of Delegates, at its interim meeting in November, directed the AMA to use screening tools from the National Institute of Drug Abuse and others to identify the patients likely to abuse prescription drugs.                                                                                                                  (Source: http://www.ama-assn.org/amednews/2011/11/28/prsd1128.htm )
• From December 7-9, 2011, Kenya will hold its first national human resources for health conference which will avail a platform for placing health as a priority in the health strategy and national development towards vision 2030. The theme of the conference will be “Renewing commitment to the health workforce towards achievement of MDGs and vision 2030”. (Source: http://allafrica.com/stories/201111291193.html )
• AstraZeneca Canada Inc., in partnership with mindyourbody and Physical and Health Educators (PHE) of Canada, together with the active involvement of the youth, has organized a program in Ontario, Canada. It is focused on improving the mental health and emotional well-being of vulnerable adolescents. (Source: http://www.digitaljournal.com/pr/505390 )
• The Capital Metropolitan Transportation Authority will be posting no smoke signs within 15 feet of bus stops in Austin, Texas, beginning from February 1^st 2012 to prevent the non-smokers from inhaling the secondhand smoke. (Source: http://www.dailytexanonline.com/opinion/2011/11/28/capmetros-policy-breath-fresh-air )
• A recent study done by Dr. Avi Dor, professor in the Department of Health Policy at the GW School of Public Health and Health Services indicates a need to develop policies to encourage medication compliance which will lead to cost savings through healthcare system in the long run. (Source: http://www.newswise.com/articles/higher-patient-adherence-to-disease-modifying-therapies-reduced-costs-for-ms-patients )
• An invitation for the bid for consultant on public health authorities’ activities with the aim to protect the environment has been issued by the Ministry of Health of Azerbaijan. (Source: http://abc.az/eng/news_29_11_2011_60039.html )

Programs

• The first WHO European Conference on the New European Policy for Health – Health 2020, held in Jerusalem, Israel has called for working together across sectors for health and well-being. (Source: http://www.epha.org/spip.php?article4859 )
• In the 44^th Annual Meeting of the American Society of Nephrology, it was said that Healthy People 2010 met the goal of lower CVD deaths in CKD patients. (Source: http://www.medscape.com/viewarticle/754362 )
• The Global Fund will not be able to fund to fight AIDS, Tuberculosis and Malaria until the year 2014. (Source: http://www.cbsnews.com/8301-202_162-57331033/massive-global-health-fund-says-its-broke/ )

Research

• A study done by a team at Harvard University involving stem cell transplant in the brain circulatory of mice could pave a way for effective treatment of Parkinson’s disease and autism. (Source: http://www.thehindu.com/health/medicine-and-research/article2659553.ece )
• According to a study done by the scientists at Indiana School of Medicine in Indianapolis, playing video games can make you aggressive. The research showed that the areas of the brain most affected were the left inferior frontal lobe and the anterior cingulate cortex. Once the gamers stopped playing, these areas of brain came back to normal. (Source: http://www.hindustantimes.com/Lifestyle/Wellness/Violent-video-games-make-you-aggressive/Article1-775010.aspx )
• In a recent study done by scientists at Harvard School of Public Health, a relationship was found between coffee consumption and rate of occurrence of endometrial cancer. They found an inverse relationship and found that the women who drank four or more cups of coffee had significant reduction (25%) in the risk of endometrial cancer than those who limit themselves to one cup of coffee per day. (Source: http://www.hindustantimes.com/Lifestyle/Wellness/Four-cups-of-coffee-can-prevent-womb-cancer/Article1-773052.aspx )
• The US Food and Drug Administration (FDA) has developed a new wet AMD drug known as EYLEA. This drug, when injected into the eye, will prevent the growth of abnormal blood vessels in the eye under retina to prevent their bleeding and preventing an abnormal blood loss. (Source: http://www.ffb.ca/research/research_news/eyelea.html )
• A new treatment for severe emphysema has been brought to light by the team of doctors at Thoraxklinik in Heidelberg, Germany. They used first endoscopic lung volume reduction system known as InterVapor that does not leave any foreign materials in the lungs but utilizes the body’s self-healing process for the treatment of this problem. (Source: http://www.reuters.com/article/2011/11/29/idUS125291+29-Nov-2011+PRN20111129 )

Diseases and Disasters

• According to a CDC report, of the 1.2 million Americans who have HIV, 20% are unaware of their status. (Source: http://www.cbsnews.com/8301-504763_162-57333212-10391704/cdc-240000-americans-have-hiv-and-dont-know-it/?tag=pop;stories )
• Egyptian scientists prepare an anti-diabetes drug from balsam pear. It has properties similar to bovine insulin and it will be taken orally, which will be a relief for the patients on insulin injections. (Source: http://www.dawn.com/2011/11/29/egyptian-scientists-to-make-diabetes-drug-from-bitter-fruit.html )
• The 2010 data indicates that in India, the state of Andhra Pradesh has the highest prevalence of HIV/ AIDS. (Source: http://www.thehindu.com/news/cities/Hyderabad/article2663262.ece )
• Nearly 6% of the population of Pakistan (about 10 million people) are infected with hepatitis C (Source: http://www.dailytimes.com.pk/default.asp?page=2011%5C11%5C28%5Cstory_28-11-2011_pg7_4 )
• The children in South Sudan are dying of preventable diseases. According to the UN, malaria is a hyper-epidemic in this country. It is said to be one of the biggest causes of miscarriage in pregnancy. (Source: http://www.iol.co.za/news/africa/s-sudan-children-dying-of-preventable-diseases-1.1188555 )
• The countries in East Africa have been hit by the nanana wilt and the Cassava Brown Streak disease which has affected the household incomes and raised the famine threat. A warning has been issued by the Food and Agriculture Organization (FAO). (Source: http://digitaljournal.com/article/315074 )

These headlines were compiled by Vani Nanda, MPH Candidate at West Chester University PA.

Addendum: What does health reform have to do with IH?

While I am sure that most of you have been riveted by my recaps of APHA’s Mid-Year Meeting on health reform, many readers are probably asking what the heck I, your friendly neighborhood Communications Chair, was doing there, and why the IH section was asked to send a representative to this meeting. The whole purpose of inviting section representatives and state affiliate leaders was to stimulate discussion about health care reform as it related to each section or affiliate’s work, and how the sections and affiliates could get more involved in the effort. Upon discovering this, my mind drew a blank.

How does health reform relate to the work of our members?

After some thought, I can see two major areas in which our membership would be interested in health reform. The first is in border health: despite the increased coverage that came with the new law, it does not cover undocumented immigrants and even some classes of migrant workers with temporary work visas (for example, those who come to work during the harvest season).

The other area is in sharing information. Our health reform battle has received much global attention, and the international health community is interested in the way the new health legislation will finally take shape and how individual communities will implement it. Also, a lot of the population health and wellness challenges that are being targeted by the Public Health and Prevention Fund grants (e.g. obesity, diabetes, tobacco use) are receiving increasing amounts of attention in developing nations as professionals are realizing that these countries share a disproportionate burden of chronic conditions. IH members who work in communities outside the U.S. may be interested in seeing how communities here address these issues, and they could apply some successful programs to their own communities facing similar issues.

The section representatives and affiliate leaders attended a luncheon that served as a breakout session to discuss these very issues. We were divided into geographic regions by table (which did not seem to make a lot of sense for section members, but it was productive nonetheless) and hashed out our impressions from the meeting and how the sessions related to the work of the sections and/or affiliates. APHA plans to use the notes from these discussions to compile a report for the sections and affiliates to use in their work as it relates to the mid-year meeting.

APHA Mid-Year Meeting, Day 3: Advocacy and Closing Remarks

Day three of the mid-year meeting started off with one last break-out, then moved to the closing general session and a break-out luncheon for the section representatives and state public health affiliates. I attended the “Assuring Population Health: Advocating for Prevention and Wellness” session, which left me wondering how the presentations in this session related to the topic. While I appreciate learning about how different communities are using their Prevention and Public Health Fund grants, I found myself asking where the advocacy was in some of the slide presentations.

One presentation which I did find interesting was one on “The Employer’s Perspective on Health and Health Care Reform” by Larry Boress, President and CEO of the Midwest Business Group on Health. Mr. Boress brought some very good points on the role of businesses in providing and advocating for health coverage (“We pay for everything, so we are advocating for how our money is spent”), as well as the incentive for employers to provide coverage for their employees – “It’s not because we’re altruistic. We do it for business reasons.” I was disappointed, however, when my question about a graph on one of his slides was completely sidestepped. It looked at the breakdown for how businesses answered the question, “How likely is it that drop health insurance coverage and let employees buy individual insurance from the new health insurance exchanges?” Twenty-six percent answered “Unlikely” while 27 percent said “Not likely” – what is the difference between these two? Are they not the same response? Unfortunately, Mr. Boress responded by explaining to me why employers would choose to provide health coverage to their workers.

On a more positive note, I was very impressed with the closing speech given by Dr. Lawrence Wallack, Dean of the College of Urban and Public Affairs at Portland State University. Not only did he spare us from a script on slides, he drove home some very important points about why health care and health reform are important, how we need to be framing the debate, and how we should engage the opposition when advocating for it. He said that there are two prevailing mentalities among Americans: the “yo-yos” (You are On Your Own) and the “wits” (We are In this Together). While the yo-yos stress personal responsibility and the idea that a person will do whatever it takes to get what he or she wants, wits believe that communities have to stick together to improve the common good, and that one person’s well-being is intimately connected to that of his or her neighbor. Most of us strike a balance between these two, and we need to appeal to the wit philosophy when framing the need for reform.

“If they can get you asking the wrong questions, they don’t have to provide the answers.” Dr. Wallack reminded the audience that we need to stop being distracted by questions that cannot be adequately answered and focus on framing the debate in terms of values that all Americans hold in common. He cited Lakoff’s three levels of analysis:

1. Big ideas and universal values like fairness, equality, justice, family, community
2. Issue types such as housing, education, etc.
3. Specific issues such as beer taxes, toxic waste sites, and health care coverage

During debates, progressives tend to argue from level three down, while conservatives argue at level one. Wallack argues that if we frame the health care issue at level one, we will have success at level three.

APHA Mid-Year Meeting, Day 1: Technology and Socializing

Greetings from APHA’s Mid-Year meeting in Chicago!  This year’s meeting is on healthcare reform, which is fortunate for me – with so much focus on international health news and topics, I unfortunately do not know much about the intricacies of the new healthcare reform legislation, or how it is being implemented on the ground.  I think many Americans are in the same position, however, so hopefully I will gain a better understanding of reform and be able to pass it on to you, the reader!

Upon checking in, I was given a flash drive in addition to a program and a badge holder.  This is such a great resource – it contains speaker bios and (most of) the PowerPoint presentations from each session.  After I arrived this afternoon, I attended one of the first break-out sessions of the conference, “Technology Implications of Health Reform.”  The panel was made up of a representative from CDC, the Kentucky state health commissioner, and the CEO of the Cabarrus Health Alliance (which, believe it or not, is actually a county health department!).  Each one gave his perspective on implementing electronic medical records and building a health information exchange on the federal, state, and county level, respectively.  While I appreciate the excitement surrounding the possibilities of electronic health records (EHRs), I pointed out that even clinicians and health institutions that have them are not able to use them beyond searching for records by patient name or consultation date, plus whatever queries have been pre-programmed into the software by the vendor so that the practice can get the “Meaningful Use” dollars from the government.  I have experienced this in my public health surveillance work – providers have no idea how to pull the information that we are looking for from their records.  We have a long way to go before EHRs are useful on a large scale to public health surveillance and research.

Later in the evening, I had a chance to meet some of the APHA section representatives that were given the same opportunity as I was to attend the meeting.  This is apparently the first year that APHA has been able to bring section representatives to the mid-year meeting, so it is exciting to be a part of it.  The challenge will be thinking about how the information at this meeting can be applied to the activities of the IH section.  What do you think?

Video on Massachussetts Health Care Spending

Politicizing our National Health Security

By Dr. Samir N. Banoob

In 1994, after the Republicans paralyzed the Clinton health reform proposal, I published an article in the Florida Journal of Public Health titled “Reforming health care in the US and Europe: Why we fail and they succeed.” It explained why health reforms succeed in other Western countries with policies of universal access and user-friendly systems. In our case, the Republicans sacrificed health security of all citizens to play the political game of “Repeal the Obama Affordable Health Care Act,” responding to lobbyists and funding from interest groups. Members of Congress who voted to repeal the law come from the same category of irresponsible politicians who represent special interests that opposed Social Security, Medicare and Medicaid for short political gains.

To review where we are, the American health care non-system:

• is the only system that does not provide health security to its citizens. The uninsured population reached 46.3 million in 2008 (compared to 36 million in 1993) and is steadily increasing. If the status quo continues by repealing Obamacare, it is expected to reach 75 million in 2019.
• is the most expensive system in the world. American healthcare expenditures made up 16.2% of our gross national income in 2008, compared to an average of 9% in Europe. Without the recently passed reforms, it will soon reach 25%, which is almost double the cost in any country of comparable national income. The cost per individual reached $7,681 in 2008.
• has one of the lowest provider-to-population ratios and the highest administrator-to-provider ratios (8 administrators per 10 health providers) among Western nations. The administrative portion of private health insurance agency expenditures is 30%, compared to 2-4% in Medicare and governmental agencies.
• has one of the lowest proportions of hospital beds for the population, the lowest hospital admission rate and the shortest length of hospital stay among Western nations. While European citizens use an average of 7-8 outpatient doctor visits per year, Americans use 3.8 visits per year.

These are just few features of our system that some falsely call “the best system in the world.” By technical and scientific standards, this system is ranked 37th among the 190 countries in the world. Life expectancy at birth, 78 years in the US, is among the lowest of industrial countries. Seven out of 1,000 American children die before their first birthday, a figure similar to that of Thailand and Lithuania. While many are proud of our rate of high-tech surgical procedures, research has demonstrated that about 20% of these procedures are unnecessary and are financially driven or performed to avoid litigation. The scientific measures of quality of care indicate that the American system is, at best, comparable to most Western countries.

Many opponents of the reforms cite concerns such as mandating insurance coverage or government involvement. However, health insurance is compulsory in most developed nations to avoid the costs incurred by individuals who do not pay for coverage and go to emergency rooms for care, shifting the cost to the insured. Also, the notion that the public option will increase government’s involvement in health care is false: about 45% of Americans’ health care costs are covered by governmental programs, including Medicare, Medicaid, Veterans health services, and state and local government services. Another allegation is the cost and the deficit, but this does not take into account the savings for individuals and families from reducing out-of pocket costs, as well as the cost to employers, who will either pay more or will lower health benefits or shift the cost to the employees. Others intentionally confuse the debate by bringing in political ideology or simply targeting the President and the Democratic party. This irresponsible act will hurt all Americans in the future.

It is essential at this time to focus the debate on the health system. To those fighting for repeal, please come with the alternatives first. What will happen to the escalating number of citizens who are uninsured, and those who have preexisting conditions, and the skyrocketing health care cost?

Let us play politics away from the nation’s health security.

More Information
WHO World Health Statistic 2009 Report (PDF)
OECD Health Data 2009

Samir Banoob, M.D., D.M., D.P.H., Ph.D., is the president of International Health Management, consulting firm in Florida that leads international health projects and trains scholars from more than 70 countries. He has taught as a professor of international health policy and management and has worked as a consultant to WHO, World Bank, and other international agencies on projects in 76 countries. He served as the Chair of the International Health Section from 1992 to 1994, and again from 2006 to 2008.

Dear Congress: I know it’s hard, but could you please try to get health reform right just once?

It would be nice if, for once, Congress could get health reform right.

In his State of the Union address, Obama all but begged Congress to not walk away from health care reform.¹ After the election of Scott Brown to the Massachusetts Senate seat formerly held by the late Ted Kennedy, journalists and bloggers have been declaring reform DOA (or, at best, “on life support”²).  Ironically, Senator Kennedy – a champion of health care reform – was replaced by a Republican who broke the Democrats’ filibuster-proof 60-seat majority and derailed the party’s plans to streamline – or, as some might say, ramrod – healthcare reform into law, with or without bipartisan consensus.  Since then, Capitol Hill has been quiet.  Pelosi has said that the controversial Senate bill does not have the support in House needed to pass it there and put it on the president’s desk.³ Other legislative maneuvers are also being considered, but it seems that, at least for now, members of Congress are letting the dust settle before they figure out their next moves.

While the Massachusetts election has been alternately hailed or blamed for de-railing health reform, it could be argued that the White House and Congress were doing a good job of mangling it during negotiation.  What Obama promised would be an open process – “broadcast on C-SPAN,” he claimed in his campaign – turned out to be the same old story of Washington back-room deals.  The Senate dropped the public option when Joe Lieberman threatened to withhold his vote.⁴ Ben Nelson managed to upset everybody when he traded his vote for the “Cornhusker Kickback” – an agreement that the federal government would shoulder Nebraska’s Medicaid burden forever. All this wheeling and dealing, combined with Republicans’ absolute refusal to join in the effort and rumors of “death panels” and “socialized medicine,” has driven public opinion away from the whole convoluted process.  A recent USA Today/Gallup poll found that 55% of Americans think that Congress should suspend work on current health care bills and start over.⁵ By the time it was ready to be reconciled, most of the public had no idea what it even said.

Ultimately, it seems our leaders are perpetually more concerned with being re-elected than they are with doing their jobs – passing legislation.  Brown’s victory is the latest in a string of recent Republican victories that are making Democrats up for re-election nervous; now that things are cooling off, many of them are reluctant to re-commit to reform effort.  Republicans seem to be more concerned with making Democrats look bad so they can regain control of Congress than with working with them to get something done.  Even the president has begun to shift his attention to other issues, such as bank reform, to attempt to regain some popularity.⁶ Those of us who were so looking forward to reform after both Roosevelts, Truman, Kennedy, and Clinton had all tried and failed⁷ may be disappointed again.

Killing Health Reform: Not This Time

 By Samir N. Banoob, M.D, Ph.D.*

“ The administration inherited a basket of bad apples from its predecessor: the budget deficit, the recession, a week economy and unemployment to mention a few. Among the problems, the health care crisis is the worst by far”

This quote is not recent since I published it on February 7, 1993 in the St Pete Times, an article titled “Health Care: Painful Remedies are needed” 

I was referring to the Clinton administration and the President’s promise to produce his Health Security act within the first administration 100 days. As a reminder, at that time Republicans raised the issues of big government, increasing the deficit, government taking over health care, eliminating choices, more taxation, hurting the private sector and the rest of the same old story. Moreover, they introduced 6 more health plan proposals to the Congress until the whole reform issue faded away and was dropped. This was paralleled with an aggressive heavily funded campaign lead by the Republican Party, insurance companies, the pharmaceutical industry and others. Since then, and until 2008, every Democratic presidential candidate, learning the lesson the hard way, dropped the health insurance and universal coverage from his agenda.

In 1994, I published an article in the Florida Journal of Public Health (vol VI, no1) on “Reforming Health Care in the US and Europe: Why we Fail and They Succeed? “ It said: “Why health reforms succeed in all western countries?  They established concrete health policies of universal access and user-friendly systems in the 30s and the 40s, guided by a solid commitment to national welfare and social solidarity. Second, the voice of interest groups is not so loud, and if it becomes so, its impact on policy-making is minimal since policy makers’ behaviors are put under stringent scrutiny of their well-informed voters. Third, the government and the elected representatives, who are elected by the watchful voters, are more trusted, and the government is allowed to govern, and elected representatives make decisions in the public interest”
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- * Samir Banoob, M.D, D.M, DPH, Ph.D. is a professor of international health policy and management and consultant to WHO, World Bank and international agencies who consulted with 76 countries.