Wednesday, July 15, 2009

RP: Health Reform Jumps First Senate Hurdle

The Affordable Health Choices Act, legislation supported by the American Public Health Association, passed through the Senate Health, Education, Labor and Pensions (HELP) Committee this afternoon. Some of the most exciting aspects of the bill (...in terms of social determinants of health) are:
  • Establish a program at the Centers for Disease Control and Prevention to "facilitate the use of health impact assessments to gauge the public health implications of major decisions regarding the built environment, including housing, transportation systems, waste disposal sites and other land-use planning decisions.
  • Establish a grant program for state and local governmental and community-based organizations to implement evidence-based community preventive health activities to reduce chronic disease rates, address health disparities (including social determinants of health), and develop a stronger evidence base of effective prevention programs and interventions.
  • Collect data and conduct research on the health and healthcare of populations that have traditionally experienced health disparities...in efforts to improve the quality and effectiveness of health services." (quotes are taken from an APHA e-mail blast)
I am excited that these components of the plan take a social determinants approach to some of the health system issues that are currently lacking. Additionally, it was wise to articulate the needed move toward an evidence-based health care system, not only in terms of medical treatment, but also prevention activities!

I had wished, however, that the creation of programs for a "public health workforce loan repayment program" would have been a grant or scholarship program for students entering graduate degrees at accredited public health schools (...am I bitter of the lack of funding for my master's degree? or the idea that I might have to fight for a stipend in a doctoral program?...)

While many health reform advocates are hopeful at this point, the slim (partisan) margin by which this bill was passed is worrisome (13-10). Next, the Senate Finance Committee holds a markup of its version of the legislation and later their version is merged with the recently passed HELP Committee bill.

Up next -- how do the House and Senate health reform legislation compare? Great question!

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