Symposium Panelists Discuss Privatization of Public Health
With health care solidly in the hands of private providers, how do public health priorities such as disease prevention and education get integrated into private health plans?
One answer may have been found in a Minnesota-based health plan described in the most recent Future of Public Health Millennial Symposium series, "Privatization of Public Health: What Role Government?", on Thursday, January 18.
Panelist George Halvorson is the president and CEO of HealthPartners, a network of non-profit health care organizations that provides services, insurance and HMO coverage to nearly 650,000 members. The plan emphasizes prevention and changing the behaviors of people at risk for illnesses.
The plan's strategies seem to be working. Halvorson reported reductions in pre-term births, heart attacks, and diabetes among enrollees. But again, he said, persuasive data is needed to convince employers to buy health plans that focus on prevention, not just to settle for the least expensive plan. They must be shown, he said, that good health habits will benefit the company in terms of decreasing time lost to sick days and depression among employees.
Money plays another significant role in the discussion of the privatization of public health. According to panelist Bruce Vladeck, director of the Institute of Medicare Practice, increased funding of political campaigns by special interest groups has resulted in widening disparities in health status among Americans. These disparities drive the debate of whether health services should be come less privatized.
He explained that historically there has been a balance between the influence of wealth on health care and the "universal franchise," or people who redress inequities.
When inequities have arisen in the past, a group has emerged to fight for a return to balance. But the underwriting of political campaigns by special interest groups has undermined the voices of the universal franchise, disturbing the equilibrium.
"The power of money eclipses the power of the universal franchise," said Vladeck.
The result--health care is not becoming more privatized, said Vladeck (a point that Dean Bloom invited the panelists to challenge in their discussions). There have been no dramatic movements away from government-sponsored health care since World War II, said Vladeck. Instead there have been shifts in political rhetoric and the resulting public perception of how people receive their health care, with American politicians dressing government-related care in a negative veil. At the same time, little is actually understood about how systems such as managed care actually work in the United States, he said.
"We end up with a debate [about the privatization of health care] that is not informed by sophisticated looks at research but instead by name calling," said Vladeck.
He urged audience members to fill in the research gaps. As more data is presented to groups such as employers, he said, better-informed decisions can be made about how to deliver health care.
