What’s in a name?

Although Shakespeare tells us that a rose by any other name would smell as sweet, when is comes to the semantics of health reform, is that really the case?

As our nation debates ways to improve the health of the public, what is primarily being discussed is universal health coverage. And this is usually encapsulated under the larger umbrella of health care reform, a term often used to describe the road to universal access to health services. You won’t find a Wikipedia entry for “health reform,” but there is one for “health care reform” and its definition focuses solely on the health care delivery system.

The problem with this situation? Although universal coverage and access to doctors are important, focusing on health care reform — instead of the broader concept of health reform — maintains the current emphasis on treating sickness and overlooks a much more cost-effective solution to improving health: prevention.

Calling it health care reform allows the emphasis to center on the medical care system and treatment of those already ill while failing to acknowledge the decades of research showing the importance of intervening on the social determinants of health and changing where we live, work, learn and play to support healthy behaviors.

So although health care reform has come to be used interchangeably with health reform, it’s essential that as we seek ways to improve health in America we don’t allow the focus to remain on the medical care system. We need to ensure that our leaders understand the importance of a health reform package built around the population-based strategies of public health.

This is a time when parsing words could make a monumental difference.

Share your thoughts on this issue. How important is it to you that our leaders move away from the language of health care reform?

Now, the real work begins

Members of Congress are wasting little time bringing President-elect Barack Obama’s health reform promises into focus. Priorities are being tapped, leaders have been nominated and the often slowing-moving legislative ball is on an optimistic roll. Let’s just hope it gathers enough speed, support and forward-looking ideas to plug the growing hole that is the U.S. health care crisis.

Shortly after the November elections, Sen. Tom Harkin, D-Iowa, was chosen to lead a congressional working group tasked with developing the prevention and public health aspects of a national health reform bill, and late last week Harkin held a hearing on “Prevention and Public Health: The Key to Transforming Our Sick Care System.” At the hearing, Harkin thanked everyone for coming to “discuss why a new emphasis on prevention and strengthening our public health system are critical to transforming America’s health care system.”

“We need to improve the performance of our health care system,” Harkin said. “And we need to get health care costs under control. But those things will not happen unless we place a major new emphasis on wellness and disease prevention, while strengthening America’s public health system.”

(Hear that? That’s the sound of hundreds of thousands of public health workers breathing a sigh of relief as public health finally takes its rightful spot in the health reform debate. That other mumbling sound? Well, that’s also public health workers. If you listen closely, sentences start to form: “It’s about time.” “We still have a lot of work ahead of us.”)

Of course, the Harkin hearing is just the beginning. So start writing letters, e-mailing your ideas and reminding your congressional representatives of public health’s central role in better health, which is what 2009’s National Public Health Week is all about. For ideas on issues to mention, you can view APHA’s letter to Harkin our Web site.

You can also listen to the Harkin hearing. Also — and this is way cool — visit Obama’s Web site to post your comments about health reform for the transition team or to sign up to lead a health reform discussion in your home, community, local coffee shop, diner, church.......

And, of course, leave us your comments! How hopeful are you for public health’s future?