ACA and Public Health

Experts urge a shift from reactive to preventative health care

This article is not about the Affordable Care Act.  It's not about policies or budgets or mandates, and it's certainly not about politics.  It's about people.  It's about public health.  Of course, those are all aspects of healthcare, but there are multiple factors that contribute to being (and staying) healthy. Let's have a discussion.

ADVANCE recently spoke with experts and officials from both sides of the debate on the subject of healthcare. Despite coming from different political spectrums in some cases, the messages were at times remarkably similar - separated mainly by the journey rather than the destination. Keith Kantor, PhD, ScD, DBA, CEO of Green Box Foods, started the discussion with an interesting interpretation of American healthcare as generally more reactive than preventative.

"People have to realize that we don't have a real healthcare system in the United States," he said. "We have a disease and accident management system."

For Kantor, the concept of healthcare is much bigger than the Affordable Care Act (ACA or ObamaCare), but should deal with the all-around health of the average citizen. He encouraged a big picture view of public health, which encompasses nutrition, prevention, treatment and education as fundamentally (and equally) important for each citizen. In terms of the average citizen, he noted that apart from annual checkups for insurance, we really only schedule appointments with medical professionals when we're already ill or injured.   

"That's not where we put any money," continued Kantor. "So, if a doctor is good at helping prevent disease, he doesn't get paid for that - or a hospital. So, somehow we have to make the system where there's an incentive for the medical and health profession to do that, and then we have to push that much more."

Enhancing the Role of Preventative Medicine
Within the ACA, the role of prevention is being expanded as evidenced by mandates on pricing for preventive services, which are free under most plans inside and outside the Health Insurance Marketplace.  According to a Center of Medicaid and Medicare Services (CMS) spokesman, "The Affordable Care Act places an emphasis on preventive care by making preventive services free for many consumers." For plans in the Health Insurance Marketplace, consumers can compare coverage options based on quality, price, benefits and any other features that are important to them. Additionally, an extensive outreach and education campaign is underway, aimed to raise awareness about everything offered in the Marketplace.

As for a look at healthcare in terms of a lifestyle rather than a system for treatment, the Food and Drug Administration (FDA) and the U.S. Department of Agriculture (USDA) each play important roles in the nutrition available to consumers around the country. A USDA spokesperson noted the need to promote healthier changes in diet to the youth of the country. They went on to discuss changes in the content of meals offered in schools as a good starting point in teaching children to make healthy choices about what they eat. 

"Sometimes it takes a generational shift to make a shift in diet, and that's why we're making sure that there's healthier meals in schools - great place to start," commented the USDA spokesperson. "Starting with kids, they start changing their palate. They start asking their parents. They grow up with a different set of things on their plates. Their food expectations are different as they grow."

Healthy Living Starts Early
Kantor had similar thoughts in terms of making education a priority, especially for children. In what is now his second book - this one a children's book entitled, The Green Box League of Nutritious Justice - he took aim at promoting a healthy lifestyle. His first book, What Matters, critiqued ObamaCare and offered solutions for a more efficient system of healthcare. In addition to his concerns with the ACA, he discussed the need for a change in regulations on food available in grocery stores and supermarkets, specifically targeting the prevalence of less-healthy processed foods.  

"Right now, the government puts the burden on the natural companies, and it doesn't put the burden on the companies that have all the processed foods," he said. "And, if they switched that burden, that would make the food less expensive and more readily available."

Looking at the availability of more natural dietary options, the USDA spokesperson pointed out the importance of making more nutritious food items available across the board financially.  They stressed the need for a change in diet and discussed programs the government is currently offering to improve access to higher quality foods, including work to incorporate more Electronic Benefits Transfer (EBT) machines for consumers enrolled in the Supplemental Nutrition Assistance Program (SNAP) in places that offer healthier food items, such as farmer's markets. This initiative would open the door to a greater variety of food available to lower income families.

"One of the things that we are really on a mission to do is make sure that more places that are selling healthier food, like fruits and vegetables - farmer's markets being a great example - are equipped with the technology necessary to process that payment method," explained the USDA Spokesperson.

Food Regulation
While Kantor pointed out a need for more focus on regulation for processed foods to open up restrictions and subsequently lower costs for natural or organic options, the USDA spokesperson maintained the need to strict guidelines for "organic" products due to the ways the foods are handled and processed, as well as produced. Additionally, the USDA spokesperson clarified the difference between "organic," which follows a specific set of regulations under the law, and "natural" foods, which fall into several categories.

Additionally, FDA spokesman Arthur Whitmore weighed in on the role of labeling, specifying that labeling does not typically address the ways in which food is processed. He commented that,  although "no federal definition has been established" for the term, the long standing policy for products labeled as "natural" is that they contain nothing artificial or synthetic, including colorants.   

"The nutrition label is the keystone of federal efforts to help consumers choose a healthful diet," said Whitmore. "To this end, FDA has been considering and will propose later this year improvements to nutrition labeling of food products. FDA has also been working with the food industry to encourage reduction of sodium in processed food products."

The Affordable Care Act is law. It has been for a while now and, despite his political stance, even Kantor doubts the effectiveness of any attempt to repeal it. For those involved in the industry, regulations concerning healthcare stand to have a significant impact on medical professionals directly. Regardless of individual opinions for or against ObamaCare, however, simply being viewed as concrete doesn't mean that the role of healthcare is beyond criticism. After all, this is a matter of public health. Shouldn't we all be striving to improve it?

Michael Jones is on staff at ADVANCE.


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