Public Health and the Role of Government in Health Care

Question #1: 500 words with one reference needed by Feb 24, 2016

After reading the WHO (2008) Copenhagen Conference document "Health systems, health, and wealth: Assessing the case for investing in health systems", consider the following dilemma. Health policy-makers have been under enormous pressure in recent years over concerns about financial sustainability and cost-containment. The resources available to any society are finite, but emerging evidence is recasting health systems not as a drain on those resources but as an opportunity to invest in the health of the population and in economic growth. Health systems, health and wealth are inextricably linked in a set of mutually reinforcing and dynamic relationships. This new paradigm offers an opportunity for a fundamental reassessment of the role of health systems in society. Please expound upon these three questions:

  • How can we improve health, wealth and societal well-being by investing in health systems?
  • How can we ensure that health systems are sustained in the future?
  • How can we monitor, manage and improve performance so that health systems are as effective and efficient as possible?

Question #2: 500 words with one reference needed by Feb 26, 2016

  • It is unfortunate that it requires a new threat or epidemic to halt the demise of organized public health and restore an effective public health structure. Why does public health have so much difficulty maintaining governmental support of its central role in maintaining the health and well-being of the American people?

Summary:

This module presented the history of government efforts to prevent or control the problems of health and disease. Efforts to protect the public's health, begun in early European history and transferred to Colonial America, were traced, with emphasis on their purpose, motivation, and success. The rise and decline of American's once elaborate federal, state, and local partnerships in the delivery of public health services were described, as well as the efforts of private and voluntary agencies. Also discussed were the barriers to effective preventive services that resulted from the lack of a population perspective in the U.S. health care system.

The goal of public health is to secure health and promote wellness, for both individuals and communities, by addressing the social, environmental, and individual determinants of health. As defined by the World Health Organization, health is "A state of complete well-being, physical, social, and mental, and not merely the absence of disease or infirmity."

Despite the merit of this intent, a lack of consensus on the public health mission, inadequate capacity in the field, disjointed decision making, hobbled leadership, and organizational fragmentation led the Institute of Medicine (IOM) in 1988 to liken public health to a "shattered vision." Two decades later, has that assessment borne out? What does the future of public health look like today, and what will it look like in the coming years?