Obamacare arrives in Allegheny County

The nation and the Pittsburgh region can now focus on preventive care

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Our fellow Pennsylvanian Ben Franklin once said that "an ounce of prevention is worth a pound of cure." In re-electing President Barack Obama, the United States re-affirmed its support of the Affordable Care Act and its strong emphasis on measures to promote public health.

In addition to providing access to care, the act begins to correct long-standing imbalances in our national health system away from reactively treating disease to preventing it from ever happening in the first place. As a result, we will be a healthier nation, and health care costs will decline -- or at least not rise as fast as they otherwise would.

Some 92,000 persons in Allegheny County currently lack health insurance coverage -- these people, our friends and neighbors, have been vulnerable to the debilitating effects and bankrupting costs of poor health for too long.

In the "shared responsibility" provision of the new law, the individual mandate requires citizens to buy insurance to provide for the health services they are certain to need. For those that cannot afford insurance, the law provides subsidies or access to Medicaid. Most Americans will now have coverage for illness and injury.

Equally important, a fully insured population -- with payments for prevention services such as blood pressure control, smoking cessation and immunizations -- will move our country from a health system focused on sickness to one that promotes wellness. When individuals have access to health services and live in communities that promote good health, they live longer, healthier and more productive lives. And health care costs are lower.

In addition to its insurance provisions, the ACA promotes sound health policy in several other important ways. It establishes a Prevention and Public Health Fund to improve health and restrain costs. A National Prevention Council has been created to develop a coherent strategy to demonstrate and encourage disease prevention. Science and best practices will be used by the U.S. Centers for Disease Control and Prevention to identify clinical preventive services and recommend community prevention and intervention techniques for individuals and for organizations delivering population-based services. And the IRS tax section of the ACA provides incentives for non-profit hospitals to become much more involved in addressing community health needs.

Here in Western Pennsylvania, we now have a once-in-a-lifetime opportunity to fundamentally improve the health and well-being of our fellow citizens. We can be justifiably proud of our outstanding health care providers, insurance companies, foundations and universities.

The Affordable Care Act provides us with the resources and policies to re-direct this health care delivery system from treatment to prevention. By pooling our resources and implementing scientifically sound, evidence-based prevention programs, we can improve the health of our community -- and save money at the same time.


Dr. Donald Burke is dean of the University of Pittsburgh Graduate School of Public Health (www.publichealth. pitt.edu).


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