Obama, Clinton on Prevention and Public Health Policy

I wanted to write about the Democratic candidates’ health plans. I will focus on what their plans say about prevention and public health rather than the broader topic of universal health care.

Obama’s plan

Lowering health care costs and ensuring affordable, high quality health care for all”.

“Less that 4 cents of every health care dollar is spent on prevention and public health. Our health care system has become a disease care system, and the time for change is well overdo.”

Covering the uninsured and modernizing America’ s health care system are urgent priorities but they are not enough. Simply put, in the absence of a radical shift towards prevention and public health, we will not be successful in containing medical costs or improving the health of the American people.”

Protecting and promoting health and wellness in this nation is a shared responsibility among individuals and families, school systems, employers, the medical and public health workforce, and federal and state and local governments.” His plan then describes how each of these can contribute to encourage Americans to adopt healthy lifestyles.

Clinton’s plan

“Quality Affordable Health Care for Every American”

“Prioritize prevention to reduce the incidence of disease that impose huge human and financial burdens.”

our back-ended coverage of health care that gives short-shift to prevention

Her plan proposes “A Groundbreaking National Prevention Initiative to Reduce the Incidence of Such Diseases as Diabetes and Cancer that Impose Huge Human and Financial Costs ” This initiative would:

  • require all insurers participating in federal programs to cover prevention priorities.
  • Coordinate public spending on prevention across federal programs in the Department of Health and Human Services to maximize high-priority prevention and push prevention outside of the boundaries of the health care system and into schools, workplace, supermarkets and communities through free provision of preventive benefits.

Her plan acknowledges the fact that our current physician payment system does not value prevention and that insurance reimbursements are higher for procedures than for counseling and patient management.

My Conclusion

Obama’s discussion on promoting prevention and strengthening public health shows that he or his health advisers understand the value of public health practitioners and how they are strained to perform their traditional functions as well as participate in chronic disease prevention and disaster preparedness. He recognizes that health is a shared responsibility which involves medical and public health workforce as well as the individual, families, schools, employers, and government.

So after reading the Democratic candidates’ plans, I believe that the Obama plan is superior with respect to prevention and public health policy because he recognizes that covering the uninsured is not enough to improve the health of Americans. The current health care system needs a change that includes a strong emphasis on public health and prevention.

His plan comes closest to recognizing the WHO definition of health.

A state of complete physical, mental, and social well being and not merely the absence of disease or infirmity.”


4 Responses to Obama, Clinton on Prevention and Public Health Policy

  1. mikelove says:

    Clinton seems to have the same rhetoric about prevention and shared responsibility of public health. Would you say it’s more central to one or the other?

  2. suelove says:

    Obama’s plan seems more focused on prevention , encouraging healthy lifestyles, and strengthening public health. I did not see any mention of the role of the state and local health department in Clinton’s plan.

  3. Cory Whitney says:

    It is hard to watch this debate taking place, Clinton is slamming Obama repeatedly and repeatedly it turns out that she is wrong. Her health care plan is not better, or claimed ‘by all the experts’ to be better than his.

  4. Frank D. says:

    Hillary’s healthcare plan will dramatically improve access to healthcare, while Obama’s plan shifts a lot of costs to consumers, so people still wont be able to afford them. Statistics of number of ‘insured’ might go up, but the actual protection against huge uncovered costs wont improve greatly. Plus, even if companies can’t turn people away, what good are plans for people with pre-existing conditions ‘who wont be turned away’. If the plans cost thousands of dollars a month, which they will need to, because of adverse selection, they will remain unreachable. Also, Obama wont stop rescission, he wont stop cost shifting, in fact, cost shifting is an integral part of his plan, its at the essence of ‘choice’ – which is a cruel gamble on an uncertain future. (Nobody *expects* to get sick.) Hillary caps people’s expenditures at 5-10% of their income. Nowadays some people are spending 50% of their income paying for health insurance. And its getting worse. Obama isn’t addressing the cost at all and he isn’t getting anything in return from the insurance companies for giving them all those new customers. Hillary is using the healthy ones to lower costs for everyone, protecting everyone from risk, its the ONLY way.

    Elizabeth Edwards thinks Hillary’s healthcare plan is MUCH better than those of the other two candidates. You can watch/hear/read her talk about it at length here: (scroll down to ‘keynote’)


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