Welcome to the Blog of the Duke Center for Research on Prospective Health Care

The mission of the Duke Center for Research on Prospective Health Care is to support the development and implementation of prospective health care, a personalized, predictive, preventive and participatory approach to care that is based on the integration of three key elements: (1) personalized health planning, (2) coordination of care, and (3) rational reimbursement. On this blog we discuss current issues in prospective health care and personalized medicine, including ongoing research and outreach in the Center, the work of other leaders in the field, and innovations in science and technology that can promote this model of care. We invite you to this important conversation and look forward to your thoughtful comments and ideas.

The views, opinions and positions expressed by the authors and those providing comments on these blogs are theirs alone, and do not necessarily reflect the views, opinions or positions of Duke's Center for Research on Personalized Health Care.

Friday, February 4, 2011

Controversy over reform – what’s the deal?

By Sanjay Kishore:

While healthcare has already become a firestorm of controversy for the Obama Administration, the President’s recent reform bill received another blow this past week – once again, from the courts. As reported by the New York Times on January 31st, a federal judge in Florida followed the precedent set by a Virginia court and struck down the constitutionality of the March 2010 Patient Protection and Affordable Care Act (PPACA).

In both court decisions, the issue in contention was the law’s inclusion of an “individual mandate” – a provision that requires all Americans to obtain health insurance or otherwise face a monetary penalty. Essentially, these two justices believe the federal government has overstepped its bounds by pressuring people into purchasing insurance – a sentiment recently echoed by Republican legislators as they passed a symbolic vote to repeal PPACA in the House of Representatives earlier this month.

Obviously, momentum for healthcare reform has shifted in the past year. But, what does all this controversy actually mean – especially in the context of prospective health?

Many advocates of PHC – including students like myself – realize the first step to increasing prediction and prevention in our healthcare system isn’t developing new technologies or utilizing fancy screenings: it’s extending access to what we already have. Before 2010, uninsured Americans had no financial incentive to seek preventive medical treatment – after all, if you’re an individual living on a tight-income, why visit a doctor when you’re healthy? As a result, almost 45 million Americans faced an economic pressure to delay seeking medical assistance until a traumatic incident – say, a heart attack – became too severe to bear.

Though PPACA’s expansion of insurance to 32 million Americans didn’t solve the problem, it was a solid start. If we are serious about halting the spread of chronic disease and promoting wellness in the US, we must extend access to health insurance.

As students interested in preventive healthcare, it’s in our best interests to keep our ears tuned – and our voices loud – for the next few years could be telling for the future of American healthcare!

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