Public Health 3.0: Creating a true universal health care system
by Ronnie Shure, President
Spring 2023
Health Care for All - Washington envisions a healthcare system that is accessible, equitable, high quality, sustainable, affordable, patient-centered, and publicly and privately delivered to all Washington residents. We developed strategies that will improve health outcomes for everybody. The 2023 Washington State Legislative Session is winding down, and we are about to celebrate several victories for social justice issues in health care. The boards, commissions, and work groups managed by our state government are improving the current healthcare market, and we are identifying the next steps to control costs and expand health care to everybody. Will these changes extend our life expectancy and improve our health outcomes? Will improvements in our healthcare delivery system prevent chronic diseases, communicable diseases, and injuries? Even though we spend more money on health care than other developed countries, weget worse health outcomes. At our annual meeting last December, four public health experts offered a plan to improve health outcomes and develop a true universal health care system.
Gary Goldbaum, Umair Shah, Anthony Chen, and Bruce Gray reminded us that the parts of our healthcare system that provide primary care and secondary care (“disease care” or “repair care”) are important, but they are not the factors that determine our health. The social and political determinants of health have the most impact. Education, housing, food, social support, environment, and safety improve health outcomes. Clean water and proper sanitation were responsible for the greatest improvements in our life expectancy, and public health measures are still needed to improve our environment today. There are marked differences between health outcomes in urban and rural communities, in rich and poor neighborhoods, and in the diversity of race, ethnicity, and gender across our state. Our public health experts told us that we must focus on disparities, because the differences in health outcomes impacts the whole community.
Public health is a part of healthcare reform. Primary care includes immunization against communicable diseases, patientcentered care of chronic diseases, and education about the social determinants of our health. Public health connects the different types of care that a true universal health care system provides - such as prevention, protecting our environment, integrating the various social determinants, demanding equity, decreasing violence and injuries.
We can advocate for public health by insisting that value-based care includes evaluation of each patient’s housing, nutrition, social support, environment, and safety. We can demand that community members with lived experience be at the table to ensure equity. We can support foundational public health services, our state’s public health transformational plan, and innovations in our communities.
Check out these resources:
1) “Public Health in an Age of Healthcare Uncertainty”
2) “Transformational Plan: A Vision for Health in Washington State (2022-2024)”