A Public Health Perspective on Health Care Reform

Abstract

This article (to be published in Health Matrix) argues that the Affordable Care Act has constructed the concepts of “prevention” and “public health” in a limited and narrow way. The law reflects an “individualist/biomedical paradigm” of preventive health that favors policy solutions that either assist individual patients to make better health-related choices or rely on biomedical screening and testing. This policy-making paradigm largely ignores the research of public health scholars indicating that the most effective interventions operate at the population level and focus on the environmental risk factors that contribute to disease. The article examines various provisions of the Affordable Care Act and demonstrates how they attempt to alter individual decision-making while leaving the broader social and environmental context unchanged.

Keywords: Health Care Reform, Public Health, Public Health Law, Workplace Wellness