Locally and nationally, politicians analyze the cost of care, the lack of access to insurance and barriers to improving quality. But there is not enough discussion about improving the health of Americans, said Bradley Perkins, who oversees strategy and innovation for the Centers for Disease Control and Prevention.
And in the end, improving health will cut costs, making universal health care coverage more practical, he and others said Tuesday during a discussion at the Little American Hotel about reform.
"Where is health in the health care debate?" asked Perkins. "So much of health is created outside of health care, through the environments we live in and through the choices that we make."
As Utah lawmakers craft a health-care reform plan this summer, Perkins said, they should change an insurance system that pays for procedures, tests and consultations instead of better health.
For now, the task force - which must create a reform plan by November - is focused on reining in costs. One of its charges is promoting healthy behaviors.
David Sundwall, director of the Utah Department of Health, which invited Perkins to speak, said he will ''keep beating the drum on what I call embedding public health in the proposal. That really is what is going to save money down the road.''
As president of the Association of State and Territorial Health Officers, Sundwall said he will also work on getting presidential candidates to talk about public health when they tout their reform plans.
Perkins said the U.S. could learn from the European system, which requires government departments including agriculture, transportation, housing and education, to consider the health impacts of policies. He said the U.S. farm policy - which ends up promoting junk food by subsidizing cheap corn - contributes to obesity instead of improving health.
In education policy, not only would promoting physical education improve health, it would boost graduation rates, he noted. For example, in Utah, obesity drops when women get college degrees, according to health department data.
Sundwall said he likes the idea of "health impact statements" for Utah departments and hopes the task force recommends it to Gov. Jon Huntsman Jr.
Perkins said the CDC is developing a "health index" for people to assess their community, like the Dow Jones Industrial Average index measures the stock market. But in the end, Perkins said, government won't solve the problem. Businesses and individuals need to take responsibility to promote health, too.
Such leaders "can be quite influential for creating the conditions where people are going to be healthier," he said.
hmay@sltrib.com
