SPH Dean Attacks Congressional Bill

The "Patients' Bill of Rights" currently before Congress does not emphasize the need for preventive health care, the dean of the School of Public Health (SPH) said this week.

In an upcoming article in Newsweek magazine, Barry R. Bloom challenges the health insurance focus of the Congressional plan with his own "Public Health Bill of Rights."

"The real issue is not how to make group health plans pay more, but how to keep Americans from getting critically ill in the first place," Bloom writes in an Oct. 11 piece titled, "The Wrong Rights." He addresses the problems behind the nation's top killers: heart disease, cancer, stroke and injuries.

According to the article, tobacco use leads to 19 percent of all deaths; unhealthy diet and inactivity leads to 14 percent, alcohol leads to 5 percent, infectious disease leads to 5 percent, firearms lead to about 2 percent and accidents lead to 1 percent.

Bloom's Bill of Rights outlines six points targeting these causes: the right to information, the right to mother and infant care, the right to childhood immunization, the right to teenage counseling, the right to health screening and the right to a healthy environment.

Bloom writes that only a small percentage of Americans would be affected by the Patients' Bill of Rights, which would give patients the right to sue their managed care providers and to appeal claims to a third party.

The bill would also require HMOs to provide access to specialized and emergency care.

Bloom argues that the bill does nothing to tackle what he sees as the underlying problem of health care in America: inadequate preventive measures.

Referring to his first point, Bloom wrote, "Although we have perhaps the world's best doctors and hospitals, Americans in some regions live 25 years less than those in others."

Robin C. Herman, SPH director of communications, provided several examples of such life-span gaps.

An Asian female in Bergen County, New Jersey can expect to live 41 years longer than a Native American in Bennett or Jackson Counties in South Dakota.

And a white male in a Utah or Colorado county can expect to live 20 years longer than a black male in Washington, D.C.--or 14 years longer than a white male in the Bronx, New York.

"We have no clue why," Bloom wrote in the original, pre-edited version of the Public Health Bill of Rights.

In the piece's fourth point, Bloom wrote, "Teenagers should have the right to counseling about AIDS...and how to protect themselves from other STDs."

When asked about issues of parental consent, Herman said she did not know the dean's response.

"He has said that waiting until they are out of school is too late... He has not said that it has to be done in schools... He has talked about outreach programs. [Teenagers] are not going to come to health authorities to ask about how to protect themselves from AIDS and other sexually transmitted diseases," Herman said.

Regarding his final point about environmental concerns, Herman said public health is beginning to focus on the quality of indoor as well as outdoor air.

"He's trying to emphasize that concern," Herman said.

The SPH's department of environmental health has been doing what Herman called "groundbreaking work" on indoor air quality and particulates--larger particles that may be the most damaging constituents of air pollution, Herman said.

SPH Professor of Health Policy Robert J. Blendon said Bloom's Public Health Bill of Rights is "an important statement."

"We've lost sight of how many lives could be saved by not looking at some of the broader health issues that face the country," Blendon said.

Blendon added that the Patients' Bill of Rights "is a very important bill to address an important but narrowly focused problem."

"It's not a bill aimed to improve the health of the nation. It's a bill to help sick people who have problems with their health insurers," he said.

"There are so many things that can be done to improve health," he added.