The Latest Reports in Health Policy

The November/December 2002 issue of Health Affairs includes a series of articles on the U.S. public health system. Summaries of some of the articles appear below:

• "Strengthening the Nation's Public Health Infrastructure: Historic Challenge, Unprecedented Opportunity": The article, written by Edward Baker, assistant surgeon general and director of the Public Health Practice Program Office for the CDC, and Jeffrey Koplan, former director of the CDC, examines the progress made in public health over the last 10 years and looks at the "immediate challenges" and opportunities that have resulted from recent events (Baker/Koplan, Health Affairs, November/December 2002).
  
• "The Public Health Infrastructure: Rebuild Or Redesign?": The article, written by Nicole Lurie, senior natural scientist at RAND, explores whether the United States should revamp or completely redesign its public health system; whether medicine and public health can work together; if relying on a market-driven health system impedes progress; whether accountability can be "buil[t] in[to]" the public health sector; and how quality of care can be improved (Lurie, Health Affairs, November/December 2002).
  
• "The Unfulfilled Promise of Public Health: Déjà Vu All Over Again": The article, written by Elizabeth Fee, chief of the History of Medicine Division at the National Library of Medicine, and Theodore Brown, professor and chair of the Department of History at the University of Rochester, looks at the public health system's failure to "sustain progress in any coherent manner" and suggests learning from past mistakes (Fee/Brown, Health Affairs, November/December 2002).
  
• "Transforming The Public Health Information Infrastructure": The article, written by John Lumpkin, director of the Illinois Department of Public Health and chair of the National Committee on Vital and Health Statistics, and Margaret Richards, deputy director of the Illinois' Public Health Department's Office of Epidemiology and Health Systems Development, examines the effect of the Health Insurance Portability and Accountability Act of 1996 and the National Health Information Infrastructure recommendations on the nation's public health system. In addition, the article explores the current state of the system and the obstacles preventing improvements in the system (Lumpkin/Richards, Health Affairs, November/December 2002).
  
• "The Public Health Workforce": The article, written by Kristine Gebbie, an associate professor of nursing and director of the Center for Health Policy at Columbia University; Jacqueline Merrill, the center's project manager; and Hugh Tilson, senior adviser to the dean of the University of North Carolina School of Public Health, examines the task of ensuring that the public health workforce, including physicians, dentists, nurses and other health professionals, is prepared for future health needs (Gebbie et al., Health Affairs, November/December 2002).
  
• "Governmental Public Health in the United States: The Implications of Federalism": The article, written by Bernard Turnock, director of the Center for Public Health for the School of Public Health at the University of Illinois-Chicago, and Christopher Atchison, an associate dean for public health practice at the College of Public Health at the University of Iowa, looks at how the shift toward federalism in the United States has "challenge[d]" the government's response to public health needs (Turnock/Atchison, Health Affairs, November/December 2002).
  
• "Public Health and National Security: The Critical Role of Increased Federal Support": The article by Sen. Bill Frist (R-Tenn.) examines several "important policy questions" concerning public health, specifically the government's level of involvement and funding (Frist, Health Affairs, November/December 2002).
  
• "David Satcher Takes Stock": In an interview, former Surgeon General David Satcher addresses the role of public health in aftermath of the Sept. 11 attacks and in the subsequent anthrax incidents (Mullan, Health Affairs, November/December 2002).
  
• "Trends in Retiree Health Benefits": The article by Lauren McCormack, a senior research associate at RTI International, Jon Gabel, vice president of health systems studies at the Health Research and Educational Trust, and others examines national surveys from 1988 to 2001 concerning availability, cost, enrollment, benefits and other issues concerning health plans for retirees (McCormack et al., Health Affairs, November/December 2002).
  
• "Viagra: A Success Story for Rationing?": The article, written by Rudolf Klein, visiting professor at the London School of Hygiene, and Heidrun Sturm, a health care researcher for the Department of Clinical Pharmacology at the University of Groningen in the Netherlands, analyzes rationing of popular medications by providers and insurers in the United States, the United Kingdom, Germany and Sweden (Klein/Sturm, Health Affairs, November/December 2002).
  
• "Exploring the Limits of the Safety Net: Community Health Centers and Care for the Uninsured": Michael Gusmano, associate director of the Word Cities Project and a visiting scholar at New York University's Robert F. Wagner School of Public Service; Gerry Fairbrother, senior scientist at the New York Academy of Medicine's Division of Health and Science Policy; and Heidi Park, a research associate at the division, look at the extent to which community health centers are able to manage uninsured patient caseloads (Gusmano et al., Health Affairs, November/December 2002).
  
• "How and Why The Health Insurance System Will Collapse": The article, written by Humphrey Taylor, chair of the Harris Poll at Harris Interactive, theorizes that the use of defined-contribution plans will eventually lead to a "death spiral of adverse selection" (Taylor, Health Affairs, November/December 2002).
  
• "Getting the Elderly Their Due": The article, written by David Carliner, co-founder and senior vice president of development for Baltimore-based Elder Health, gives a "firsthand view" of an HMO administrator regarding the "helplessness" some seniors feel while trying to access health services (Carliner, Health Affairs, November/December 2002).
  
• "An Unsuspecting American with No Medicare Coverage -- Me!": Gordon Schiff, a practicing internist at Cook County Hospital in Chicago, looks at the coverage gaps in the Medicare system, detailing his own experiences (Schiff, Health Affairs, November/December 2002).
  
• "Medicare Spending for Injured Elders: Are There Opportunities for Savings?" The article by Christine Bishop, a Brandeis University health policy professor, Daniel Gildon, president of JEN Associates, and others examines how covering services that help prevent fractures among the elderly, which account for 67% of total Medicare injury claims expenses in 1999, could help Medicare realize "substantial savings" (Bishop et al., Health Affairs, November/December 2002).
  
• "Racial Variation In Quality of Care Among Medicare+Choice Enrollees": Beth Virnig, assistant professor at the University of Minnesota School of Public Health, Nicole Lurie, a RAND senior natural scientist, and others examine access and quality issues various racial groups experience in Medicare HMO plans (Virnig et al., Health Affairs, November/December 2002).
  
• "Medicaid Coverage for the Working Uninsured: The Role of State Policy": The article by Randall Bovbjerg, an Urban Institute principal research associate, Jack Hadley, also a principal research associate, and others examines the role state-sponsored health plans can play in insuring low-income workers, 37.3% of whom were uninsured in 1999 (Bovbjerg et al., Health Affairs, November/December 2002).
  
• "Addressing Both Health and Health Care: An Interview with Steven Schroeder": Schroeder, who will retire as the CEO of the Robert Wood Johnson Foundation in December, discusses several health topics, including the future of medicine, palliative care and the health policy process (Iglehart, Health Affairs, November/December 2002).
  
• "The Pfizer Foundation's Community Health Ventures Program: Providing Models for Community Health Partnerships": The article, written by Caroline Roan, manger of philanthropy programs at the Pfizer Foundation, and Carolyn Clark, former program manager for DDB Bass and Howes, examines how "modest grants" to community health centers can be effective (Roan/Clark, Health Affairs, November/December 2002).