How the Disease Focused Abuse Health Access
Names and Naming Must Be More Important
United States leaders have developed the nasty habit of calling things what they are not. No Child Left Behind reflects a process of American education that leaves most behind. American primary care training is 70% not primary care in result even though deans and health professional associations claim otherwise.
I just searched “Health Access” to see emerging web sites. I was not surprised to be third to Health Access and Health Access Project – groups focused on consumers in California and people left behind in health access in Salt Lake County. Basic Health Access comes in 3rd perhaps due to my use of Google.
At number 6 on the listing was the Clinton Health Access Initiative. I thought perhaps this might be a good source to contact. But the site explained that it is really about access to drugs and treatments. The site is about disease focus. Granted HIV/AIDs is important and is even more important in children in Africa, but health access should be more about health and basic health care.
Where basic health access focus exists and where basic health services exist, health is going to be higher quality. This is less about the term or the services and more about the conditions reflected. When there are better designs for people, the people can focus attention on health and their health and the health of their children. People decide about healthy behaviors or not or about when to seek care or not. Improving people in the earliest years is most important regarding health outcomes. When people have better beginnings, then health actually gets a chance to exist. Also when people live under these conditions, people can also spend much less on disease and treatment and hospitals and even somewhat less on primary care – by design.
At the Clinton site “CHAI with UNITAID funding, has become the largest buyer of pediatric fixed dose combination formulas and DNA PCR tests, and the third largest buyer of ready to use therapeutic food. At least there is some recognition that disease treatment works better with better nutrition. Better nutrition for nearly all can do far more than disease treatment however. Disease treatment focus can compromise better nutrition for nearly all.
I clicked on the rural program link at CHAI which may have existed once but does not exist now.
I guess I was hoping for more from those who helped craft the 1990s brief move toward primary care and health access (business and government managed care coalition). This has been the only interruption of 32 years of steady deterioration in these areas and 32 years of domination of disease focus. This was also a brief but important move for all in the United States. This move slowed health care spending for a short time – time enough to allow the economy to catch up to be able to afford health care. This set the US on the longest run of economic progress in recent history. It was about a brief move away from disease focus - one that can result in substantial benefits for most Americans by design.
This time has passed us by long ago as health care is crippling the economy and has less and less to do with health or health care. The focus is more and more on disease research, testing, and treatment – as with this CHAI site.
Names are important as they help guide the attention of people. Access to HIV treatment is important. But when disease and treatment is the focus, the name of the foundation should reflect the focus.
Perhaps now I know why our Secretary of State focused attention upon the elimination of HIV/AIDs in recent statements.
At some point we should have a leader focused on Basic Health Access for basic health access purposes rather than cost cutting or disease focus - the two main players in the US health care design. And we will soon see the across the board cuts that will only slightly impact non-primary care and disease focus but will devastate primary care.
Thanks to all 12,000 who have visited Basic Health Access in 2011.
Dr. Bowman is the North American Co-Editor of Rural and Remote Health and a Professor in Family Medicine at A T Still University School of Osteopathic Medicine. He was the founding chair of the Rural Medical Educators Group of the National Rural Health Association, he was the long term chair of the STFM Group on Rural Health, he is the founding director of Priority Infrastructure at http://www.infrastructureamerica.org/ and he is the author of the World of Rural Medical Education, and Physician Workforce Studies
Clinician Specific Medical Education