Open Source: How Will Public Health Fare Under Trump?
I don’t think there’s any reason to believe there will be any broad shift from the current public health policies. I think Mr. Trump and his administration will continue to invest in biomedical research to keep the U.S. at the forefront of developing new cures and therapies. There’s certainly broad agreement that the current trajectory of premiums on the Affordable Care Act exchange is unsustainable. The specifics of how we will make them more affordable for those who don’t receive subsidies will be debated over the next two years.
Andy Harris, MD, MHS ’95, is the U.S. Representative from Maryland’s 1st District.
One of the most intriguing analyses of the election results found that the Trump-Pence ticket was especially popular in areas of the country with the poorest health metrics. If so, the new President would do well by his voters—and by many others—by investing in effective public health programs to address chronic illness, opioid addiction, obesity, depression and other prevalent conditions. After all, public health problems are not red or blue—and science and evidence do not belong to any political ideology.
Joshua M. Sharfstein, MD, is associate dean for Public Health Practice and Training at the Bloomberg School.
When President Trump and the Republican Congressional leaders call for a repeal of the Affordable Care Act, we have to fear a real setback in public health. That law requires a minimum set of benefits for all health insurance—not just in the individual market—which would cover prevention services, such as immunizations and women’s health screenings, as well as a guarantee of reproductive health. They seem to ignore that block-granting Medicaid will leave many services in danger of being dropped for children, seniors and others who need them.
Henry A. Waxman, JD, is a former U.S. Representative from California’s 33rd District and the 2015-16 Centennial Policy Scholar at the Bloomberg School.
It has been really hard to watch the progress we’ve made on so many public health issues be put at such risk—the Affordable Care Act, climate change, reproductive rights—but I see some pathways forward. Science and data and facts do matter if you know where to put them to work, and in the regulatory arena they can be game-changers. The sanctity of evidence is still a critical part of advocacy. It’s a credibility issue, and credibility is a valuable commodity that public health can bring to table.
I’m optimistic that providing flexibility to state Medicaid and social services programs will free up wasted dollars in health care services. Coupled with more accountability for health outcomes, states can be incentivized to invest more in true prevention and nonmedical determinants of health such as housing. With health systems increasingly [responsible] for population health, more than ever they need the expertise of public health to manage these populations, while public health needs access to the health system resources to scale up evidence-based interventions. We should be reaching out to each other.
Anthony Keck, MPH, is senior vice president and chief development officer of Mountain States Health Alliance.