Message from the Director

Public policies in the United States must hold both rights of the individual and benefits to the collective in tension, which by definition empowers some while potentially limiting others. American policy has balanced these two forces across a wide variety of topics from foreign policy to alcohol control to education and to healthcare. Many advances in health care policy came during wartime beginning with the Civil War. Theodore Roosevelt was the first American President to develop plans around health policy at the turn of the 20th century, yet the first major expansion of health care policy did not occur until social security was expanded in the 1960s. One of the defining arguments around expansion of health care was related to the amount of money health care was costing the US economy, an argument that remains valid today. This economic burden is why it is critical for data to serve as a cornerstone for health policies. The data need to be used not only to develop robust and effective policies, but also to evaluate whether a policy has had the intended impact at the cost projected. Future health policies should use data to help individuals understand how to protect their own liberty while maintaining that liberty for all of society.

Good public policies should protect health by creating systems that support healthy lifestyles and allow each individual to experience life to the fullest extent possible. Often in the United States, we define health as the absence of disease rather than attainment of health; our public policies reflect this mindset. This is because disease is easy to measure, while a more comprehensive approach to health is nuanced and varies with age, situation, and opportunity. There have been many times in my life when I was unwell but did not have time to notice, so in the end I would have said I was well. Not noticing an issue is not the same thing as being healthy. Future health policies will be rooted in attainment of health and not merely the absence of disease.

When examining the various factors that lead to the success of a health policy, considering financial implications must also be a part of the discussion. Rolling out new policies that are too expensive for consumers, businesses, and governments will not lead to the long term impact the policy set out to create. The value of health will be one of the great debates for the next round of leaders who must listen to a variety of voices when determining that benefit. Future health policies should clearly demonstrate their value through strong cost-benefit analyses.

Good health policies in the future will seek to ensure a more holistic definition of health, balance the individual vs collective rights, utilize data as both inspiration and metric, and work within financial constraints to truly drive forward all forms of health: mental, physical, and social. We at the Lister Hill Center for Health Policy in UAB’s School of Public Health look forward to being a part of the discussions around health policy.