Pathways to better health

By Christopher Atchison

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In June 2012, the Supreme Court of the United States ruled the Affordable Care Act was constitutional, but gave states the option to expand Medicaid to their citizens or not. The Medicaid decision caused a great political division in Iowa, and many who follow the legislative happenings in Des Moines never thought a solution would be reached.

At stake was health insurance coverage for an estimated 150,000 low-income Iowans. Remarkably, in the waning hours of this year's legislative session, a compromise was reached to cover these Iowans in a hybrid system expansion of Medicaid that incentivizes personal responsibility and healthy outcomes. The Iowa Health and Wellness plan is a unique concept that shows the importance of access to care and the need to be proactive in the health of all citizens. The collaboration between patient advocacy groups, Republicans and Democrats showed how Iowans work to resolve differences and this practice should be a model for others across the nation.

When it comes to health care, we must be non-partisan. Gridlock is not an option when lives are at stake.

The Iowa Health and Wellness Plan will result in positive health outcomes. Increasing access for all low-income Iowans, not only pregnant women, their newborns and the elderly. It will increase the well-being of these individuals who should no longer choose to seek basic care through an emergency room. This expansion should save money by catching health needs earlier, thereby reducing the acuity of any condition. It also should produce better outcomes for the same reason.

This change to Medicaid confirms that Iowa cares about health and this is just the latest example.

When we look back at the many public and private sector initiatives undertaken in the last few years, the evidence of a concerted effort to make Iowa the healthiest state in the nation is clear. IowaCare, the Healthiest State Initiative, the Blue Zones project and now the Iowa Health and Wellness Plan all point to the collective belief that if we invest in health, we save on health care, improve the quality of life for every Iowan and help achieve an even more vibrant state economy.

Therein lies a critical message. Although access to medical care is necessary, access to treatment does not guarantee improved health. Wellness and prevention should always be among our highest priorities. We should continue to strengthen our health system through a patient-centered, holistic approach to care that places emphasis on nutrition, exercise, tobacco cessation and alcohol moderation.

Unhealthy behaviors in these categories cause much of the cost to the United States' health care system through diabetes, heart disease and cancer. Preventing these conditions from occurring in the first place is vital to reducing billions in costs and immeasurable heartbreak these conditions can produce.

We must also recognize that we increasingly rely on medications and procedures to reduce the effects of many of our chronic conditions. We must encourage innovation in our health care system to enable optimal timeliness in getting new treatments to the consumer in a safe and timely manner. Encouraging federal agencies to streamline and simplify their approval processes will enable companies to get their life saving drugs to consumers quicker as well. This is essential for chronic conditions with no treatment or known cure, including cystic fibrosis, Alzheimer's and multiple sclerosis.

The last year has shown how Iowa works. We see complex issues with many occasions for disagreement, but we work through those challenges because we share a common goal of having the healthiest state. I applaud the patient advocacy groups in Iowa who are engaged in these debates and are working together to be a catalyst for change in bringing care and cures to their patient population.

It is now in the hands of average Iowans to make health a priority as we work to become the healthiest state in the nation by 2016.

Christopher Atchison is associate dean at the University of Iowa, College of Public Health, and former director of the Iowa Department of Public Health. Comments: catchison34@yahoo.com