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AJPH First Look, published online ahead of print Dec 17, 2009
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February 2010, Vol 100, No. 2 | American Journal of Public Health 205-211
© 2010 American Public Health Association
DOI: 10.2105/AJPH.2008.156588

GOVERNMENT, POLITICS, AND LAW

Integrating Public Health and Personal Care in a Reformed US Health Care System

Dov Chernichovsky, PhD and Arleen A. Leibowitz, PhD

Dov Chernichovsky is with the Department of Health Systems Management, Ben-Gurion University of the Negev, Beer-Sheva, Israel, and the National Bureau of Economic Research, Cambridge, MA. Arleen A. Leibowitz is with the Department of Public Policy, School of Public Affairs, and the Center for HIV Identification, Prevention, and Treatment Services, University of California, Los Angeles.

Correspondence: Correspondence can be sent to Arleen A. Leibowitz, Dept of Public Policy, UCLA School of Public Affairs, Box 951656, Los Angeles, CA 90095-1656 (e-mail: Arleen{at}ucla.edu). Reprints can be ordered at http://www.ajph.org by clicking the "Reprints/Eprints" link.

Compared with other developed countries, the United States has an inefficient and expensive health care system with poor outcomes and many citizens who are denied access.

Inefficiency is increased by the lack of an integrated system that could promote an optimal mix of personal medical care and population health measures. We advocate a health trust system to provide core medical benefits to every American, while improving efficiency and reducing redundancy.

The major innovation of this plan would be to incorporate existing private health insurance plans in a national system that rebalances health care spending between personal and population health services and directs spending to investments with the greatest long-run returns.






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