Dean Bloom Assails 'Patients' Bill of Rights'

October 07, 1999

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By Alvin Powell
Gazette Staff

With a "Patients’ Bill of Rights" winding through Congress, School of Public Health Dean Barry Bloom issued his own declaration this week, asserting that the nation’s health priorities are backward and ought to focus on prevention, not treatment.

Bloom, who described public health advocates as "a voice in the wilderness," issued his own six-point "Public Health Bill of Rights," calling for measures such as universal immunization, teen counseling about sexually transmitted diseases, and cancer screening. Bloom said an investment of just a fraction of the trillion dollars spent on health care annually in this country would bring huge returns by preventing illness before people ever need treatment.

Bloom compared the Patients’ Bill of Rights to warning labels on cigarette packs, saying both are int ed to give the impression of action, rather than to do anything concrete.

The Patients’ Bill of Rights before Congress would give patients the right to sue their health plans, to appeal a denied claim to an indep ent board, and would force managed care providers to guarantee access to specialists and to emergency care.

The Patients’ Bill of Rights has already caused a stir. It has been fought in television advertisements by the American Association of Health Plans, it has been addressed by presidential candidates, and was part of President Clinton’s weekly radio address, delivered Oct. 2.

But even if enacted, Bloom said, the bill would affect just a small fraction of those seeking medical care each year.

"There is a concern that a large amount of ink and verbiage is fixated on the Patients’ Bill of Rights. It’s [about] who you can sue and whether you can see a specialist and who will pay for it," Bloom said. "Of the trillion spent on health care annually, only 4 to 5 percent is spent on preventing diseases rather than on treating them."

Bloom’s Public Health Bill of Rights, published as an editorial in the Oct. 11 issue of Newsweek, addresses the causes behind the nation’s leading killers: heart disease, cancer, stroke, and injuries.

Those causes, which include tobacco use, an unhealthy diet, inactivity, alcohol consumption, infectious diseases, firearms, and accidents, can be attacked through behavioral changes and simple preventive care, such as ensuring that all children are immunized.

Public health suffers from a perception problem, Bloom said, because its effects, if successful, are difficult to measure. A patient getting sick who then is cured can tell a much more dramatic story than a healthy person who gets a shot and stays healthy.

"When we succeed in public health, the net result is nothing happening," Bloom said. "It hasn’t been looked at in terms of gains and losses."

The Public Health Bill of Rights includes:

• The right to information on how to promote health and prevent illness, with the aim of reaching all Americans and eliminating regional disparities in health care quality that results in Americans in some regions living 25 years less than those in others.

• The right to mother and infant care, leading to a national strategy to eliminate disparities in infant mortality rates, which are higher among ethnic groups and low-income Americans.

• The right to childhood immunizations. For every dollar spent on childhood immunizations against rubella, mumps, and measles, $13 is saved on medical treatment, totaling $4 billion a year.

• The right to teenage counseling about AIDS and other sexually transmitted diseases, as well as about addictive substances, including drugs, alcohol, and tobacco.

• The right to health screening. Simple tests can detect early stages of different cancers as well as problems such as high blood pressure, which can lead to stroke. Routine screening for colon cancer, for example, reduces the risk of dying from the disease by 33 percent.

• The right to a healthy environment, including greater protections for municipal water systems, tighter controls on air pollution, and increased attention to the quality of the indoor environment, especially that in schools and workplaces.