Spiritual_Wellness_Holistic_Health_and_the_Practic

CHAPTER
26
HEALTH CARE REFORM:
INSIGHTS FOR HEALTH
EDUCATORS
T HOMAS O ’ R OURKE
H ealth care reform continues to be a topic on the public agenda. Nothing new there.
It probably always will be, regardless of whatever reforms are initiated. Health educators
are affected by the debate in their roles as health professionals, citizens, taxpayers,
and consumers of service. The problem is that the current paradigm guiding health
care reform is flawed. It eliminates the possibility of improving health, while consuming
huge resources in the process. This article challenges some current paradigms and
suggests another for consideration.
A decade ago, soaring health care costs and increasing numbers of uninsured
pushed health care reform onto center stage. The collapse of the Clinton health reform
effort in 1994, a strong economy, and a lower rate of health care inflation moved
health care from the spotlight but kept it warm on the back burner. The recent economic
downturn and an accelerated rate of health care cost increases are sure to bring
the issue to the front burner. For example, the health insurance program for federal
government employees and retirees (the largest purchaser of private insurance) recently
disclosed a 13.3 percent premium increase, the largest increase since the 1980s. Some
outcomes are obvious. Many employers (especially in a labor market favorable to