CDC Director Dr. Tom Frieden Discusses the ACA, Winnable Battles, and the Future of Public Health

By Ian Goldstein, Digital Media Specialist, NACCHO

Since 2009, CDC Director Dr. Tom Frieden has controlled both infectious and chronic diseases in this country and globally. Previously, Dr. Frieden led programs that reduced illness and death and increase life expectancy substantially as commissioner of the New York City Health Department from 2002 to 2009. As CDC director, Dr. Frieden has intensified CDC’s 24/7 work to save lives and protect people through effective response to outbreaks and other health threats at the local, state, national, and global level. The following is an excerpt from a recent podcast.

NACCHO: We’re heading into a critical period for the implementation of the Affordable Care Act (ACA). How are you coordinating implementation activities across the CDC, given that there are many moving parts?

Dr. Frieden: We have create a unit and a committee and through both of those parts, we’re getting all parts of CDC to figure out what we can do to help and what the ACA can do to help public health. I think it’s important to recognize that expanding access, waiving preventative service fees, and many other aspects of the Affordable Care Act can dramatically improve public health in this country. In addition, public health departments around the country can do a lot to increase access to healthcare by encouraging and facilitating enrollment in both marketplaces and Medicaid.

NACCHO: How is CDC thinking about the role of local health departments?

Dr. Frieden: This is a very important issue. There is a misconception out there that public health is healthcare for poor people and since that’s now taken care of with the Affordable Care Act, that public health is no longer necessary. That is completely wrong on basically every count. It is something that gets some credence in some circles. For one, we need to adapt. There are changes in how the healthcare system is structured. Taking into account those changes, we need to figure out everything from, for example, services that we will continue to provide, which may in some jurisdictions include immunizations, tuberculosis control, STD control—[health departments] may need to learn to bill for those services.

In addition, we need identify areas where we in public health can collaborate with healthcare providers on things like diabetes prevention program where providers may refer and insurers may pay for community-based services. And third, we need to engage with healthcare to improve the quality so we can improve the prevention value of the services provided—most importantly, the Million Hearts agenda but also very important areas ranging from teen pregnancy prevention, opioid overdose prevention, immunization, and more.

To hear Dr. Frieden’s thoughts on the CDC Winnable Battles and the future of public health under sequestration, listen to NACCHO’s podcast.

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