Anthony Robbins, M.D., M.P.A., APHA President, 1983

Improving Access to Health Care

I want to talk about some opportunities. APHA is at its best when it seizes opportunities. I want to mention two such opportunities. The first of these may suggest some major chinks in the movement towards for-profit managed care. Kaiser Permanente, the Health Insurance Plan (HIP) of New York, Group Health of Puget Sound, Families USA, and the American Association of Retired Persons (AARP) have gotten together and requested governmental intervention for the protection of consumers in the medical care system. The news isn’t that they have asked for it; the news is that both the non-profits and consumers are at such risk in where we are going that there may be an opportunity for those of us who believe in doing something better – a single-payer universal system.

An even bigger opportunity, however, because I do not think there is any question that medical care is going to get more and more organized. People who were totally out of the system bought into it. And government is going to be asked to do that eventually. We in public health have always wanted to be in touch with everyone in the population, to be able to do proper and complete disease surveillance, and to be able to respond with the proper care and attention to individuals who are exposed to hazards in their community. Neither in Canada nor in Europe have we seen national or provincial health systems used for public health.

So the history is going to be made in this country when the public health movement recognizes that universal care systems are the way we can have eyes and hands that do the whole job of public health surveillance.

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