J Law Med Ethics. 2011 Sep;39(3):328-39. doi: 10.1111/j.1748-720X.2011.00603.x.
From health care reform to public health reform.
Assistant Professor at New England Law - Boston and Director of the Center for Public Health and Tobacco Policy.
Even when turning its attention to public health topics such as preventive care and workplace wellness, the Affordable Care Act law embodies a highly individualistic paradigm of health. The provisions of the law implicitly assign the primary responsibility for prevention to individuals, who should be urged to make more responsible and healthier choices about what they consume and how they live. Relatively little in the law reflects the "population perspective" set forth in public health scholarship that focuses on environmental and social determinants of health. This article explores the cultural and economic factors that led Congress to embrace a highly individualist conception of public health, and it suggests how public health advocates and legal scholars might seek to reframe the public discourse surrounding preventive health issues.
© 2011 American Society of Law, Medicine & Ethics, Inc.
PMID: 21871031 [PubMed - in process]