Redesigning primary care, addressing the global health care workforce shortage, and making real progress against health inequities—these are the challenges we’re supposed to be addressing with robust policy debates in the U.S. This is one of the key lessons emerging from the Commonwealth Fund/AcademyHealth health study tour that took a group of eight leaders in health care and policy from the U.S. to New Zealand, Australia, and Singapore this past April.
Dave A. Chokshi, clinical professor of medicine and population health at the NYU School of Medicine who served as the 43rd Commissioner at the New York City Department of Health and Mental Hygiene, leading the City’s response to the COVID-19 pandemic, shared his reflections in a two-part series in JAMA Health Forum.
Part 1 of Dr. Chokshi’s essay features Singapore’s Healthier SG campaign to strengthen primary care in light of an aging population and rising health care costs, relying on personal responsibility as well as government incentives for the use of preventive care. In part 2, he shares insights from efforts in Australia to shore up the health care workforce and improve the digital health infrastructure for both providers and patients; in New Zealand, narrowing the disparities in health outcomes between the Māori and non-Māori populations is central to the health policy reforms currently being implemented.
A related guest essay recently published in The New York Times by Aaron Carroll, distinguished professor of pediatrics and Chief Health Officer at Indiana University, highlights comparisons between the U.S. system and other countries beyond the three visited in April. The progress and outcomes in New Zealand, Australia, Singapore, France, and Britain demonstrate the value of universal coverage as a baseline that allows the health policy community to focus on bolstering public system-provided services and advancing social policies that support health and well-being throughout the life course.
The U.S. is facing similar challenges as these other countries and could draw inspiration from their success in moving beyond the debate about health care coverage to effect change in the other parts of the health system.