Expert Panel to Call for Overhaul of U.S. Public Health System

A bipartisan panel of health experts will call on Tuesday for a reform of the US public health system that would greatly expand the role of the federal government, giving Washington the power to set minimum health standards and coordinate a group of nearly 3,000 states, counties and localities. tribal agencies.

The recommendations stem from what the panel, the Commonwealth Fund Committee for the National Public Health System, called the shortcomings and inequalities of the US response to the coronavirus pandemic, which has killed more than a million Americans.

But in a report to be released on Tuesday, the commission said it also wanted to address the failures of the country’s public health agencies to protect Americans from other health risks, including drug overdoses, diabetes and maternal deaths.

In recommending the creation of a “national public health system,” the bipartisan commission, funded by the Commonwealth Fund, a nonprofit research group focused on health care issues, is sinking its feet into controversial political waters.

While other countries have central public health authorities, public health in the United States is largely managed at the state and local levels. The Centers for Disease Control and Prevention, the federal public health agency, does not have the authority to compel states to act — it cannot, for example, investigate infectious disease outbreaks in a particular state unless it gets invited by state officials to do so. So.

State health agencies and the Centers for Disease Control (CDC) have a long history of collaborative work, but throughout the pandemic, elected state officials — particularly in red states — have been reluctant to relinquish control. When the Centers for Disease Control and Prevention required states to sign agreements to share vaccination data with the federal government, for example, a number of states refused.

In its report, the committee cited “old approaches to data collection” as one of the causes of many Americans’ deaths. She called on Congress to give the Department of Health and Human Services the authority to establish and enforce standards for data collection.

Committee member Dr. Julie L. Gerberding, who served as director of the CDC in President George W. Bush’s administration, said the pandemic “has taught us that we have to have a coordinated, integrated public health network that works — and the only way we can standardize that is by through a national approach.”

The committee’s report comes as Congress considers legislation that takes a different approach to support the nation’s public health infrastructure. The Senate Health Committee has passed a bipartisan measure requiring Senate approval for the director of the CDC, and calling for additional steps to improve coordination between the nation’s public health agencies.

The committee’s recommendations are more comprehensive. The committee, led by Dr. Margaret Hamburg, commissioner of the Food and Drug Administration under President Barack Obama, is calling for the creation of a new position — the undersecretary of public health — within the Department of Health and Human Services, overseeing the national public health system.

The undersecretary will coordinate the work of the more than a dozen federal agencies that play a role in public health, and will have the authority to set minimum health standards for states.

“Our public health system is a federal system in which states and localities have significant autonomy — and appropriately, as they adapt to the needs of their states and communities,” Dr. Hamburg said in an interview. “However, the public health protection measures that individuals receive should not depend entirely on where you live. There should be a basic set of expectations.”

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