Health Policies for the 21st Century: Challenges and Recommendations for the USDHHS

Boufford, J.I. & Lee, P.R.
Milbank Memorial Fund, Fall

This report recommends a comprehensive reassessment of federal health policies, programs, and processes, including federal-state roles and relationships, and some immediate actions to promote and protect the nation's health and to provide leadership in world health. The report concentrates on the challenges facing the secretary of the U.S. Department of Health and Human Services (DHHS) as the head of the lead health agency in the federal government. The federal government is responsible for five main functions related to health policy: financing; public health protection; collecting and disseminating information about U.S. health and health care delivery systems; capacity building for population health; and direct management of services.

Unlike the current categorical, or highly specialized, approach leading to policies and programs addressing the needs of a specific population, illness, or organizational constituency, a new, comprehensive approach to policy for the 21st century should promote coordinated efforts across programs in order to achieve three goals:

* create conditions that lead to longer, healthier lives for all Americans;
* eliminate health disparities;
* protect communities from avoidable health hazards and help them to address their own health problems.