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Is it time for a national public health system?

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Since the early months of the covid-19 pandemic, it’s been clear that the U.S. public health system needs major improvements. Now, a blue-ribbon commission assembled by the Commonwealth Fund has issued a report with a rather provocative conclusion: The United States needs a national public health system.

To better understand the rationale, I spoke with three commission members. Former New York state health commissioner Nirav R. Shah explained to me that there is a fundamental problem with public health in America that long predated the pandemic: “It’s disorganized, under-resourced, poorly coordinated and disconnected from the health-care delivery system.”

He’s right. There are nearly 3,000 local health departments with vastly different capabilities. Depending on where someone lives, they could be served by a well-funded city or county health agency that provides many safety-net services, or one with a handful of staff and a shoestring budget. The result is evident in the disparities seen during the pandemic: Some areas were quick to set up big vaccine clinics and free testing sites; others struggled with the basics of contact tracing.

The Commonwealth Fund commission wants to set a national standard for health department........

© Washington Post

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