Q and A: Dr. James Leone on Obamacare
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The Patient Protection and Affordable Care Act, known to most as Obamacare, will continue to be a hot topic as the election approaches. Dr. James Leone, assistant professor of health and author of Concepts in Male Health: Perspectives Across the Lifespan, has been studying the impact the legislation is having, particularly on men. The “Lifespan” approach he recommends considers healthcare from pre-conception to post-death, with a holistic view of treatment and prevention, encompassing not only physical, but emotional, financial, occupational, environmental and social health.
Overall, Dr. Leone says, men’s health is often overshadowed for a variety of reasons. And when it comes to Obamacare, “Male health is one area that seems to have been left to its own devices with limited direct funding, loosely connected programs, and no formal government office to coordinate efforts, unlike the Office of Women's Health and particulars in the new legislation.”
Dr. Leone and his colleagues at the Men’s Health Network and Men’s Health Caucus of the American Public Health Association believe further discussion as to how Obamacare, the election, and politics in general affect male health outcomes in the United States is warranted.
Recently, we sat down with him to discuss these matters.
Q: In general, what is the state of men’s healthcare today?
A: The first issue is how do you measure it? It’s a very difficult topic to conceptualize, because if you go on life expectancy, men don’t live as long. But it’s more about how to measure whether we’re doing better or worse. There are a lot of stats that show globally men have worse health outcomes than women. Next, the question becomes: Is this in men’s biological makeup or is it socio-cultural? The good news is if it’s the latter, we can develop public health approaches to address some of the problems.
Q: From a men’s health perspective, what are some of the issues with Obamacare?
A: There’s a broad net being cast and a lot of questions about how much it can sustain. The issues I look at are who and what fall through the cracks. That big safety net covers a lot of ground, but in the area of male health the issues don’t even get discussed. We need to elevate these topics to better population health of the United States.
Q: What are the topics and why aren’t they given voice?
A: Chronic health/medical issues, coupled with the violence. Sometimes masculinity gets in the way of expressing concern or having a strong voice to deal with life and health issues. We need to think in terms of doing things that will help families and the entire population, instead of doing things in isolation and forgetting the other half (whether male, female, minorities, etc.). Obamacare presents an opportunity to do it right and to reanalyze and restructure things that have been in place for eons. We have to be able to accommodate men within the system, and provide an accurate context and, to be honest, we need to look at caps on spending instead of just supporting systems that might prove unsustainable. These days, healthcare is about greed and sick care. When we say men’s health needs to be addressed, (Congress) just sees that it’s going to cost money. We need to move it past the rhetoric and move toward actionable items.
Q: What are the first steps?
A: The advocacy really needs to focus on what you’re doing, all the while keeping the lifespan perspective in focus at all times. Ask yourself what are you doing this for and what does it do? That’s the perspective we all need to have, whether looking at Obamacare or men’s health. It’s not a gender war and it shouldn’t be. And when you do things from a lifespan perspective, you naturally start offering improved services. If we want a healthier America, we need to be inclusive and not pass biased legislation. I view men’s health in the context of equity; I am reminded of JFK’s quote, “A rising tide lifts all boats.” Hopefully, Obamacare will be that tide.