The other week I recalled a presentation I made a few years ago in a law school seminar on one aspect of the Patient Protection and Affordable Care Act (PPACA) or “Obamacare,” if you must. As I was a dual degree student in the School of Public Health, I wanted to focus my presentation on some of PPACA’s more traditional public health elements. To that point, most of the seminar’s material was focused on the health system/ individual health insurance market changes. As I began my presentation, however, I wanted to make one disclaimer – I “heart” modern medicine!
I love the power of cutting edge innovation and technology. I am the beneficiary of remarkable technology that has allowed friends and family to live healthier, longer and fuller lives. I realize I am incredibly fortunate that my love ones have had access to this beautiful modern technology. Therefore, this love poses complicated dilemmas for me as I work in public health.
Public health, with its population focus and macro statistics, works to achieve the aim of what is in the best interest for the population. However, as Adam Smith reasoned – I am inherently self-interested – I am human. I grapple with how can I promote population-based arguments that may have, in theory, limited the access to the technology that I, personally, am so grateful to have in my life?
I do not think my challenge is unique. In fact, I believe it may be one of the biggest communication challenges for both law and public health – personalizing subjects that are actively intended to be impersonal. Often when a public health legal intervention is rationalized to an individual/personal level, the thought may be “well I don’t want that for me, it’s an invasion of my privacy or an invasion of my liberty” or “it doesn’t impact me, so I shouldn’t have to pay for it.” As public health professionals and lawyers, it is a unique challenge to try to confront the rational individual-discomfort with a particular intervention. We must try to personalize a population-level intervention so that individuals are comfortable with the intervention’s intended outcome – even if it may have implications on an individual’s freedom or liberty.
I am often asked, “What is public health law?” “What does law have to do with global health?” I can provide basic elevator-speech explanations, mention Ebola, e-cigarettes, measles outbreaks or the dog-flu in Chicago and get a few nods, but often times I feel as though there is a remoteness in my response. As I continue to work at the O’Neill Institute, and throughout my career, I hope that I can help further enunciate the argument of the personal importance of public health laws and interventions. I know I will continue to face the moral dilemma of personal self-interest with population health goals. I feel fortunate, however, because my personal self-interest provides context to potentially opposing arguments. So as much as I “heart” modern medicine, I believe there are population-level interventions that may need to impede on individual liberty to protect the population’s wellbeing. Where that line is drawn, however, I do not know. I look forward to my future work discovering those boundaries and persuading individuals about the personal importance of public health.
The views reflected in this expert column are those of the individual authors and do not necessarily represent those of the O’Neill Institute for National and Global Health Law or Georgetown University. This blog is solely informational in nature, and not intended as a substitute for competent legal advice from a licensed and retained attorney in your state or country.