Outrage at the latest cuts to public health funding
Good God, the horror that our government should work to improve the lives and health of its citizens!
Outrage at the latest cuts to public health funding
Michael Yudell, Associate Professor, Drexel University School of Public Health
Late last week the American Public Health Association launched a campaign opposing dramatic cuts to the U.S. Department of Health and Human Services’ Prevention and Public Health Fund. The cuts, passed as part of a Republican House bill to preserve the current low interest rates in federally subsidized student loans, would wipe out $6 billion in the Fund. A proposed Senate bill to be taken up next month alternatively preserves the current interest rates by closing a tax loophole “that allows wealthy individuals to avoid paying the same income taxes that middle-class Americans pay.” The president has threatened a veto of the Republican-passed bill.
The Prevention and Public Health Fund was created as part of the Affordable Care Act “to provide expanded and sustained national investments in prevention and public health, to improve health outcomes, and to enhance health care quality.” Since its creation in 2010, the fund has “invested in a broad range of evidence-based activities including community and clinical prevention initiatives; research, surveillance and tracking; public health infrastructure; immunizations and screenings; tobacco prevention; and public health workforce and training.”
The politicization of the Fund is nothing new, and it has been targeted for cuts from both sides of the aisle. Democrats voted with Republicans last year to cut $5 billion from the fund to help pay for the payroll tax break, and the President has proposed additional cuts to help pay for other programs. Sadly, public health remains an easy target.
Republicans are leading this latest round of cuts, and I would suggest that the Fund’s current crop of opponents get their facts straight. Rep. Ann Marie Buerkle (R., N.Y.), for example, criticizes it as a “slush fund” that supports “bike paths, jungle gyms, and worse yet, lobbying campaigns.” Congresswoman Buerkle and others who supported the Republican bill can read about what it actually does by looking at the list of fiscal year 2012 allocation of funds.
For a short analysis of what the Fund is doing, read a piece by The Wonkblog at the Washington Post, which calls attention to the Fund’s biggest commitments: “increasing the size of the health care workforce and implementing community-based, health care interventions.” Wonkblog profiles one such program in Philadelphia: the development of a network of 600 healthy corner stores in low-income neighborhoods.
Other projects funded this year include Centers for Disease Control and Prevention programs to promote breastfeeding, screen for viral hepatitis, and modernize our public health immunization infrastructure, an Administration on Aging program on “Alzheimer’s Disease Prevention Education and Outreach,” and a Substance Abuse and Mental Health Services Administration program on suicide prevention.
Good God, Rep. Buerkle, the horror that our government should work to help improve the lives and health of its citizens!
Accolades to the American Public Health Association and other public health groups who have drawn attention this fight. Mary Pittman at the Public Health Institute rightly lambasts Congress for pitting popular programs, like the student loans, against the more politically nebulous Prevention and Public Health Fund. Because the fund helps everybody (the whole population) and thus seems directed at nobody specifically, Americans remain disconnected from the endless benefits of public health.
The public health community would do well to rethink its plan (if it even has one) for garnering grassroots support for its programs. We need our own Don Draper moment — a complete re-imagination and Madison Avenue-like makeover of strategy to capture Americans’ support for the myriad programs that make up our population health and prevention successes. An essential part of such a campaign would be to convince the public that broad prevention and individual treatment go hand in hand — which, of course, they do.
As long as our health care culture continues to consider them dichotomous, instead of complementary parts of an organic health care whole, you can bet that we’ll prioritize treatment every time. Wouldn’t you?
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Our programs could be healthy if we did not send so much money overseas and fight in so many conflicts around the world. There is an answer, we have the sourses to provide, but we have to quit supporting the world and ingnoring our own country.— Rotor Wash- The pain that this country has experienced over these past four years will seem like the good old days if we continue to spend money we just don't have. $16,000,000,000,000.00 is not what I consider chump change and that's growing at a rate of over $4,000,000,000.00 a day! Taxing our way out of this is impractical at best, disastrous at worst considering the anemic state of the economy. If benefits are to be given, cuts need to be made. That being said EVERY government program has a constituency and this is no different. If they attempted to cut something else they'd be howling as well. We have to come to the harsh realization that government needs to be scaled back across the board. No sacred cows. Everything needs to be scrutinized. If the government were doing this from the start we wouldn't be in the pathetic state of affairs the economy finds itself in at the moment.— sleestack
Comment removed.- The way forward is not a Republican or a Democrat way. It is not about increasing income from taxes OR cutting spending. It is a matter of we -- as a society, as a nation -- having a conversation about what the roles of government should be, and then adapting our taxing and spending to support those roles.
Public health spending is neither experimental or novel. I would think that we could reach some consensus that the kind of public health spending detailed here fits our image of what role government should be playing -- certainly more so than much of what we allow our Medicare dollars to be spent on (e.g., costly useless technology-heavy health care in the last weeks of life).
The role of our elected officials should be to articulate the choices, forge consensus, and propose a path forward (which might include cuts and might include changes to the tax structure. "You have to stop spending" is no more a solution than "you have to print more money." Log off and join the real world.— jjaeger3 - My sense is that over these past few years many Americans expect the government to be all things to all peoples without the proper understanding of what it actually costs and the future burdens that will have to endured because of it. You can't spend your way to prosperity with borrowed money any more than you can tax your way to prosperity. Eventually the piper needs to be paid. The longer we wait the more painful it will be. I for one do not view this in a partisan fashion. However if we continue down the path we currently find ourselves America is going to be in for one terrible disappointment.— sleestack
- Here is a thought that could save a lot of money for public health. Stop having so many illegitimate children. Not politically correct to say, but it greatly adds to every welfare program Federal, State and local governments offer. Of course the taxpaying working stiff gets to support their own kids as well as the kids of the deatbeas.— fgomarty
- In the story and in the comments, we always are led away from the enormous waste and poor outcomes caused by a for profit privatized health care catastrophe. Medicare for all would allow a much better medical system for all, at a lower overall cost than we spend now. The people who gave us Romney/Obama care always new they were going to gut the already stressed public funding programs to send a half trillion dollars for the insurance company bailout. (Junk insurance is a highly profitable product.)
The parts of the ACA that would be supported by honest health care reformers were NEVER intended as long term improvements. All of these ostensibly good data driven community improvements were always temporary smoke and mirrors to benefit insurance and Pharma companies and call it health care reform. Medicare for all could save the economy, so don't believe the angry nonsense about socialized medicine. We have a stupid health care system so that a few plutocrats can make billions, and the rest of the world knows this.— glennm7 - igomarty - no child is "illegitimate". The child may be born of two persons who are not married, but is legitimate in every sense of the word. As far as welfare goes, lets get rid of corporate welfare programs, unless you feel it is okay for a company to pay no taxes.— gb
- We need to put a dollar tax on each bottle of soda and candy bar. Use the money for health care. We eat like pigs and expect health care like kings and queens. The problem starts how we all eat. Take responsibility first for yourself before you start telling the govt what to do. And the govt is the rest of us who have to put up and pay up for your lack of good eating discipline. Tell me how responsible you have lived your life, then I`ll care.— denjamr
- We need to put a dollar tax on each bottle of soda and candy bar. Use the money for health care. We eat like pigs and expect health care like kings and queens. The problem starts how we all eat. Take responsibility first for yourself before you start telling the govt what to do. And the govt is the rest of us who have to put up and pay up for your lack of good eating discipline. Tell me how responsible you have lived your life, then I`ll care.— denjamr
- We need to put a dollar tax on each bottle of soda and candy bar. Use the money for health care. We eat like pigs and expect health care like kings and queens. The problem starts how we all eat. Take responsibility first for yourself before you start telling the govt what to do. And the govt is the rest of us who have to put up and pay up for your lack of good eating discipline. Tell me how responsible you have lived your life, then I`ll care.— denjamr
