'The Cost of Cutting Public Health' by Valerie Bassett

While swine flu may seem like the biggest threat to public health right now, the bigger danger may be deep cuts to public health budgets.

The proposed House Ways and Means budget would gut MA Department of Public Health (DPH) non-hospital programs by almost one–quarter, and the Governor’s budget also disproportionately cut public health. At the same time, the state has been holding strong on its commitment to sustain full funding for health reform and critical access to health care – but at what cost?

Protecting health reform might be possible today, because of additional FMAP support and other state programs bearing more of the share of cuts. But this won’t be sustainable in the long-run without success in slowing the growth of medical costs – exactly what public health can do.

For example, in the current House Ways and Means version of the state budget, the line item that funds Health Promotion and Disease Prevention is cut by half.

This hobbles DPH wellness programs to prevent overweight and obesity and to prevent and manage diabetes — major drivers of the rising cost of care, especially Medicaid costs. DPH has estimated that in 2007 Massachusetts spent $1.82 billion dollars on medical care for obesity-related illness. This is one example of many planned cuts that will lead to greater costs: tobacco control, health care institution infection prevention and control, teen pregnancy prevention and addiction treatment are others.

We are currently going in an extremely shortsighted direction – but one that if we turn our collective attention to it, we can turn around. Without adequate local and state public health infrastructure, we will definitely be in for a rude awakening in the near future if swine flu takes hold in Massachusetts. Without sustained investment in public health programs, we hold health reform hostage to unchecked negative population trends like rising rates of obesity. This is preventable – by investing in prevention.

The United We Stand for Public Health Coalition will be at the State House today – calling for the state to stop the disproportionate cutting of public health. We need more people who care about health reform and understand what is at stake to join this chorus.

Valerie Bassett
Executive Director, Massachusetts Public Health Association
Chair, United We Stand for Public Health Coalition