Only 3 cents of each United States health care dollar goes to public health despite the fact that it plays a far bigger role in keeping Americans well than medical care, according to a top federal official at a forum sponsored by insurer Cigna and USA Today.
Local and state public health departments were hit particularly hard by the recession and are yet to recover, stated acting assistant secretary of health at the Department of Health and Human Services, physician Karen DeSalvo.
Former health commissioner of New Orleans, DeSalvo added that public health infrastructure is there when necessary, but at the same time is being more and more under-funded and marginalized year after year.
Although 80% of people’s health is affected by what occurs outside of hospitals and doctors’ offices, around 97% of funding pays for medical services, according to DeSalvo.
Public health concentrates on prevention instead of treatment – things like reducing communicable diseases, educating the public about the importance of exercise and diet and ensuring they have access to nutritious foods and all the ingredients for a healthy life.
Cigna CEO David Cordani stated that there is a societal and social opportunity in maintaining people’s health instead of just treating them when they are sick; however, there is a strong economic argument as well.
He added that from a financial standpoint, currently the cost of health and health services is about the first budget item. The more effective they can be there, you’ll free more potential to invest more in transportation and education. This is a winning argument no matter which way you look at it.
No one was saying that public health is the government’s responsibility alone. It’s vital for states, communities, individuals and doctors to jointly work to improve the health of their whole population.
Some complained about the United States’ comparatively meager investment in public health considering the possible savings – both financial and human.
- A Trust for America’s Health analysis discovered that the $30 billion invested nationally in chronic disease was $20 billion short of what was required. TFAH’s deputy director, Richard Hamburg, stated that chronic disease is chronically under-funded.
- Last year, another TFAH study found 22 states cut down on public health spending in the previous two years – some for two or three years running. State funding also differed greatly, with one state committing $150 per person to public health and another state just $3 per person. This is in spite of the fact that research illustrates each dollar spent on prevention saves $5.60 in health spending.
- DeSalvo, when she was New Orleans’ health commissioner, stated that she had $4.62 per resident each year to spend, which was approximately in the mid-range of what other states had. She added that that sum of money doesn’t allow you to do much – she couldn’t even afford a flu shot with that.
- Public health funding is available during emergencies but is basically not sustainable over the long haul, according to executive director of the American Public Health Association, physician Georges Benjamin.
For example, Benjamin stated that reductions in funding for tuberculosis in the 1980s resulted in the disease coming back with a vengeance in a drug-resistant form.
More recently, preparedness money committed to public health following the terrorist attacks of September 11, 2001, dissipated in later years, according to Benjamin.
The money is always there when something terrible happens, but those are emergency funds that come and go.
Everyone carries the cost when the country fails to consistently spend enough money on maintaining people’s health. If an uninsured patient receives care in an emergency room and is unable to pay his bill, the rest of society pays through higher insurance costs and medical bills.
Although many countries spend a lot on health care, the US leads the world in per capita health spending, but their health outcomes and health status continue to be challenged.
Where you live, your income and other factors that help make healthy choices easy, really matters.