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Fri Nov 23, 2012, 02:56 PM

The Fallacy of Cutting Public Health Funds to "Save Money"

Question: Why does the United States spend twice as much per person on health care as any other industrialized nation but achieve results on par with Mexico?

Answer: Because we refuse to invest in disease prevention, aka public health.

So, what do Republicans want to trim from the federal budget? Public health spending. Even though public health dollars pay for themselves many times over in reduced disease, time off work, disability and health care costs. And, if the press is to be believed, the Democrats are willing to negotiate on this part of health care reform in order to insure as many people as possible.


Why the short-sightedness? Votes. The GOP hopes to gather the votes of the already insured who will be happy to vote for the party that "reined in Obama-care." The Democrats hope to gather in the votes of the newly insured.

Part of the problem is folks do not always know what "public health" does for them. Public health keeps your water clean so that you don't have to worry about cholera, a big killer in the old days in urban areas. Public health wiped out small pox and has virtually wiped out polio, rabies, tetanus and a bunch of other old time killers from industrialized nations. When you invest pennies to pay for mosquito curtains to prevent malaria deaths, you are investing in public health. Pap smears have helped doctors reduce the rate of cervical cancer, a big killer in the 19th century. Back in the 19th century, one out of three of us would die of tuberculosis, too. And syphilis was the number one reason people were put into insane asylums.

If you want to know what "public health" is doing for you now, check out any war-torn or natural disaster ravaged country. Want to live like the folks in Haiti post earthquake? Eliminate all public health spending.

Under W. public health took a beating. Dollars that should have been spent on things like raising the levees in New Orleans (flood control is also part of public health) were spent instead getting tiny towns in the middle of no-where ready for an Al Qaeda "dirty bomb" terrorist attack that was never, ever going to come. We have had one Al Qaeda attack on U.S. soil. We have many hurricanes every year in this country. For several years before Katrina, those in the public health profession were talking about the risks of flooding in that city. Did the federal government listen? No.

Certain industries would also prefer that the U.S. reduce its public health spending. The biggest preventable cause of illness and death is tobacco use. Eliminate smoking and the nation's health care spending would fall dramatically. But that would also make R. J. Reynold's profits fall. Overeating is causing an epidemic of obesity, sleep apnea, degenerative arthritis----resulting in massive spending on knee and hip replacements, cardiac surgery, medications and obesity surgery. Simply tackling America's taste for sugary beverages would save a ton of money---and help us live longer, healthier lives. But the fast food industry does not want that.

And, sadly, portions of the medical industrial complex want us to "just say no" to disease prevention. I am referring to drug companies, the manufacturers of prosthetic joints, hospitals with big ICUs and surgical suites. Their ideal economy is one like we have now----lots of disease, lots of insurance to pay for treating that disease.

One of the essential functions of the government is to pool tax dollars and figure out ways to spend them that provide a benefit for everyone at low cost. Money invested in public health helps everyone---the rich have no special immunity to cholera---at pennies to the dollar of the cost of a hospital. Make that pennies to the thousands of dollars of the cost of a hospital.

So, please, don't sacrifice our nature's health and economy for a short term political gain. If we don't do something now to make people healthier, in a few years we will see a small number of healthy young workers supporting a huge number of retired/disabled middle aged and elderly Americans. And that is going to hurt much worse than any vaccine.

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