On February 22, 2012, President Obama signed legislation to cut funding from the Prevention and Public Health Fund. This fund was created by the Affordable Care Act (ACA) and invested $15 billion over 10 years to prevent disease and promote wellness in our society. This was a major advancement in U.S. health policy which shifted focus on creating a healthy and productive society rather than one that only reacts to disease once patients are already ill.
Prevention and public health are frequently the first place to start enacting cuts, but this is a huge mistake. Most diseases and causes of death in the U.S. are preventable, yet we continue to turn our backs on efforts to stop disease, illness, injury, and even death before they develop. When we have an unhealthy society, this affects many sectors of our economy as sick or injured workers are not as productive as they could be. Additionally, by continuing to only invest at the end of the line, care is reactionary and costly for the patients.
I think three primary reasons explain why investments in public health and prevention are often overlooked. First, people do not understand what public health is. It is more than just responding to infectious disease outbreaks or tracking influenza strains. Public health makes sure that the food we eat is sanitary, the air we breathe is clean, and that our roads are safe to drive on. Nearly every facet of our lives places us in danger, but public health professionals seek to minimize risks. Most public health interventions are inconspicuous and out of the public eye, so it is not surprising that political will for public health initiatives is minimal.
Second, prevention does not make anyone any money. Health care is big business these days and bottom lines for those in the health industry only decrease when people are healthy. Money comes at the end of the line: surgery for the diabetic with a foot ulcer, radiation for the cancer patient, and laser treatments for cervical pre-cancerous lesions are profitable interventions. Building a society that facilitates health and wellness reduces profits for many influential stakeholders.
Third, public health and prevention does not create the emotional appeal that many other political topics do. Take abortion, war, or even education. These issues are emotionally charged and can be divisive. Public health does not have the same appeal and as a result, it is often overlooked. Legislators are able to make cuts in this area without the political fallout or emotional reaction.
Cutting funds for the Prevention and Public Health Fund is unfortunate. Grassroots movements and public awareness campaigns are needed to highlight the necessity of public health interventions; I believe these campaigns should be led by primary care providers. Primary care providers are respected and are leaders in building a healthy society. Getting involved at the grassroots level is the best way to show communities, states, and the nation, how important investments in public health and prevention are to our country.
Health Affairs Policy Brief, “The Prevention and Public Health Fund,” Health Affairs, February 23, 2012
Schroeder, S., "We can do better -- Improving the Health of the American People," The New England Journal of Medicine; 2007; 357: 1221-28