Healthcare Policy Expert, Robin Scott, is a contributing blogger for Protestants for the Common Good.
America spends more on health than other nations – almost
$2.5 trillion in 2009 – and yet scores less than other wealthy nations on life
expectancy, infant mortality and other indicators of population health. The bulk of U.S. health expenditures (75
percent) are spent treating chronic diseases, many of
which are preventable. (Chronic diseases include obesity, diabetes, high-blood
pressure, heart disease, and cancer.) A
mere fraction of U.S. health expenditures (3.1 percent) is spent on prevention. An Institute of Medicine report released in
2012 concluded that the federal government’s public health investment ($11.6
billion in 2009) should be doubled to begin to fund public health efforts at a
level that would address current needs.
The Affordable Care Act makes public health and the
prevention of chronic disease a United States priority for the first time by establishing
mandatory funding for the Prevention and Public Health Fund. Fifteen billion dollars over 10 years was set
aside for the Fund. The Fund already has
provided $1.25 billion for prevention and public health activities: $500
million in FY 2010 and $750 million in FY 2011.
Another $1 billion has been allocated in FY 2012 and is in the process
of being distributed.
The Fund is anticipated to be used for programs at the
local, state, and federal level.
Illinois has been awarded more than $31 million in Prevention Fund
grants. Funding is intended for
community prevention, clinical prevention, public health workforce and
infrastructure, and research and tracking.
Community prevention includes tobacco prevention and obesity prevention
and fitness. Public health workforce and
infrastructure includes supporting training of public health providers.
The Prevention and Public Health Fund is intended to
supplement not supplant existing federal commitments for public health and
prevention. However, the Affordable Care
Act allows Congress to use money from the fund to spend on existing prevention
or health promotion programs that met the goals of improving health and
restraining growth in costs. Also,
Congress can still pass laws to reduce the amount of money allocated to the Fund. Congress can even amend the Affordable Care
Act to eliminate the Fund. Funding of
the Prevention and Public Health Fund has already been cut by $6.25 billion
over nine years to help postpone a cut in Medicare physician payments.
The Fund remains at risk. Earlier this year, Congress passed
the Sequestration Act which would make across-the-board cuts in defense and
nondefense discretionary programs in January 2013 if a deficit reduction plan
was not passed and signed into law. So
far, a deficit reduction plan has not been enacted. According to an OMB report released mid
–September critical programs that protect the public’s health face an 8.2
percent cut. (The Prevention and Public
Health Fund would be subject to cuts of 7.6 percent.)
Some useful websites for more information:
http://www.healthaffairs.org/healthpolicybriefs/brief.php?brief_id=63 http://www.healthcare.gov/news/factsheets/2011/02/prevention/il.html
