Advocates note that the cuts would put the nation's health system in reverse, away from stopping health problems before they get out of hand.
Most of the early attention to the House Republicans’ American Health Care Act (AHCA) has focused on its potential effects on the individual market. But experts are now pointing to a cut of $931 million to the CDC’s Prevention and Public Health Fund, which may not be well-known to the average consumer but, in the words of one House member, is “more important to the average American than … the Defense Department.”
US Representative Tom Cole, R-Oklahoma, offered that assessment to STAT while noting that the typical citizen was more likely to be exposed to a pandemic than a terrorist attack. Cole oversees CDC’s budget, and when interviewed this week was not yet sure what to do about the proposed cut contained within AHCA.
Some of his fellow Republicans call the prevention dollars, which are 12% of CDC’s budget, a “slush fund” that has been misspent on things like Zumba classes. They propose a new fund that offers flexibility to the states.
Chrissie Juliano of the Big Cities Health Coalition, writing in Health Affairs, warns the CDC cut scheduled to be axed from core health programs, that cover everything from tracking diseases, providing immunizations, and preventing lead poisoning.
The CDC Prevention Fund, Juliano and others note, was one of several pieces of the Affordable Care Act designed to take the nation’s health system out of the reactive posture and toward a model of care that caught problems before they got out of hand. The CDC cuts affect the nation’s ability to battle the most common chronic conditions—heart disease, diabetes, stroke, and asthma. They set back scientists’ efforts to fight the Zika virus or to help the children in Flint, Michigan.
As Juliano writes, funds in prevention are dollars well spent, with returns on investment of $17 to $221, yielding savings of $181 million to $269 million. She wrote, “Even without considering the human cost, this investment makes good fiscal sense.”
The cut comes the same week that CDC warned that a strain of bird flu is killing people in China; the agency spread the word through its publication, the Morbidity and Mortality Weekly Report, the bible of public health. Public health is a partnership of information sharing among local, state, and federal health officials, who share reports up and down the information chain, with the CDC offering testing and analysis, and guidance to local officials in the case of outbreaks of contagious or uncommon diseases. Without resources, however, that partnership breaks down.
“Protecting the Prevention and Public Health Fund is about defending the very core of our nation’s public health system, which has been chipped away year after year,” Juliano wrote. “Without a doubt, just as every American has a right to access care when they become sick, every community has the right to be healthy and safe and to know their government is protecting them from the dangers of disease outbreaks and natural disasters. Every parent should be able to attend school without their parents worrying that they could contract a previously eradicated, life-threatening disease.”