APHA Finds President's Budget Proposal a Mixed Blessing: Good News for Homeland Security, Lost Opportunities for Prevention

2/4/2002

From: Carole Zimmerman of the American Public Health Association, 202-777-2434, e-mail: Carole.Zimmerman@apha.org

WASHINGTON, Feb. 4 -- The American Public Health Association (APHA) finds that while the President's budget proposal has a number of bright spots, it doesn't light a path toward long-term improvements in health status.

"We applaud the President's strong support for basic public health systems at the state and local level, and for programs that strengthen readiness in communities, among hospitals and first-responders. These basic grassroots improvements will help us cope with complex disasters of any sort, as well as day-to-day obstacles to better health for Americans," explained American Public Health Association Executive Director Mohammad N. Akhter, MD. The proposal is wanting in other areas, and if adopted, will force us to face a growing burden of illness and injury in the future.

The President proposes cutting chronic disease prevention programs at the Centers for Disease Control and Prevention (CDC), when heart disease, cancer and stroke are the three leading killers of Americans.

Domestic and international HIV/AIDS programs receive lukewarm support. The devastation faced by developing countries is well known. But we are also facing an increase in domestic cases for the first time in eight years, yet the president's budget freezes spending at last year's level. More needs to be done to prevent the spread of HIV/AIDS, and to provide care for those already affected.

Worker health and safety programs at CDC and the Occupational Safety and Health Administration are sharply cut in the budget proposal. Together, these two agencies are responsible for protecting worker safety and health in the American workplace. In addition, these programs protect workers responding to terrorist incidents and natural disasters.

Facing growing inflation, Americans need to believe that Medicare is secure, and that rising prescription drug costs will not force older Americans into poverty. The President's proposal to offer privatization options for Medicare threatens the stability of the program, and is not acceptable. As was the case last year, the funding proposed to establish a prescription drug benefit is inadequate to provide an affordable benefit.

And, facing an aging population, America needs a diverse, stable and well-trained healthcare workforce. While APHA welcomes the President's efforts to address the domestic nursing shortage, failure to stabilize other healthcare professions also in shortage, or to craft supports that stabilize these professions more than one or two years at a time, raises grave concerns about the quality of care that may be available to seniors and others 10 years from now.

The constant erosion of prevention programs will cost us all, in time. To remedy these problems, APHA recommends serious reconsideration of our nation's long-term health priorities and their budget implications, and will work with Congress to assure that a view to the future is not lost in the funding plan for the coming year. APHA recommends:

-- Support for prevention programs for chronic diseases, HIV/AIDS, substance abuse, infant mortality, unintended pregnancy and a host of other health threats. Good prevention programs should include health promotion components when lifestyle choices are important to good outcomes. They should also include ongoing prevention research components to assure the best use of scientific evidence in service to America's health. -- Support for programs that anticipate future needs, especially the aging Baby Boom generation. It is essential to provide the short and long-term incentives needed to train and retain a diverse healthcare workforce, to assure that Medicare is strong and to provide a prescription drug benefit in Medicare that is affordable for all. -- Support for programs that eliminate health disparities. Healthy People 2010 seeks to assure that all Americans enjoy good health. To get there, we must commit to supports for minority healthcare professionals, for service delivery to urban, rural and other underserved areas, for expanded health services research to identify and track disparities, among others. -- Support for programs that expand access to health care. In the short term, the federal government must provide additional Medicaid support to states, and means to keep the newly-unemployed from becoming the newly-uninsured. In the longer term, the greatest nation in the world must find a way to assure that all its citizens have access to healthcare.

The American Public Health Association, the oldest and largest organization of public health professionals, represents more than 50,000 members from over 50 public health occupations.