“What you don’t see is what you get.” That’s a good motto for public health. When you drink tap water, go out to a restaurant or drop off your kids at school, you are assuming a level of safety and health that doesn’t just happen. It is the result of public funding for public health.
When we talk about communicable diseases, bioterrorism, West Nile virus, immunizations, safe water and disease prevention, we are talking about public health. It enables each of us individually to assume a certain level of public well-being. It is no panacea – it doesn’t prevent illnesses and accidents. But without it, we can be sure that we would all be much more vulnerable to biological and environmental forces over which we as individuals have no control, such as airborne diseases, epidemics and floods.
County governments used to get almost 3 percent of the motor vehicle excise tax as a dedicated funding source for public health. But the motor vehicle excise tax was cut in 1999, and funding for public health was zeroed out, thanks to Tim Eyman, the initiative salesmanwho makes a living by undermining funding for public goods and services.
The state backfilled 90 percent of the lost funding. However, the backfill has not kept up with inflation or population growth. So now we are among the bottom 10 states in the country in public health spending, at only $81 per person.
So how long can this underfunding continue? A long time. There is no apparent crisis. But each year that goes by with a declining system of public health means that we will be that much less prepared for the next natural disaster or flu epidemic.
The Legislature recognized this in 2005 when it established a bipartisan study committee led by Rep. Shay Schual-Berke (D-Normandy Park) and joined by Sen. Rosa Franklin (D-Tacoma), Sen. Dale Brandland (R-Bellingham), and Rep. Bill Hinkle (R-Cle Elum), among others. The committee’s charge was to determine the state’s responsibilities for public health and figure out a way to fund this work. The committee defined public health responsibilities to include preventing the spread of communicable diseases, such as whooping cough, ensuring safe drinking water and food, preventing chronic diseases like diabetes, preparing for health emergencies, such as those caused by the wind storm we went through in December, and helping people get access to the health care they need.
The need is getting greater, as West Nile virus has spread into our state, the threat of pandemic flu increases, diabetes is increasing, and more than 600,000 people don’t have health insurance in our state. The study committee unanimously recommended that the state identify $50 million of new funding for public health annually. Right now public health is in competition with education, social services and transportation when the governor and legislators divvy up the budget. It doesn’t make sense to be rolling the dice every year to see how much funding is allocated to public health.
The study committee recommended that we figure out dedicated funding sources. Here are a couple ideas:
One of the greatest public-health threats is the spread of disease from other countries and states via air travel. A simple $1.50 fee on air passengers at Sea-Tac and Spokane airports would raise more than $45 million a year, providing a continual stream of funding for disease prevention.
We know that kids drink too much soda pop, and that is one of the reasons for the early onset of diabetes. A tax on soda would discourage consumption and pay for a public health campaign to reinforce that message. It shouldn’t be too hard to swallow. But last year the Legislature moved in the opposite direction, approving a tax credit for pop syrup. This will result in the loss of $10 million in state revenue annually, while only encouraging kids to drink soda. We could recapture these funds, and dedicate the proceeds to public health and the control of lifestyle diseases which are making more and more of our children sick.
The development of dedicated funding sources isn’t rocket science. What we need now is for the good work of the public health study committee to be taken up and taken seriously by the Legislature. We will know that has happened when the Legislature approves a dedicated funding source for the crucial umbrella of public health.
John Burbank, executive director of the Economic Opportunity Institute (www.eoionline.org), writes every other Wednesday. Write to him in care of the institute at 1900 Northlake Way, Suite 237, Seattle, WA 98103. His e-mail address is john@eoionline.org.
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