One of the controversial elements of the Affordable Care Act is creation of the Prevention and Public Health Fund, which sets aside about $15 billion to finance public health programs over the next decade. Under the program, the Health and Human Services department awards grants for projects that prevent illness or promote health.
Supporters of the program say that it will ultimately save money by detecting diseases early and better managing costly chronic conditions. Opponents have deemed it a “slush fund” and are seeking to eliminate it.
Dr. Georges C. Benjamin, executive director of the American Public Health Association (APHA), offers his views on the Prevention Fund.
Rheumatology News: Why has the Prevention Fund been caught up in politics?
Dr. Benjamin: I think the fund has been grossly misunderstood. For years, public health has been the most underinvested part of our health system. The goal of the Prevention Fund was to build on existing funding sources and, for the first time, create a stable, reliable funding stream, which would allow the system to mature and reach its full potential. People who want to demonize the fund have said things that don't represent its intent.
Rheumatology News: The APHA supported the creation of the Prevention Fund. Why is this type of investment important?
Dr. Benjamin: From a pure fiscal perspective, this is our best chance to address some of our health care costs. If we don't do this now, it's going to be years before we can actually begin to get our hands around it. To have a major national restructuring of the way we deliver health care services and not put in a prevention component would be foolhardy.
Rheumatology News: Can prevention efforts like this really save money?
Dr. Benjamin: We know that screening for high blood pressure is cheap. We know every patient with diabetes that does not progress to diabetic retinopathy represents a huge savings for the health system. But what often doesn't get captured in our economic analyses are the savings outside of health care. If a child doesn't get exposed to lead because of a good public health program and doesn't suffer complications, there are savings to the health system but also savings to other sectors. In that case, we don't count the savings from special-education programs. We don't count the potential savings to the juvenile justice system. When folks say prevention doesn't save money, they are usually looking only in the health bucket.
Rheumatology News: Is the Prevention Fund likely to survive in the long run?
Dr. Benjamin: The fund will survive. If we are going to continue to throw $2.5 trillion into health care, to only spend about 3% of that on prevention is poor public policy. I hope that we'll be able to make the case that not only is this fund needed, but that the amount of money dedicated to this area must grow.
Dr. Benjamin is currently serving as a distinguished fellow in public health at Hunter College, part of the City University of New York system. He will return to his role at the APHA in 2012.
What often doesn't get captured in our economic analyses are the savings outside of health care.
Source DR. BENJAMIN