After years of tenuous public health funding that has forced critical programs and services to the backburner, a new report out today offers guidance on how key investments in public health ought to be directed to improve U.S. health outcomes – or at least bring them up to par with healthier nations.
The Institute of Medicine report, For the Public’s Health: Investing in a Healthier Future, outlines key recommendations on how to more efficiently fund the nation’s public health system. The U.S. is a top spender when it comes to health care costs and at the bottom of the rung in health outcomes, including life expectancy and infant mortality.
“Spending has opportunity costs. It limits our ability to spend on proper programs and housing and engage all sectors of society to achieve better value” said Marthe R. Gold, chair of the IoM committee that produced the report and professor at City College of New York on a call with reporters.
Guidelines drawn up by the committee recommend that the U.S. develop new goals to be shared across the medical and public health industries for life-expectancy and per-person health spending. State and local health departments should cover a basic package of public health services to combat communicable disease, for example.
Success largely hinges on a sustained federal investment in spending. Seen as a starting point to explore community needs and estimated costs, the report suggests the federal investment in public health be doubled — something that might be hard to come by at a time when public health has been a target for recent budget cuts. Funds, laid out in the report, could be raised by a tax on medical care services, much like the tobacco excise tax that was allocated for community-based tobacco control services.
“Given the tremendous need to contribute to global competitiveness… it’s an investment that we really can’t afford not to make,“ said George J. Isham, medical director and chief health officer at HealthPartners Inc.
The report also identifies areas within the public health system where existing resources could be more coordinated, specifically with clinical care.
“To enable public health to focus on population health needs, [the report] urges public health departments to work with the clinical care system to build better capacity to carry out those services, according to David Fleming, director and health officer of the Department of Public Health Seattle
Today’s report is the third in a series examining various aspects to strengthen the nation’s public health system. The other two focused on public health measurements and law policy. Read an article on health outcome measurements from the February 2011 issue of The Nation’s Health. The full report is available at www.iom.edu/phfunding.