On Defunding Public Health

By: Jeff McLaren

ABSTRACT:
Defunding Public Health will cost the health care system much more down the road

Needless deaths and unnecessary risks to our local population are the concerns of the KFL&A Board of Public Health. Recent changes to public health funding will put the KFL&A population at a greatly elevated risk and result in the unintended consequences of unnecessary deaths. The announced $200 million per year budget cut, which is a 26% cut, now will lead to a yearly increase of $2.86 billion in community costs in the future from increases in preventable diseases and conditions. Evidence shows that every dollar invested in public health saves $14.30 in future costs. This comes from an overwhelming amount of scientific scholarly peer reviewed literature on the effects of cuts to public health in other jurisdictions. 

Prevention is better in every way than treating or curing disease. Financially, prevention is better by a factor of 14.3. If you are concerned with taxes and/or the quality of health care in the province then it should be of great concern that the Provincial Government is choosing to cut public health, which is all about prevention, because we will pay for it in increased costs in a few years’ time.

Consider two representative examples. First, as a result of public health’s efforts Kingston is today immune to measles, mumps, polio, chicken pox, and about 6 other painfully debilitating diseases. This means that if a bus load of measles infected tourists were to pass through Kingston, shop in our stores, eat in our restaurants and visit our public spaces there would still not be a measles outbreak in Kingston because we have herd immunity. KFL&A Public Health’s budget for infectious disease control in 2018 was $1,401,219. A 26% cut would see a “savings” of $364,317. per year but the scientific literature shows that cuts to just infectious disease control will lead to a 34 fold increase in hospital costs to treat patients who miss out on the benefits of public health immunization efforts. Due to this budget cut we will very likely lose herd immunity which will result in an additional $12,386,776. yearly increase in costs and this does not consider the pain, grief and lost productivity of people who fall prey to diseases that we should be immune to.

Another example is the enforcement of proper food health regulations throughout the whole food supply chain. At the local level KFL&A Public Health ensures that food venders of all kinds keep up with provincial and federal standards in order to prevent foodborne illnesses such as from E coli and salmonella. Make no mistake these are deadly bacteria which are much more likely to slip through the cracks of public health testing and enforcement. Public health’s reduced capacity will endanger us all. Related to this is the fact that KFL&A Public Health is one piece of the safety processes of our public water supply. By cutting Public Health’s capacity the safety mechanisms that keep our potable water supply safe to drink are reduced. This means that boil water advisories may come out later thus allowing more people to get sick. To put it more bluntly these cuts make another Walkerton public health emergency more likely.

These budget cuts come on the heels of 4 years of zero budget increase. KFL&A Public Health has been engaged in looking for and finding efficiencies. Today we can say that Public Health is incredibly efficient at doing their job. Local public health budget cuts now are a painfully short term “solution” to provincial budget cuts that will lead to greater health costs down the road for all of us.

KFL&A Public Health is more than just a harm prevention organization it is also the most innovative public health problem solving organization in Ontario. Our local KFL&A Public Health identified a knowledge gap in the diagnosis and treatment of lyme disease which led to physician education programs and the formation of a national lyme network to study and fill in those knowledge gaps. KFL&A Public Health also identified a lack of timely information sharing between healthcare providers and developed a program to link all primary care providers with the historical information that they need to best treat patients. KFL&A Public Health, recognizing that speed of detection is the most limiting factor in reacting to outbreaks, developed a surveillance program to monitor in real time ICU admissions across the province and get instantaneous information leading to better decisions in the case of pandemics of all kinds. These programs are in danger of not being brought to their full beneficial potential because a 26% cut in our local budget will necessitate staff and program cuts.

The examples here are just 6 programs that KFL&A Public Health operates to keep our region healthy. KFL&A Public Health also runs many more programs in chronic disease prevention, school health, reproductive and child health, dental and vision health, sexual health, and environmental health. All of these categories of health will suffer with the recently announced budget cuts. In general, taking all of these programs together, “The median ROI for public health interventions was 14.3 to 1”. This means that in the near future we will have to fund yearly increases on the order of billions of dollars in order to treat problems we are avoiding now. This cut will overwhelm our community’s institutions at their current funding levels or there will need to be massive tax increases on the order of 14 times today’s cuts just to fund these avoidable expenses.  A budget cut to public health of this magnitude is a very bad idea.

Added on: 2019-05-13 09:55:32