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Public Health 101: The leading Challenges
for the U.S. in the Coming Decade

Correspondence

Op-Ed: The Health of the American People: Congress Needs to Act

When Congress returns to Washington in September, it will face many pressing issues, but none is more critical than the health of the American people. This is not a reference to the Patient Bill of Rights, or Medicare reform, or a prescription drug benefit for seniors, which are also vital issues that need attention. The health of the American people is more broadly and fundamentally affected -- every day -- by a part of the health system that Congress must fund through the yearly appropriations process - the U.S. Public Health Service.

The eight Public Health Service agencies conduct a host of essential federal activities that most of us take for granted. The Public Health Service safeguards our food and medicines. It conducts biomedical, behavioral, and health services research that represents hope for millions with debilitating diseases and disabilities and holds the key to how medical care will be effectively delivered in the future. It is preparing the nation to deal with the possibility of a bioweapons attack. It is working to protect us against new and emerging infectious diseases to which we are highly vulnerable in a global economy. It helps provide childhood immunizations, adult flu vaccines, cancer and cardiovascular disease screening, services to aid those living with disabilities, as well as services to prevent a host of chronic diseases that together cause 70 percent of all U.S. deaths. It is combating the growing resistance to organisms that no longer respond to our arsenal of antibiotics. It works to prevent birth defects. It helps provide critical treatment and prevention services for those with mental illness and substance abuse problems. It helps provide basic, as well as specialized, health care services for the growing numbers of uninsured, especially mothers, infants and children. It funds a comprehensive range of services for those suffering with HIV/AIDS.

Undergirding most of these vital health activities is a well-educated, diverse, professional workforce that the Public Health Service trains within the Health Resources and Services Administration (HRSA). This workforce includes primary care physicians, nurses, physician assistants, dentists, pharmacists, psychologists, allied health professionals, and an array of specialized public health professionals. They deliver essential heath care services in: community health centers, maternal and child health programs, public health clinics, mental health centers, substance abuse treatment and prevention programs, health centers in Native American communities, community prevention and early intervention programs, HIV/AIDS programs, and programs that monitor the health status of state and local populations and provide emergency response in infectious disease outbreaks, or environmental disasters.

Despite the fact that repeated government reports document that many of these essential healthcare professionals are in short supply, and provide critical services in rural and urban areas of our nation that are medically underserved, the Bush Administration is proposing a 60 percent cut in funding in FY 2002 for the programs that train them. In addition, except for the National Institutes of Health, which is expected to receive a significant increase, it is anticipated that most other public health programs will be frozen at this year's levels or receive cuts. What is even more alarming is that senior Congressional staff predict that, because the federal budget surplus has shrunk dramatically, Public Health Service agencies and programs will be subject to even leaner budgets for the foreseeable future.

For a nation that prides itself on its health care, this is simply unacceptable. Congress must act responsibly in September to protect and enhance the health of all Americans by providing a consistently strong funding base for all the agencies and programs of the U.S. Public Health Service.

©2008 Coalition for Health Funding