IOM: Double health spending
The Institute of Medicine has ambitious goals for the U.S. to transform its investment in public health amid congressional battles to rein in gov- ernment spending.
In a report released last week, the IOM recommended the U.S. at least double its annual federal spending on public health to about $24 billion from its current level of about $11.6 billion and floated a new healthcare tax to pay for it.
Despite “its unrivaled wealth,” the U.S. ended the last century behind many other developed countries in health status in terms of mortality, morbidity and loss of potential productivity, the reported noted, and the IOM concluded that the country must pay more attention to population-based prevention efforts; fix how public health funding is allocated, structured and used; and make sure there is stable funding for public health departments.
Committee members also suggested the National Prevention, Health Promotion and Public Health Council convene expert panels to determine the components and costs of a minimum package of public health services and called on Congress to authorize a stable and long-term financing structure to deliver those minimum services in every community. The report proposes a national tax on all medical-care transactions as a way to “close the gap” between the funds that are needed and the funds that are available.
“This is a government function that needs to convene partners to make a measurable difference,” said Steve Teutsch, vice chairman of the IOM committee that produced the report. “We’re talking about $12 billion. It’s really not a huge amount to make a start.”
To begin, the report recommended HHS’ secretary adopt an interim life-expectancy target, establish data systems for a permanent health-adjusted life expectancy target and also set a per-capita health expenditure target to be achieved by 2030. The report, For the Public Health: Investing in a Healthier Future, is the final in a three-part series that began in 2009 when the Robert Wood Johnson Foundation asked the IOM to examine measurement, the law and funding in public health.
Dr. Georges Benjamin, executive director of the American Public Health Association, said no one wants to mention the “T” word, but the recommendation is especially important given recent cuts to the Prevention and Public Health Fund created in the Patient Protection and Affordable Care Act. In February, President Barack Obama signed payroll tax legislation that cut the fund by about $5 billion over 10 years.
“They were asked to come up with a funding mechanism,” Benjamin said of the IOM committee. “I think that tax is a starting point. It’s going to be an interesting discussion. I think it’s important in light of the fact that the prevention fund was intended to create a funding stream for public health,” he added. “We do need to have that national conversation.”