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68 comments on The Economic Crisis Impacts on Public Health

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Antoinetta III on March 11, 2009 - 4:32pm Permalink | Subthread | Parent | Comments top

“Public Health in general laments the fact that such a large proportion of their budget goes to funding direct medical care.”
Posted by Paranoid

In other words, they would rather focus on more preventative approaches. This is all well and good, but regardless of how effective these approaches are, there will always be those who require direct medical care, and a disproportionate number of these will be the poor and uninsured. Certainly with the inflated cost of to-day’s healthcare, it is a lot cheaper to inspect restaurants than to treat people, but the latter must still be done, and for the aforementioned poor and uninsured, where is to come from except from public health?

Also, while things like “clean air and water” certainly effect our health, from an organizational and budgetary perspective, most activities relating to this come from and are funded by the EPA or other “environmental” departments rather than from public health departments.

And when budgets become really tight, I imagine things like second hand smoke or mosquito abatement will simply quietly fade away.

But in the end, I think the bulk of public health resources need to go to direct medical care, to the thousands of clinics and emergency rooms that are the only medical options for millions of people.

Of course, they really should adopt a European type of true healthcare system if they really wanted to be effective, but that’s a whole discussion in itself.

Antoinetta III

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penury on March 11, 2009 - 5:03pm Permalink | Subthread | Parent | Comments top

Antoinetta III Unfortunately many people believe as you do. Yes primary care of patients is included in Public Health as are Center for Disease Control, and the research programs run by the government and private laboratories.The Indian Health Service is under the auspices of the Navy but is considered part of Public Health. The FDA is also part of the Public Health Service and some pf the functions of the Department of Agriculture also contribute to Public Health. As far as a focus on preventative measures go, you are right that this is considered the best place to get the most bang for the buck. If by eliminating sources of disease we can also eliminate the risk of infection then the money is well spent. The safety of milk and dairy products come under Public Health, the elimination of the worst of the insanitary practices in the dairy industry contributed greatly to a reduction of childhood mortality. Unfortunately with the spread of an emphasis on "natural" products the consumption of unpasteurized milk and milk products has increased. While not inherently bad, improper care can cause large scale outbreaks of disease and in some cases lead to death. So yes some of us prefer to emphasize preventative measures in fact about 90 per cent of all Public Health eemployees are thus engaged.

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Antoinetta III on March 11, 2009 - 5:24pm Permalink | Subthread | Parent | Comments top

Hopefully, I didn't leave the impression that I am opposed to preventative measures. I'm just saying that no matter how successful they are, nothing works 100% and there will always be those needing direct medical care.

Until and unless the USA can come up with some sort of European-style, less profit oriented system, there will unfortunately be millions of low-income, uninsured people who will need direct medical care, most of which is provided by hospital emergency rooms or neighbourhood/community clinics. And since direct care is substantially more expensive that preventative activity, unless these people are going to be abandoned, it follows that much, if not most of public health dollars will need to be directed to direct medical care.

Antoinetta III

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lengould on March 12, 2009 - 10:36am Permalink | Subthread | Parent | Comments top

In a world where we maximize return on investment, individual medical care would take a back seat to public health.

All seem to be missing the great benefits achieved by having a single-payer universal healthcare system, such as in Canada. When public health systems are paid for from the same pocket as primary medical (in Canada both are paid for mainly by the provincial governments), THEN the emphases start to get placed properly. eg. incentives to prevent rather than treat are great, and the results show it (eg. far better population health outcomes at FAR lower cost than US)

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Dryki on March 12, 2009 - 11:47am Permalink | Subthread | Parent | Comments top

Tainter cites public health as the reason for the bulk of the progress in healthful living standards. The private individual care amounts to very little beyond that first public health component. Clean water, for instance. The best definition I've see of public health is from Dr. Peter Montague of Rachels Environmental News; he frames it as public health and precautionary principle and rolls in everything from climate change to economic inequality. [It's people like him should be in charge of state and county level EMA, not military hacks. Think about who is in charge and how they respond.]

Nor are the benefits of single payer being missed. They are not benefits to the people in power. Anthem in Maine is going for a 20% rate increase. That's the point and that tells you who benefits. They want more breast cancer because it's good for their bottom line, etc....

There is a large section of health care that should be offered - and use encouraged - in a public health model because society benefits as a whole. And as you point out, it aligns health care industry properly. I'd love to see my health care coop helping to shut down incinerators or build food security. Right now, that cuts into profit.

cfm in Gray, ME

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68 comments on The Economic Crisis Impacts on Public Health

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