House Payroll Tax Vote Compromises Health

12/15/2011 10:48 am ET | Updated Feb 14, 2012
  • Larry Cohen MSW, Executive Director, Prevention Institute

Who turns down a $50 billion savings for the country? Who turns down the opportunity for better health for all Americans? The House did, on Tuesday, as the majority of representatives voted to gut the Prevention and Public Health Fund as a means to pay for increased doctors' Medicare reimbursement, called the "doc fix."

We must address the rates that Medicare pays doctors, but doing so by raiding the prevention fund is a short-sighted solution that will cost money, not save it. Quality, affordable medical care and community prevention work hand-in-hand. The President has already said he would veto HR 3630, the payroll tax bill, which houses the Medicare doc fix. In the Senate, Sen. Tom Harkin said the doc fix "isn't going to happen," and Sen. Max Baucus called it "not a good idea at all."

What do the Senate and White House know that the House seems to be missing?

Prevention works.

By supporting local communities through $15 billion over 10 years, the Fund advances our nation beyond a focus on sickness and treatment to one of ensuring health and well-being through innovative, evidence-based community prevention. Communities are already putting these strategies to work in their neighborhoods -- creating safe places for play and physical activity, streets that make it easier to bike or walk to work and school, healthier school lunches, and smoke-free environments. Together, these interventions are making it easier for all Americans to lead healthier lives.

Every dollar we divert from prevention will cost us as much as five dollars down the road. By reducing expenditures and reducing need in the first place, investments in comprehensive prevention bend the cost curve and stem the rising tide of expenditures on preventable chronic diseases.

A recent Gallup poll found that U.S. businesses suffer $153 billion in annual lost productivity due to chronic diseases, including those resulting from lack of access to healthy food and opportunity for physical activity. Since Johnson & Johnson implemented workplace wellness programs, the percentage of employees who smoke dropped by more than two-thirds since 1995. According to the Harvard Business Review

the number who have high blood pressure or who are physically inactive also has declined -- by more than half... Johnson & Johnson's wellness programs saved the company $250 million on health care costs over the past decade.

In times of great economic need, our businesses, our communities and our health care system will all benefit from more prevention funding -- not cuts.

Public health is not separate from health care delivery. In fact, in a new national survey from the Robert Wood Johnson Foundation, three out of four physicians surveyed wished our current health care system would cover the costs of addressing their patients' social needs -- the very needs community prevention resolves -- such as lack of safe open spaces for physical activity and lack of meaningful access to affordable housing and nutritious food.

Using the Fund as an offset for the "doc fix" takes our country backward, stifling the opportunity to build a health care system where public health and health care are fully integrated.

We will better advance the health and well-being of our nation by helping public health and health care work together better, not by pitting them against each other.