This week, Sen. Mike Johanns (R-Neb.) is due to offer an amendment to the Small Business Jobs and Credit Act that could effectively kill the Prevention and Public Health Fund. This would be a grave mistake.
Bear in mind that a major transformational element of the new health reform law -- with broad bipartisan support -- is its array of provisions promoting wellness, disease prevention and public health. These provisions will jumpstart America's shift from our current sick care system into a real health care system -- one designed to keep people healthy and out of the hospital in the first place.
This emphasis on preventing chronic disease is critical to restraining costs and keeping down insurance premiums over the long term.
The Johanns amendment would cost $18 billion -- most of it paid for by drastically cutting the Prevention and Public Health Fund. This attack on investments in prevention and wellness is the same old penny-wise-pound-foolish thinking that now makes America's health care system so costly and ineffective.
The United States spends a staggering $2.3 trillion annually on health care -- 16.5 percent of our gross domestic product, far more than any other country. We spend twice as much per capita on health care as European countries, but we are twice as sick with chronic disease.
The reason for this overspending and underperforming is clear: We have systematically neglected wellness and disease prevention. Currently, 95 percent of every health care dollar is spent treating illnesses and conditions after they occur. But we spend peanuts on prevention.
The good news is that, by ramping up our investment in preventing obesity, diabetes, heart disease and other costly conditions and illnesses, we have a big opportunity to improve the health of Americans and restrain health care spending.
To do this, the new health reform law makes significant new investments in wellness, prevention and public health. For example, it requires insurance companies to cover recommended preventive services with no co-payments or deductibles. It also ensures that seniors have access to free annual wellness visits and personalized prevention plans under Medicare.
A critical feature of the new law -- essential to a sustainable push for wellness -- is the Prevention and Public Health Fund. Health care is not limited to the doctor's office. Where Americans live, work and go to school also has a profound effect on our health.
That's why the fund provides community transformation grants, so localities can tailor wellness and prevention programs to specific needs and environment. It also invests heavily in strengthening the primary care infrastructure -- including training for the physician assistants and nurse practitioners who typically practice in small clinics.
A 2007 study by the Trust for America's Health found major savings from community-based prevention programs designed to raise levels of physical activity, improve nutrition and a reduce smoking rates. The study found that a national investment of $10 per person per year in these kinds of programs could yield net savings of more than $2.8 billion annually in health care costs in one to two years; more than $16 billion annually within five years, and nearly $18 billion annually within 10 to 20 years.
These fledgling initiatives to promote wellness and prevention would be strangled in the cradle if the fund is raided and put on hold for the next eight years -- which is what the Johanns amendment would do. This effectively kills our opportunity to put America on a healthier path.
I am sympathetic to the broader aim of the Johanns amendment. On a bipartisan basis, senators want to change the information-reporting rules for small businesses under the health reform law. But the amendment's $18 billion cost is excessive. Moreover, to pay for this by slashing funds for wellness and prevention is deeply misguided.
This perpetuates the disastrous notion that we can neglect and de-fund prevention efforts without paying a huge long-term cost in unnecessary chronic disease and disability -- as well as skyrocketing health insurance premiums.
It was Ben Franklin who said, "An ounce of prevention is worth a pound of cure." The Johanns amendment -- or, for that matter, any effort to undermine the Prevention and Public Health Fund -- is an attack on that principle.
Johanns must find some other "pay-for" for his amendment. Or his amendment must be defeated.
Sen. Tom Harkin (D-Iowa) is chairman of the Senate Health, Education, Labor and Pensions Committee and the Appropriations Labor, Health and Human Services, Education and Related Agencies Subcommittee.
This post first appeared on Politico.