Public health coalition calls for increased federal spending

A coalition of public heath and medical advocacy organizations sent a letter Thursday to President Bush and members of Congress appealing for a boost in public health spending in fiscal 2005.

The letter was signed by more than 370 organizations, including the American Cancer Society, Trust for America's Health, the American Public Health Association and the Association of Public Health Laboratories. The group called for a 12 percent increase in federal public health spending to fight "an unprecedented range of threats."

It appeared unlikely, however, that the White House would include a substantial public health funding boost in its fiscal 2005 budget proposal, which is due Monday. Earlier this month the Bush administration said nondefense-related spending increases would be limited to 1 percent.

On Thursday, Health and Human Services Secretary Tommy Thompson reiterated that plan. According to Thompson, hundreds of millions of dollars in federal public health funding are still unspent and "there is plenty of money available to build the public health infrastructure."

Public health advocates assailed the 1 percent limit and said that ignoring public health concerns could put Americans at risk.

"It is extremely thin out there on all fronts," said Shelley Hearne, director of Trust for America's Health. "We're not making a significant investment … we're not being smart."

Specifically, the coalition is seeking more funding for Function 550, a broad portfolio including most federal public health initiatives, bioterrorism preparedness and medical research spending. In fiscal 2004, Congress appropriated about $50 billion for Function 550.

Daniel Smith, vice president for government affairs at the American Cancer Society, said that his organization and others were willing to mobilize grass-roots supporters to put pressure on lawmakers.

"We have to band together as a health community and work together as a health community," Smith said. "The only way to change the process is to apply pressure. I don't think we have to live with 1 percent."

Smith said he was hopeful that Bush would boost public health funding, but he noted that Congress has the final say on spending. "We will be working with both branches," he said.

Trust for America's Health and the American Cancer Society also released a survey Thursday showing that Americans are more concerned about everyday killers-cancer, heart disease and obesity-than they are about biological terrorism. Cancer is the top health concern of 25 percent of Americans and 21 percent said obesity is their most pressing health worry. Only 4 percent said biological terrorism is their most immediate concern. Hearne and Smith said that these results show federal spending should be focused on preventing the most prevalent causes of death in the United States.

"It's not just that the American public thinks so, the facts back them up," Hearne said.

According to Hearne, money spent on early prevention can help avoid costly medical procedures down the road. Lawmakers, she said, can "spend a few more pennies on the front end to keep people out of the health care system."

Secretary Thompson warned, however, that the record budget deficit and the president's pledge on nondefense spending limits meant that federal public health workers would have to watch their spending.

"We all have to tighten our belts a little bit," Thompson said.

Public health advocates said that it is unwise to shortchange programs that have made progress against cancer and heart disease.

"To not give even inflationary increases for programs that are saving peoples lives? That is not the direction most Americans want their government to be going," Smith said.