The following is presented as part of The Columbian’s Opinion content, which offers a point of view in order to provoke thought and debate of civic issues. Opinions represent the viewpoint of the author. Unsigned editorials represent the consensus opinion of The Columbian’s editorial board, which operates independently of the news department.
Four years later, the meeting seems positively prescient.
“As our population goes up and our funding goes down, I’m concerned about our preparedness,” Dr. Alan Melnick told The Columbian’s Editorial Board in 2017.
Melnick is the Clark County health officer. You might have heard of him; he’s been in the news a bit over the past 12 months or so. A couple years ago, he visited the Editorial Board to talk about public health and, specifically, a bill that was pending in the Legislature.
That proposal, House Bill 1432, was titled “Concerning foundational public health services.” It passed the House by an 86-12 vote but ultimately was ignored by the Senate.
While the details of the legislation are foggy, the coronavirus pandemic has added clarity to the issue of public health and its importance. And it has led to questions about whether or not we have learned our lesson and whether or not Americans will increase their investment in public health.
As the American Public Health Association explains: “Public health promotes and protects the health of people and the communities where they live, learn, work and play. While a doctor treats people who are sick, those of us working in public health try to prevent people from getting sick or injured in the first place. We also promote wellness by encouraging healthy behaviors.”
And as an editorial in The Columbian opined in the wake of Melnick’s visit: “That presents a Catch-22 for public health departments. When they are most effective, they are largely invisible to the public. You are not likely to hear a lawmaker suggest that epidemiology is an important function of government – even if the lack of such a function quickly becomes evident. Prevention of widespread disease is essential, and it is the type of endeavor that will not be undertaken by the private sector.”
The impact of the pandemic – the closing of schools, the shuttering of businesses – should drive home the importance of public health and prevention. Not to mention that coronavirus has contributed to the deaths of some 550,000 Americans.
It is possible that nothing could have been done in advance to prevent that. COVID-19 was a new disease, arriving with no roadmap for keeping it from spreading or treating it when it did. Health workers and public health officials had to learn on the fly.
But with the next pandemic or with diseases that are relatively common but don’t pose a shut-down-society threat, the question is whether we are prepared. Or whether we care enough to be prepared.
There are other questions, as well. Such as the role of the federal government in preparation and response. The previous administration shifted much of the responsibility — and the liability for blame — to the states, with President Donald Trump famously saying, “I don’t take responsibility at all.”
But in many ways, all of this was predictable. A new study from Health Affairs finds that public health spending at the state level dropped from $80.40 per capita in 2008 to $75.83 in 2018. “Without institutional reform, states are susceptible to continued neglect of public health with only short-term emergency infusions of federal funding in the midst of a crisis such as COVID-19,” the authors write. “Without substantial and sustained investment by states and ongoing robust federal support, the U.S. may well continue its ‘default’ approach to public health funding: ‘neglect, panic, repeat.’ ”
That fits with a common narrative. For years, this nation has been reluctant to make investments that provide a sturdy foundation for a society. You know, things such as roads, bridges and education – not to mention public health.
The mantra, for far too many, is that as long we get our tax cuts and as long as the military is well-funded then everything is hunky-dory. But eventually there is a price to be paid.
That will be one of the lingering lessons from the coronavirus pandemic. Nobody could have foreseen the disease or its broad impact – unless, of course, they were paying attention.
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