Public Health: Pay now, not later

Of all the things to underfund, local public heath service seems to be a dangerous one. Here's where we stand at the moment:

Our state's baseline funding for our 35 local public health jurisdictions sits at $48 million per biennium, which has flatlined since the motor vehicle excise tax, a portion of which was a dedicated source of funds for public health, was repealed in 1999. Public health officials had asked for a $100 million increase to the budget, but the House has recommended an additional $20 million, and the Senate on Wednesday proposed the same in its budget.

According to the bipartisan Joint Select Committee on Public Health Financing, the funding gap sits at $600 million per biennium; King County's share of that deficit is about $210 million.

Washington ranks 44th in the country on public health spending, and one source told us that as of right now, some local public health offices can "barely afford to keep the lights on and the doors open."

That doesn't just mean dimly lit offices and closed doors. It means that as it stands, the public health system has the means of looking into only half the communicable diseases reported by health care providers.

So the outbreaks we hear about -- the drug-resistant strain of HIV recently reported in Seattle, the outbreaks of norovirus in two nursing homes and those flu cases -- are just the tip of the iceberg.

Then there are public health's other functions that are diminished through weak funding, such as programs educating young mothers on healthy pregnancies and efforts that reduce chronic diseases (heart disease, diabetes) and environmental risks (via, say, animal-borne diseases at petting zoos).

If we spend more on public health now, we'll end up spending less later in health care costs. We already know this. Spending $26 million on tobacco control and prevention in one year cut the number of smokers in our state by 200,000. That's a $1.8 billion savings in future health care costs.

For too long, counties have been relying on unsteady sources such as grants and licensing fees to cover the rest of their spending. That a dedicated source of funding is needed is clear -- we have to pay, via some tax or the other, for the services provided. It's the only logical thing to do.