Udall, Walsh Urge Boost for Preventive Health Programs

Posted March 9, 2007 at 3:35pm

Today Members from both parties urged the Bush administration to increase funding for preventive health programs, but efforts to boost prevention were greeted tepidly by some Members, including House Appropriations Chairman David Obey (D-Wis.).

Reps. Tom Udall (D-N.M.) and Jim Walsh (R-N.Y.) used today’s Appropriations subcommittee hearing on the administration’s fiscal 2008 budget request to chastise the White House for cutting various preventive medicine programs. According to these and other lawmakers, the decision to zero out funding for preventive health initiatives and block grant programs risks saddling Americans with future ailments including heart disease and diabetes.

Congressional critics expressed concern over the Bush administration’s decision to transfer $17 million in funding from the Steps to a HealthierUS Initiative to an adolescent health program and zeroing out the $99 million Preventive Health and Health Services Block Grant program.

Chronic illnesses account for 83 percent of health care costs, Udall said during the subcommittee on Labor, Health and Human Services, Education and related agencies hearing. That makes such cuts “extremely shortsighted.” Udall, in an interview, suggested increasing funding for prevention by at least $116 million.

Udall intends to take steps to restore these funds, the lawmaker told CongressNow. He is considering legislation to orient the Centers for Disease Control and Prevention more toward preventative health. The proposed $116 million in funding these programs represent is the minimum of what is needed to prevent chronic diseases. In fact, Udall said, it may take 10 times that amount to curb the number of Americans that develop these ailments.

These issues need to be addressed because of their long-term impact on health care costs, Udall said. Preventing the behaviors that lead to chronic illnesses “makes a substantial difference” in these costs.

But Obey was not convinced. Preventive medicine is a “meaningless concept” for the 44 million Americans without health insurance, he said.

Another problem that lawmakers such as Udall face is how to increase these funds under the chamber’s newly enacted “pay-as-you-go” spending rule. Under the House version of PAYGO, any spending increase must be offset by cuts elsewhere. Lawmakers looking to increase CDC funding for certain programs face “terrible choices” because the agency has so many important programs, making it hard to find what areas to cut, Udall said.

CDC Director Julie Gerberding agreed that these were important issues but noted that with a limited budget, the agency needs to make difficult decisions.

“We are in a very tight budget environment. We have some really tonight choices to make,” Gerberding said.

Besides, the HealthierUS Initiative was not meant to be a permanent program, she said. Once the pilot program expired, Gerberding said, the CDC felt that the money was better spent on adolescent initiatives.

The initiative funded communities to implement chronic disease prevention and health promotion programs that target three major chronic diseases: diabetes, obesity, and asthma and their underlying risk factors of physical inactivity, poor nutrition and tobacco use. The block grants funded various state preventative programs.

The block grants are a tough issue for the CDC, Gerberding told CongressNow. While those grants were meant to help states get preventative programs started, there still is a demand for these funds even after the programs have been established. The CDC also lacks the metrics to prove how well these grants perform, making funding difficult in an “era of accountability” in the federal government, she said.