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A cut in prevention would require a ton of cure
by Dr. Sylvia Sekhon, HealthPartners Como Clinic
From the Pioneer Press, March 20, 2008
Whining about government budget cuts is nearly an American pastime but that doesn't mean proposed cuts should be enacted without very careful scrutiny. Minnesota is facing a budget shortfall such as we have not seen since 2003. The no-new-taxes governor says he will veto any new taxes, making for limited options for a financial fix. Some current proposals may help fill this year's budget hole while digging us a deep hole in the future and at a tremendous human cost.
To save about a million dollars, the governor's budget targeted three children's health programs: lead abatement, tobacco use prevention and fetal alcohol syndrome. The cost of achieving that million-dollar savings could easily be in the billions, but that is in the future.
Parents of children who are so profoundly disabled that most Minnesotans never even see them testified at the Legislature about how devastating proposed cuts would be for their families. Seeing children needing help to breathe and care for the most basic of bodily functions tore at the hearts of all who saw them, and the question of how we could even consider making cuts to their care-givers was on everyone's mind.
But the issue of preventing these tragic situations was former Gov. Arne Carlson's point. "Do we continue to pay for faulty outcomes or do we put more money into prevention? Every time there is a budget crunch, it is the prevention side that gets cut to pay for the faulty outcomes."
What do faulty outcomes have to do with lead, tobacco and alcohol?
– Lead poisoning costs Minnesota $8.2 million per year. Lead poisoning is a preventable ailment that affects young children. It can affect a child's brain, kidneys, lungs, bone marrow and other body systems and increases the risk for cancer. Low-income children under the age of 6 are at the highest risk. The consequences of lead poisoning for individual children are reduced intellectual functioning, increased antisocial behavior, and higher school dropout rates.
The financial cost of lead-caused disease is high, and the resulting costs of pain and suffering are incalculable. The governor proposes to cut $388,000 from this program, leaving it a budget of $100,000 per year. This small program leverages additional federal funds as a match. If these funds are cut, access to federal funds will also be diminished.
– Tobacco use is a pediatric disease. Nearly all smokers begin using tobacco while children. By the time they reach adulthood, the power of nicotine addiction makes quitting difficult. Of current Minnesota youth, according to the Centers for Disease Control, 118,000 will ultimately die from smoking-related disease.
The current annual cost of smoking in the state due to excess health care costs and lost productivity due to premature death is nearly $4 billion. The human suffering behind this staggering number includes lung cancer and heart disease but also tragic pregnancy outcomes such as low-birth-weight babies, pre-term deliveries and slow fetal growth. Premature and low-birth-weight babies face an increased risk of serious health problems during the newborn period and chronic lifelong disabilities such as cerebral palsy, mental retardation and learning problems, according to the March of Dimes.
The CDC's Best Practices for Tobacco Control recommends that Minnesota spend $7.98 per person on smoking prevention programs. Currently spending 65 cents per person, the governor proposes to cut $325,000 from the youth smoking prevention program, leaving an expenditure of about 55 cents per person.
– Fetal Alcohol Spectrum Disorders are 100 percent preventable and, tragically, they last a lifetime and affect every aspect of a child's life and the lives of the child's family. There is no cure. Children with these disorders can have problems with growth deficiency, their central nervous system, heart, kidneys and bones, learning, impulse control, memory, attention span, communication, vision and hearing.
These problems also often lead to difficulties in school and getting along with others. According to the CDC, the estimated average lifetime cost for one individual with fetal alcohol disorder in 2002 was $2 million. While society as a whole pays the price, the family, very often a foster family, bears the emotional cost.
The governor proposes to cut $500,000 from this program, leaving it a budget of $1.2 million per year.
The economic and human toll is simply too great to make these cuts. As Arne Carlson said, prevention is always an easy place to cut the budget but it should not be done.
Dr. Sylvia Sekhon has been a pediatrician at the HealthPartners Como Clinic in St. Paul for 25 years.
source: http://www.twincities.com/opinion/ci_8629352
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