Impact of the Sequester on Public Health

4/01/2013 08:23:00 PM
Update: I did a quick calculation: existing literature says that that the market value of a life is \$3 million to \$7 million. Thus, it only requires 50 to 117 lives saved to equal the value of the \$350 million congress cut from the CDC. That amounts to a pretty small outbreak of disease. Thus, if it takes the CDC even slightly longer to solve the next outbreak, the cuts will have hurt more than they helped anyone.
The spending sequester, as a fraction of total spending, is not huge. But we need to keep in mind that it took place against the backdrop of a government that was barely funding many of its most vital functions to begin with. Shoe-Leather Epidemiology Needs More, Not Less Funding by Andi L. Shane, MD:
Infections from contaminated steroid injections, influenza outbreaks, destruction from Sandy, West Nile Virus, measles and pertussis outbreaks. These are just a few of the public health crises we faced down in 2012, thanks to the tireless efforts of local and state health departments. Each outbreak takes tremendous resources on top of day to day surveillance activities, but public health is now facing its own crisis of funding: The sequestration will cripple local and state public health departments. Analysts calculate an effective funding reduction of 9%, with the Centers for Disease Control and Prevention losing \$350 million. While every federal agency will have to tighten its belt, for public health there are no more belt holes.
...In November, after a recall of the tainted products, there was a lull in new cases [of lethal fungal meningitis infections]..... a new cluster of infections was discovered. ...One of Tim’s [Dr Tim Jones's] challenges was how to pay for all of it after depleting his department’s budget so early in the fiscal year.
...To date, more than 700 individuals around the country have experienced infections related to the tainted injections, and 47 have died. Without the rapid response of public health workers at local, state, and national levels, those numbers would have been exponentially higher.
... Federal funds from CDC support local and state efforts... during the meningitis outbreak, the agency helped 23 health departments notify 14,000 people at risk of exposure in a matter of days... If the CDC has to slash its state resources, local and state health departments will have no choice but to discontinue their surveillance activities, which means our nation’s ability to detect and respond to disease outbreaks will be compromised.
...These reductions will all but eliminate our country’s capacity to control the next outbreak....
No one is saying we shouldn't cut wasteful spending. But we are saying, or at least should be saying, that Congress as a moral obligation to determine whether the spending actually is wasteful before cutting it. The fact that Congress has chosen not to do so is sickening. Literally. We're dying of fungal meningitis.