MMA Viewpoint
A Strong Public Health System is Crucial
Looking back on the history of medicine, we see the greatest advances in health and life expectancy have occurred because of public health initiatives.
Improvements in water and sewage, immunizations, clean air standards, germ theory, and hygiene have become the mainstays of efforts to improve public health. It is amazing how recently we have made these advances and, as the tsunami in southeast Asia and Hurricane Katrina have shown, how tenuous they are. Disruption of our present services can result in devastating problems.
A strong public health system is one of the four key elements of the MMA’s health care reform plan. If we are to control costs and improve outcomes, we need to ensure Minnesotans have clean water, air, and immunizations, and to put more emphasis on preventing disease.
Environmental factors and behavioral choices have a tremendous impact on our health, and yet the nation spends only about 5 percent of its health care budget addressing these issues. The MMA is bringing public health issues to the forefront in discussions of health care reform, pointing out the link between preventable risk factors such as obesity and tobacco use and higher health care costs.
Smokers and those who inhale secondhand smoke are more likely to suffer cancer, heart disease, and stroke. The annual direct health care cost of treating tobacco-related illnesses in Minnesota is estimated to be almost $2 billion. Obesity and overweight lead to hypertension, type 2 diabetes, heart disease, stroke, and some types of cancer. A national study showed that costs related to overweight and obesity accounted for about 9 percent of U.S. medical expenses in 1998.
The MMA’s top advocacy priorities reflect the importance of preventing disease. Last year, we successfully pushed for a higher tobacco tax as a way to discourage smoking. Unfortunately, a district court ruled that the 75-cent fee violates the 1998 tobacco settlement and the state constitution. Soon after the ruling, the MMA participated in a news conference to emphasize that keeping cigarette prices high is good health policy. Research shows that about 90 percent of smokers start smoking in their teens and that high cigarette prices discourage teens from smoking. The constitutional issue is still unresolved. The governor has asked the state Supreme Court to act quickly to overturn the district court’s decision. If necessary, we will be back at the Capitol advocating a higher tobacco tax.
Another high priority for the MMA is the Freedom to Breathe Act, a statewide ban on smoking in all workplaces including bars and restaurants. Our challenge will be to convince lawmakers that the threat to public health is real, that secondhand smoke really does increase the risk for heart disease and cancer.
Obesity prevention is also high on our agenda. The MMA along with Allina and PreferredOne are sponsoring The Power of the Pyramid, an educational play to teach children and their families about the importance of eating healthy foods and getting physical exercise every day (see “The Play’s the Thing—to Fight Obesity,” p. 22). The MMA is also urging the Department of Agriculture to remove fruit juice from the list of WIC-eligible foods, and add fruits and vegetables.
The needs of future generations will be great, but the basic building blocks of a strong public health system are in place. We must build upon our success. Finding a way to fund improvements will be the challenge. To comment, contact me at ainslm@parknicollet.com or call me at 952/993-3337.