Four years ago, in an editorial that now seems particularly farsighted, The Columbian’s Editorial Board addressed the issue of health care.
“It is human nature to view the issue from a personal level rather than thinking about the importance of a healthy community and the effects that has upon the individuals in that community,” we wrote. “But public health should not be overlooked. In many ways it has as great an impact upon our health and that of our families as our individual insurance or our personal doctor.”
That assertion has been reinforced over the past 14 months, with the coronavirus pandemic upending every aspect of society.
Health officials — such as Dr. Alan Melnick, Clark County’s Public Health officer — have been at the forefront of identifying the pandemic and formulating a response to it. The fact that Washington has relatively low rates of COVID-19 infections and deaths attributed to the disease are a tribute to leaders from the state level down to county officials who have directed local efforts.
But when the pandemic has subsided to the point where we can regain some sense of normalcy, the question will be whether we are prepared for the next pandemic. The hope is that public health will never again be an afterthought.
Gov. Jay Inslee last week signed a bill designed to bolster public health systems. House Bill 1152 will increase funding for the state Department of Health, remake county health boards and create regional public health centers. The bill was supported by Southwest Washington Democrats, plus Republicans Rep. Paul Harris and Sen. Ann Rivers.
The need for additional funding has been made clear over the past year. As Melnick told the Editorial Board before anybody had heard of COVID-19, “As our population goes up and our funding goes down, I’m concerned about our preparedness.”
Funding for public health is not only about dealing with a pandemic or a smaller outbreak of disease; it also is about providing education and quick response to prevent an outbreak.
A recent study from Health Affairs found that public health spending from states dropped from $80.40 per capita in 2008 to $75.83 in 2018. The authors wrote: “Without institutional reform, states are susceptible to continued neglect of public health with only short-term emergency infusions of federal funding … Without substantial and sustained investment by states and ongoing robust federal support, the U.S. may well continue its ‘default’ approach to public health funding: ‘neglect, panic, repeat.’ ”
The change to county health boards will require a mix of elected and nonelected positions; in Clark County, the county council currently serves as the health board. The new law requires that nonelected members include members from three categories: Those with experience in health care; consumers of public health, including members of communities that face health inequities; and other stakeholders, such as community-based organizations.
The establishment of regional health districts, however, received pushback from some legislators. While coordinating a regional response can have benefits, it also can create additional bureaucracy that hampers the ability of local officials to respond to crises. County officials best know what is needed in their immediate area and should be able to act expediently.
Legislators next year should remove the provision for regional health districts. But they also should continue to provide much attention to the important area of public health.