And, while Massachusetts has done a good job addressing the problem of underage drinking, the Commonwealth still ranks as one of the states with the highest rates of underage drinking and adult binge drinking. Youth, in particular, are very sensitive to even small price increases. We believe that ending this exemption will help decrease underage drinking and frequency of use. It may also delay the first use of alcohol for some teenagers. Studies suggest that the likelihood of alcohol problems in adulthood increase with early-age drinking.
In any year, the proposal for a Commonwealth Wellness Fund would be considered a bold and innovative approach to serious public health problems. But this year, there is an added reason why it’s a good idea; it’s imperative. The Department of Public Health, like every other state agency, has undergone significant budget cuts already and will lose more funding from the state budget next year. This current year, we’ve lost $30 million in funding, and the current economic crisis means that we will have to cut $40 million more next fiscal year.
The proposal for a Commonwealth Wellness Fund makes a statement. It says that prevention — which is the core of what public health does — is important and in a tanking economy we need to find a way to pay for it. Massachusetts has always been a leader in innovation in health care and public health. The revenue generated for the Commonwealth Wellness Fund will support core public health activities, such as addiction and tobacco control services, health and wellness promotion, and violence prevention. It will also support programs that seek to expand our health care workforce, which is critically important to the continued success of Health Care Reform.
The proposal will no doubt be controversial — all new ideas for revenue usually are. But, if we believe that public health is important, if we believe that helping to prevent illness and injury is a better course than paying for costly care after people become sick, then we should support the Governor’s proposal.
In my thirty years in public health, I have never seen such dire times. And, I’ve never been more convinced about the need for strong public health leadership. Public health problems usually get worse during economic downturns, not better. The Commonwealth Wellness Fund is not a cure for all that ails us, but it is an important step in stopping the bleeding of important public health services. On the economic battlefield that we’re operating on, that’s called progress.
My wife does some work in health disparities, so I’m pretty sympathetic to your overall argument.
Can you provide a link that explains where the cuts have been made and will be made?
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p>I was trying to find the info on the DPH website but couldn’t.
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p>And if the new tax passes, would you restore the old cuts, or do something different with the money?
You can find the detail on the $30m FY ’09 9C cuts here. About $28m came in the first round of 9c’s annouced by the Governor, and the additional $2m or so were announced last Wednesday. You’ll see they touch pretty much every area of DPH. The proposed FY10 budget will have to absorb approximately $40m more in cuts. One tool the Governor did provide this year is the consolidation of budget line items. DPH’s budget is made up of more than 50 accounts in the budget, but in the Gov’s proposal he allowed the consolidation of those accounts down to about 12. This will give managers more flexibilty as they work to absorb the cuts in their areas.
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p>If the Wellness Fund passes — which we think is critical — it won’t necessarily restore all of the cuts, but it will allow us to continue with very important prevention and treatment activities, like tobacco control and cessation efforts.
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p>Your wife is working in a very important area of public health — eliminating racial and ethnic health disparities is a priority of the department.
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p>Tom Lyons, DPH
It appears to me that some of the projected anti-obesity effects of ending the sales tax exemption will be reduced by the proposal to add deposit costs to more bottled beverages. The initial purchase costs for healthier drink options (say water and fruit juices) due to deposit will increase just as much as the sales tax adds to the price of sodas. As is mentioned in the section on alcohol, youth are particularly aware of small price variations.
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p>Should anti-obesity advocates oppose the deposit expansion?
I don’t think so. I think people who care about public health issues will support the proposed Wellness Fund. The other point I would make about anti-obesity efforts is that there is no silver bullet — it will take a comprehensive approach to address the problem. That is the goal of the Administration’s recently announced Mass In Motion program. We need to tackle the problem from a number of different angles.
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p>Is a pretzel candy? How about one dipped in chocolate? Is cake candy? How about a Twinkie? Where is the line drawn for those foods — a Snickers bar is obviously candy, but is a Tic Tac?
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p>Same goes for beverages. It would seem that a can of Coke would be sweet, but what about a Sunny Delight? Gatorade? Diet Coke? What about drinks that are also made with fruit juice? What about Kool-Aid mix, which isn’t (yet) a beverage and is as sweet as can be?
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p>In both cases, I agree that public policy could include taxing those items, but how sweet is sweet?