I was recently asked by a reporter how I would fund public health in Alaska and below is my response.
Take a look at the senate majority survey results https://www.alaskasenate.org/2016/polling. You will note only 43 percent think state spending is too high while the majority believe it is about right or too low. 57 percent support a sales tax, 55 percent support an income tax and 55 percent support a fuel tax. In summary, the data points indicate the majority of Alaskans want revenue generation (sales, fuel, income taxes) and are opposed to more cuts. Alaskans know it is a very small-minded approach to the fiscal crisis to seek more cuts alone. The price of oil isn’t rebounding anytime soon. I would propose a small tax in all three areas, beginning with a fuel tax which hasn’t been increased since the 1980’s.
Second, continuing to cut causes job losses, immediate economic harm, and underserves Alaskans. Preserving public services is a constitutional obligation. Each of you took an oath to uphold the Alaska constitution and public welfare, including public health, as a statutory obligation. Article VII of the Alaska Constitution: Health Education and Welfare, which clearly and unequivocally states the “The legislature shall provide for the promotion and protection of the public health. And “the legislature shall provide for public welfare.”
Third, the finance committee is simply going against their own survey and their oaths to uphold the Alaska constitution by proposing cuts alone. The most vulnerable (children, poor, elderly and disabled), who by the way are the least able to advocate for themselves, are already feeling the pain.
Third, we are in the middle of an opioid crisis and PHN’s are instrumental in the distribution of Narcan kits. It seems odd to me in the age of Ebola, Zika, H7N9, opioids, domestic violence and suicide to propose cuts to the one section within the division of PH with boots on the ground throughout the state living and working in high-risk communities.
Fourth, after watching the testimony on Feb. 28, it seems Sen. Peter Micciche, R-Soldotna, wants to believe CHC’s and PHC’s do the same thing, they don’t. Community Health Centers provide sick care while Public Health Centers staffed by nurses work outside the clinic providing infectious disease investigation, prevention education and work toward equity-oriented health policies that tackle the root causes of negative population health outcomes. You simply can’t replace one with the other. In fact, the Institute of Medicine warns against doing just what Micciche is proposing.
Fifth, these cuts will lead to a sicker general population, higher medical costs, a wider distribution of infectious disease and more premature death.
Kindly join me is opposing cuts to DHSS.
• Jennifer Meyer, RN, MPH, CPH, is the past president of the Alaska Public Health Association.
