This story comes from our partner 
‘s Shots blog.
It may sound counterintuitive, but a panel of experts from the Institute of Medicine has concluded that the best way to slow the nation’s breakneck spending on medical care is to impose a tax on every health care transaction.
That tax — amount TBD, but possibly a half-percent or so — would go to replenish the coffers of the nation’s state and local public health agencies. In so doing, according to the IOM panel, the public health workforce could renew its historic role in looking at population rather than individual health care, and thus “offer efficient and effective approaches to improving the nation’s health.”
Currently, said Marthe Gold, professor of Community Health and Social Medicine at the City College of New York and chair of the panel, the U.S. spends only about 3 percent of the $2.5 trillion it spends on health care overall on public health. It has a history of “unpredictable, inadequate and uncoordinated funding.”
Yet “public health also has a track record of achievement in vanquishing the historic causes of death and disease,” she said, from early successes like ensuring clean water and sanitary food to more recent campaigns to get people to stop smoking or use seat belts.
The public health infrastructure has taken a hit during the recent economic downturn: Roughly one-fifth of the local public health workforce has been lost through attrition and layoffs. Renewing that infrastructure could have a profound impact on slowing the rate of growth in health spending, the panel argues.
For example, public health measures — including community-based outreach — could help reduce adult obesity by 50 percent, the panel says. Sounds ambitious, but as the panel notes, that’s about the same relative reduction in smoking rates that resulted from the “public health community’s multifaceted attack on smoking” in the past few decades. It would also save the U.S. an estimated $58 billion in health care spending.
In order to meet those goals, the panel says every public health agency would need to be able to deliver a “minimum package of services.” That would include what it calls “foundational” services, such as the ability to do basic disease surveillance and communicate with the public, and “programmatic” services, such as injury prevention and communicable disease prevention.
But to get there, the federal government would need to at least double the $11.6 billion it invests each year in public health activities, according to the panel’s estimates.
Which brings us to that pesky tax.
Panel member George Isham, medical director at HealthPartners in Bloomington, Minn., acknowledged that “it’s difficult to propose any kind of increase in taxation.” But the group considered a number of different financing mechanisms before settling on a minimal tax on medical transactions as the best solution: It’s a tax related to the goal; it would raise sufficient funds; and it would not have a bad economic consequence. In short, said Isham, “it’s an investment we can’t afford not to make.”
Now they just have to convince the rest of the nation of that.
Subscribe
let me guess! Drs and hospitals will have to pay the tax.
Hey Doc, instead of whining and crying to the Supreme Court, Republicans could have done it the easy way and let the individual mandate stand and we wouldn’t have had to worry about “New Taxes To Pay For Public Health”. Face it, the individual mandate was a GOP idea in the first place, right? Didn’t the ultra-conservative Heritage Foundation come up with the idea of the individual mandate back in 1993? Didn’t Newt Gingrich write volumes about the virtues of the individual mandate? Didn’t GOP Presidential nominee Mitt Romney get the individual mandate passed and enacted as Governor? In fact, it was such a good idea that Obama finally warmed up to it and got it passed and enacted in the Affordable Care Act. Now, all of a sudden, it’s a bad idea? Talk about dopes! So, if five of the nine dopes on the Supreme Court decide to strike down the individual mandate, guess what?
“let me guess! Drs and hospitals will have to pay the tax.”
Don’t assume that I or most docs are Republicans. Im independent and many of my physician partners are Dems. I strongly believe that healthcare was neglected under GWB and that is why we are in such a difficult situation. The problem is politicians and not the GOP or Dems. They both use Medicare and healthcare as a political tool but they and their East Coast thinktank academics dont understand the real issues. Healthcare was socialized in the early 90s with the EMTALA act which requires hospitals to provide the “standard of care” to any pt that comes through the door. That includes transportation to a “higher level of care”. This law resulted in states de-funding academic indigent care(tertiary care centers) and allowed pts and employers to drop insurance.(you dont need insurance;just go to the ER) The ever increasing flood of no-pay pts into hospitals has resulted in extreme cost shifting toward medicare and insurance . IMO insurance companies are getting ripped off by these big govt controlled hospitals and the current system is heading for a breakdown real soon. Insurance cos will start demanding that the cost shifting stop and will force the development of a seperate non-govt system where costs are lower and service better. Obviously without the cost shifting the big hospitals will be in trouble and then they will be the ones whining to the govt for help. The sub-medicaid level reimbursement Obama care indigent plan is not going to fix this IMO. EMTALA has never been challenged ,but I believe its unconstitutional, forcing Drs and hospitals th work for free. Healthcare needs to be affordable ,but pts need to pay their bills or have a lower standard of care (charity care). It’s funny, if there is one part of the Affordable Care Act that I agreed with its the individual mandate. I’m sick of taking cate of fat, lazy, dumb tobacco abusers who made a decision decades ago to spend all their money on entertainment, fast food, alcohol and cigs and not have health ins.
The profession of Medicine has been harmed enough over the past 20 yrs and Drs should not and will not be taxed to pay for “public health” Heck I do it all for free now!
Gee Doc, your post begs the next most obvious question…
With all of the MD and PhD mega-brains contained in the nation’s health care industry, with all of you so-called geniuses that are supposed to be guiding health care policies for “THE BEST (AND MOST EXPENSIVE) HEALTH CARE THE WORLD HAS EVER KNOWN”, why haven’t you collaborated and cooperated to figure out a solution to lower costs and why do you keep using the lame excuse that consumers are the main cause of the problem? Don’t tell me? The money’s too darn good, right?