Public health on the sequester chopping block

Here's what austerity has achieved for the nation so far: 46,000 lost public health jobs in five years. The latest manufactured budget crisis, the sequester, is likely to take another big chunk out of public health. While direct benefits to patients were not included in the sequester agreement, the administrative cuts from Medicare to the CDC to public health clinics will take a big bite out of health care'second only to defense.

Although the Medicare program will account for the largest chunk of dollars cut from healthcare simply because of its great size, the scheduled 2% reduction in its payments to doctors and hospitals is significantly smaller than what many public health and research programs face.

Laboratories at major universities and medical centers are already laying off scientists, even before the latest round of cuts is scheduled to take effect. And local public health officials, hit by years of cutbacks, are scaling back immunization campaigns and other efforts to track and control infectious diseases. [...]

A Health and Human Services Department spokesman said only that the agency would be sending general notifications Friday to those who rely on federal money. More specific instructions will follow. The agency is expected to cut about $15.5 billion from its overall spending, with about two-thirds of that coming from Medicare, which covers the elderly and disabled. [...]

Ironically, what worries some medical leaders more is the possibility that Congress and the White House could reach a larger deal to avert the sequester. Any such deal might involve steeper cuts in Medicare or reductions in Medicaid, which was exempted from the sequester.

What does all this mean for public health? Plenty, including 424,000 fewer HIV tests; 840,000 fewer vaccinations; 300,000 lost health care jobs; fewer food inspectors, and thus more food-borne illness; fewer research projects into things like mental health and gun violence. There will be cuts to EPA programs to cut air pollution and to keep drinking water clean and sewage treatment plants functioning.

This all comes on top of the austerity measures that have already hit the public health system. Austerity, the gift that keeps on giving; giving things like crumbling infrastructures, unemployment and disease.