A reader sent me a link to The Salt Lake Tribune that made me do a double-take: Health department on chopping block:
Utah could become the only state in the country without a state health department.
Republican lawmakers are considering handing the duties of the health department — from tracking and responding to communicable diseases and trying to reduce obesity and cancer rates to inspecting child care facilities — to other agencies.
The proposed dismantling would save $1.7 million in administrative costs by cutting director and division director budgets. It came as a shock to David Sundwall, the department’s director, who learned of the proposal Wednesday morning.
“It would be a breathtakingly bad idea,” he said, noting Utah’s public health system is one of the reasons the state is often ranked as one of the nation’s healthiest. (Heather May, Salt Lake Tribune)
After the initial shock, I read on. Republicans in Utah are trying to cut $50 million (7.5%) out of their Human Services and Health budgets this year alone and another $102 million (15%) out of next year’s budget. And a disproportionate amount is coming from the Health side. The proposal will go all the way and submerge all of the health department’s functions into the human services agency. It’s not just reducing administrative redundancy, though. There will be major cuts in routine functions such as inspecting child care facilities. And no more unannounced inspections. Since these facilities are also feeling the economic pinch, they are under pressure to do just what the state is doing: cut corners. But in this case the result will plausibly be dead infants and toddlers. Such deaths occur even now, under more stringent inspection and will plausibly be more likely if no one is checking whether workers are properly trained and licensed and whether facilities are safe. Cuts will also affect infectious disease outbreak response, something that potentially endangers the whole community. There’s more, but it’s too depressing to detail. If you want all of it, go to the link.
I understand there is a budget problem. Not enough revenue and too many expenses. Administrative consolidation on its face seems like a reasonable way to avoid even deeper and more hurtful cuts. But I doubt very much if the proposed Republican solution will be a good one. It isn’t being proposed for humanitarian reasons. It isn’t just a consolidation but makes a statement about public health. The Mormon Church has enormous political power in the state and is not particularly sympathetic to anyone who doesn’t adhere to their life style. Their life style (no smoking or drinking) is a generally healthy one, which is good — for them. I don’t smoke and I drink very little (socially), but that doesn’t mean I want to abandon anyone who gets diseases in which smoking or drinking is a potential factor, any more than I want to abandon anyone with a disease of the uterus because I don’t have one or someone with asbestosis because I don’t work with asbestos or some one with diabetes because I don’t have it. I don’t have children in school but I still pay for schools. One could say that people with children didn’t have to have them. I think the fact is that Republicans in Utah don’t care about public health and public health functions. These functions are not only expendable but they disapprove of the regulatory functions that a public health department carries out. They are still deregulatory zealots, even as houses are being repossessed because right wing Republicans like those in Utah abandoned oversight. Some of the problem could be addressed by raising revenues. But dead infants and children are not as big a sin as raising taxes for these folks, so that’s a non-starter.
I hope an influenza pandemic doesn’t start in Utah. Because it will be around the world twice before we find out about it from a state without a full fledged health department.