Pay Now or Pay More Later

Public health values prevention. In many cases, this means spending a relatively small amount of money up front (on things like water treatment and vaccination) to avoid spending a lot more money later (on medical care, lost productivity, and reduced earning potential - not to mention quality of life).

In the past few days, I've come across two examples of governments facing a stark choice between paying for something now, or paying a lot more later. It at least one case, it looks like the elected officials will stick with boneheaded option.

Here's Lynda Waddington at RH Reality Check, explaining the choice that Iowans face:

When it comes to making family planning services available and accessible to low-income women, Planned Parenthood of Greater Iowa has a question for Iowa officials and taxpayers: "Do you want to pay $1 now or $4 later?"

Iowa has roughly 100,000 low-income women -- 12.3 percent of all women of childbearing age -- who need, but are not receiving, publicly assisted family planning services. The lack of access has been costly to Iowa, a state where half of all pregnancies are unintended. Planned Parenthood is advocating for the development of a state fund that would be used in conjunction with Medicaid, the Medicaid Waiver, Title 10 and other federal funding streams to provide low-income women with the birth control they need. ...

The legislative priority received a boost at the beginning of the legislative session when Gov. Chet Culver tentatively earmarked $1 million for the fund. With legislators poised to tighten the state's belt, the climate in Des Moines is not necessarily conducive to new appropriations.

I realize that state budgets are squeezed this year, but this seems like it ought to be a priority. 

Meanwhile, Matt Canham of the Salt Lake Tribune checks in on the nuclear waste piled on the banks of the Colorado River, threatening the drinking water of 30 million downstream users:

The uranium tailings span 130 acres at the edge of the Colorado River, where studies have found that uranium and ammonia are contaminating the water. 

The tainted dirt is left over from a uranium-processing mill that was operated by Charlie Steen's Atlas Mineral Corp. The company closed the mill in 1984 and filed for bankruptcy in 1998. 

Two years later the Energy Department took control of the site. 

Its original plan was to move the uranium tailings out on rails, finishing up by 2012. But last year Bodman told Congress that budget constraints have pushed that deadline back another 14 years to 2028.

Canham reports that Energy Secretary Samuel Bodman cites other sites as having a higher cleanup priority -- and then, of course, there's the overall budget issue: "President Bush has budgeted $30.5 million for the next fiscal year. But the department would need more than $45 million next year to keep on pace to reach the 2019 deadline."

Is this the same president who justifies spending billions in Iraq because on the grounds that we have to fight them over there so we don't fight them here at home? Such a prevention-minded guy ought to see the value of cleaning up nuclear waste now, rather than dealing with the fallout from costly health problems later. Or maybe he doesn't care, because someone else will be in office and have to foot the later, larger bill.