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Wednesday, February 06, 2002
Ann McFeatters, Post-Gazette National Bureau
WASHINGTON -- In the movies, the public health team moves in to handle an outbreak of infectious disease or bioterrorism with dispatch, competence and heroism.
In a real-life catastrophe, officials in the White House say, cell phones often don't work, there is not enough vaccine, the right hand doesn't know what the left is doing, and turf wars hinder fast reaction.
Homeland Security Director Tom Ridge says he has been frustrated by the lack of communication among levels of government amid last year's anthrax scare.
"As we looked at the public health system, it was pretty clear that it had not received the attention that it should have over the past several years," he said this week.
President Bush's budget would beef up public health systems -- and the emergency medical personnel first at the scene of a disaster -- to help the country respond better not just to terrorism but also to "all diseases and mass-casualty incidents."
If enacted, Bush's budget would have a surprisingly large impact on what it deems long-neglected public health programs and research, pumping 312 percent more (a total of $5.9 billion) into preparations to fight bioterrorism and $1.6 billion to help state and local responders. Of the proposed $37.7 billion in the homeland security budget, 9 percent is to prepare police, fire and emergency medical personnel, and 16 percent is to combat biological terrorism.
But at the same time, Bush is proposing to cut the budget for the Centers for Disease Control and Prevention, which is the nation's central sleuth for medical mysteries, such as the anthrax outbreak, and a linchpin of the effort to guard against bioterrorism at the Salt Lake City Olympics. The federal centers, based in Atlanta, would lose $57 million for their chronic disease program and $28 million for their worker safety promotion efforts.
And there is criticism on Capitol Hill that the Bush budget would shovel out money too quickly to agencies that haven't performed well in the past.
The Partnership for Community Safety -- an organization that represents doctors, hospitals, public health associations, nurses, medical colleges, health officials, medical board, fire chiefs, city and county health officials, emergency medical service directors and ambulance companies -- praised Bush's budget, saying it "firmly sets us upon that path" to strengthen the safety and security of the country. The one caveat the group raised is that money will have to continue to be provided every year.
Ridge agrees, saying the homeland defense budget "is not a one-shot deal."
But complaints are pouring into the White House that other public health programs, such as mental health and safe drinking water, are being ignored by the Bush White House.
Critics argue the White House is being penny-wise and pound-foolish by pouring billions of dollars into protecting communities from disasters such as nuclear power plant accidents, nerve gas toxins and plague or smallpox outbreaks that are only remotely likely, but ignoring real hazards that threaten more people.
The U.S. Public Interest Research Group, or PIRG, contended that proposals to reduce environmental enforcement, cut clean drinking water programs and reduce Superfund cleanups of toxic-waste dumps would negatively affect more Americans than are positively affected by Bush's proposed increases for disaster preparedness.
Noting that the Environmental Protection Agency has concluded that the nation needs to invest $102.5 billion to "ensure the continued provision of safe drinking water," PIRG said the White House request for $850 million for state loans to provide safe drinking water is insufficient -- and $150 million less than Congress has authorized. PIRG also was upset that the White House wants to cut 112 "environmental cops on the beat" and reduce money for civil enforcement and compliance monitoring.
The National Mental Health Association expressed disappointment that there was no increase for mental health funding, which it regards as an actual reduction given double-digit inflation of medical costs after Sept. 11 and a recession that has "exposed an underfunded, overburdened and failing public mental health system." The association quoted Health and Human Services Secretary Tommy Thompson as saying after the Sept. 11 terrorist attacks: "The country needs additional resources to fund a vast, well-coordinated network of mental health support to battle the anxiety that follows tragedies."
Ron Pollack, executive director of Families USA, argued that the Bush budget would compromise the health of millions of Americans in the short term to prepare for emergency scenarios that might never take place.