Aside from ideological disagreement over the proper size and role of government, most of the debate over cuts in public expenditures has been over the expected economic impacts – notably, the effects on job creation and unemployment.
Far too little attention has been paid to non-economic impacts. There’s a dangerous misconception – an implicit and unexamined assumption, really – that we can keep zapping public budgets, yet somehow manage to carry on essential public services more-or-less as before.
That misconception will shortly be exploded, I suspect, as the health consequences of sustained cuts start to emerge. It appears that the process has begun. A case in point has just popped up in Washington state, parts of which are being walloped by a spring whooping cough (pertussis) epidemic.
Nearly 1300 cases of whooping cough have been reported so far, ten times last year’s rate, prompting state public health officials to declare an epidemic and the national Centers for Disease Control to send out investigators. The situation calls for speedy reaction and an intensification of preventive actions. But hobbling Washington’s ability to respond is the cumulative impact of successive reductions in public health budgets. Hard-hit Skagit County, north of Seattle, has lost half its public health staff to budget cuts since 2008. County prevention programs are virtually non-existent.
If we continue on our present course, Skagit County’s experience will become the rule, rather the exception, across America. Short-term savings at the expense of public health are long-term stupid, plain and simple. As the saying goes, “pay me now, or pay me later.” In the case of public health, “later” means not merely more money, but unnecessary human suffering.