Indianapolis Business Journal. November 25, 2022.
Editorial: Legislature should consider full funding for public health
Hoosiers are an unhealthy lot. It’s been well-documented.
In study after study, Indiana consistently ranks among the nation’s least healthy states.
According to America’s Health Rankings, one of the most trusted surveys, Indiana weighs in at No. 41 in overall health. We’re the fifth-most-obese state, and we’re also in the top five for smoking and physical inactivity.
These poor rankings lead to poor health outcomes, costing more than $75 billion a year in medical costs and lost productivity due to heart disease, cancer, stroke, diabetes, kidney failure and other chronic diseases, according to a 2018 study by the Milken Institute, a California-based economic think tank.
Clearly, it’s beyond time to do something to stop eating, smoking and lounging ourselves to death—and save a lot of money in the process.
The Governor’s Public Health Commission is trying to make some progress. After much study, the panel concluded that the state needs to spend an additional $242 million a year on public health to bring it in line with the national funding average, improve Hoosier health and lower medical costs.
Currently, the state ranks a dismal 48th in terms of the amount of money it devotes to public health. That fact alone should be enough to justify a significant increase. Besides, studies show it’s a smart investment. Every $1 spent on public health generates a return of $5.60 in lower health care costs, according to a study by the Trust for America’s Health.
But, as IBJ’s Peter Blanchard reports on the front page, the proposal’s price tag already has received a tepid response from key leaders in the Republican-controlled Indiana General Assembly.
With a $6.1 billion state surplus, Senate President Pro Tem Rod Bray is suggesting a go-slowly approach before the Legislature even convenes in January to consider the commission’s proposal.
Legislative leaders appropriately note that a recession might be on the horizon and that many other worthy interests will be clamoring for a piece of the surplus.
But that doesn’t mean the funding level recommended by the governor’s health commission should be immediately dismissed out of hand. And it certainly doesn’t mean the state’s health problems can be blamed solely on individual Hoosiers’ failure to eat healthily and take good care of themselves.
Some Hoosiers can’t afford access to quality health care. Others simply need to be prodded to do the right thing and make good choices.
Government should play a role in that, especially if it means that such an investment will more than pay for itself in reduced health care costs. Luke Kenley, co-chair of the health commission, believes that it will, and he’s a former lawmaker who once held the state’s purse strings as chair of the Senate Appropriations Committee.
Our hope is that legislators will pay full attention to their former colleague and strongly weigh the financial benefits of a significant investment in public health before trying to limit it to some artificial level that won’t get the job done.
Anderson Herald Bulletin. November 26, 2022.
Editorial: Holcomb in right place, but not Legislature
Indiana Gov. Eric Holcomb might have asked himself privately numerous times the same question he posed aloud recently to attendees of the United Nations 27th Climate Conference of the Parties (COP27) held in Egypt: “Am I in the right place?”
Egypt, an authoritarian country hoping to become a major natural gas exporter, hosted the conference amid allegations that it has imprisoned or driven into exile its critics including environmental activists. But human rights issues weren’t broached in Holcomb’s two speeches touting Indiana’s role in renewable green energy.
In his first speech, he referenced Indiana’s state ranking as fourth in clean energy capacity under development. That statistic is from a fourth-quarter 2021 report by the American Clean Power Association policy group which praised Indiana for projects in the pipeline.
Holcomb, however, leaned into the fact that the state provides more than one-fourth of all steel produced in the U.S. and that Indiana still uses coal to produce energy “enabling our economy to grow and keep the home lights and refrigerators on.” Clean energy can do the same.
He referenced coming advances by Cleveland-Cliffs in replacing coal with natural gas as well as Cummins and Duke for setting carbon goals.
Most of his citations involved private enterprise recognizing the future of clean energy.
He added, “And in regard to our infrastructure, broadly defined, it’s our state government mindset, because it’s the key to scaling up innovation and therefore solutions.”
The governor may have missed legislative discussion on Senate Bill 411 during the last regular session. When introduced, the bill set standards for wind projects, such as addressing height and shadows flickering on neighboring properties.
Originally, the bill would have provided $1 per megawatt in taxes as an incentive for governments to adopt wind power projects. On Feb. 21, State Rep. Ed Soliday, who sponsored the bill in the House, said the legislation was an attempt to compromise with Hoosiers who fought renewables — notably residents opposed to wind projects being installed at a neighbor’s farm.
No action was taken by the House Ways and Means Committee which could have advanced the bill. Instead, the next day, the $1 provision was axed because legislators couldn’t determine who would end up paying for infrastructure needs, whether it would be local communities or state government.
“We weren’t quite prepared for state government to do that,” Rep. Timothy Brown, chair of the Ways and Means Committee, said.
The Indiana General Assembly has shown it’s not as forward-thinking as Holcomb might tout in Egypt. While some previous state legislation has meant well for clean energy, utilities still rule.
In 2011, the Legislature passed a voluntary clean energy portfolio plan by which electric utilities could pledge that 10% of their electricity would come from clean energy by 2025. No one had signed up as of 2021, according to the U.S. Energy Information Association.
In the last session, the Hoosier Environmental Council had difficulty in urging passage of bills that would have created a climate task force in the General Assembly. Similarly, the Citizens Action Coalition lost its fight by mid-session for pro-solar bills including an extension on net metering availability.
Holcomb’s cheerleading in Egypt was a proper sales pitch to an international market. So yes, he was in the right place to talk clean energy.
But when, Hoosiers might ask, will the Indiana General Assembly end up in the right place?
Fort Wayne Journal Gazette. November 25, 2022.
Editorial: GOP leaders lukewarm to public health proposals
Indiana Gov. Eric Holcomb said in July one of his four priorities for the coming legislative session would be more funding for public health. But top lawmakers from the governor’s political party are expressing doubt about the size of any increase.
During Monday’s annual Indiana Chamber of Commerce legislative preview, Republican Senate President Pro Tempore Rodric Bray said he found the governor’s plan to hike health spending by $243 million annually “... a little difficult to swallow.”
GOP House Speaker Todd Huston said the General Assembly already invests in public health, though “it may not be as much as people like.” If the legislature puts more money toward health, he said it should “support actionable goals with measurable outcomes,” the Indiana Capital Chronicle reported Tuesday.
Indiana performs poorly compared to the rest of the nation when it comes to public health. Atlanta-based Sharecare, a digital health care company, partnered with the Boston University School of Public Health and ranked Indiana 41st on its list of the healthiest states in 2021.
In August of last year, Holcomb established the Governor’s Public Health Commission and charged its 15 members with examining the strengths and weaknesses of Indiana’s public health system and making recommendations for improvements.
The commission submitted a 107-page report to Holcomb in August. It advocated starting a health care workforce plan to mitigate staffing shortages, increasing access to state data for local health departments and establishing a strategic equipment stockpile, as well as stepping up public health spending by about 65%.
Programs that combat problems associated with infant mortality, smoking, obesity and children’s health top the list of services provided inconsistently due to funding deficits at the county level, said Mindy Waldron, a member of the commission and administrator of the Allen County Department of Health.
Indiana ranks 48th in public health funding, spending about $55 per Hoosier or $36 less than the national average of $91 per person. The commission wants to close the funding gap by $36 per resident at a cost of about $243 million per year.
“Currently, state funding to local public health departments is extremely low, which requires use of property tax monies, various grants and user fees to make up the difference in operational funds needed,” Waldron told The Journal Gazette. “In Allen County, direct state funding to the health department makes up approximately 5% of the roughly $6 million yearly budget. This results in the inability to provide a wider array of preventative services, which, in the end, leads to higher medical costs across the community.”
Huston said Monday he had asked Public Health Committee Chair Rep. Brad Barrett, R-Richmond, and Ways and Means Committee Chair Rep. Jeffrey Thompson, R-Lizton, to do a “deep dive” on the commission report. He was noncommittal on what would come from the analyses.
“Some (recommendations), not all, will be successful – or certainly entertained,” the House speaker said.
Luke Kenley, co-chair of the commission and a former Republican chairman of the state Senate Appropriations Committee, emphasized that transparency played an important role in the commission’s process. Members hosted seven listening sessions across the state, and read every comment the commission received online or at its public meetings. Kenley sent reports to lawmakers after each listening session.
“We have a lot of problems here when it comes to health care in this state, and health care costs (are) obviously one of those,” House Minority Leader Phil GiaQuinta, D-Fort Wayne, said Monday. “...I think it signals that we aren’t taking the issue seriously if we don’t really adhere to the recommendations.”
Indeed, the Governor’s Public Health Commission took its assignment seriously and identified specific actions in addressing the state’s acknowledged shortfalls in this area: Ensuring core public health services are provided locally by promoting collaboration and quality improvement; investing in public health to improve outcomes through consistent delivery of services; training the public health workforce to expand capacity; coordinating and modernizing data to provide tools to help communities make better-informed health decisions; and improving student learning by eliminating barriers to health care.
Holcomb, GiaQuinta and other like-minded legislators should go all-in on the Public Health Commission’s funding and other proposals.
County health departments in the Hoosier State have one of the 10 lowest expenditures per capita in the nation, and many of their workforces are ill equipped to deal with the communicable disease issues they face, such as COVID-19, monkeypox and sexually transmitted diseases.
The cost of preventive care is almost always far less than addressing the aftereffects of disease. Increased and sustainable funding, more staffing and better trained public health officials can lead to better public health outcomes in Indiana – and that benefits all Hoosiers.