The Healthy Maine Partnerships are proposed to be virtually eliminated under Gov. Paul LePage’s budget. As a fellow Republican and a registered nurse, I am extremely disappointed in the governor’s proposal to dismantle the historically successful public health infrastructure that has combated the three major risk factors associated with preventing chronic disease. This has been accomplished by utilizing evidence-based strategies to improve nutrition, increase physical activity and decrease tobacco use.
Without health promotion and disease prevention efforts chronic disease will continue to grow and health care costs will continue to rise. Healthy families are the key to a healthy economy. When people are healthy, children do better in school, workers are more productive, families have more money in their wallets and businesses can create jobs all because health care costs are low.
I recall working at St. Joseph’s Hospital in Bangor in the mid-1980s and talking with a seasoned intensive care registered nurse who said, “I’d be out of a job if people quit smoking.” A majority of those people being treated in the intensive care unit at that time was the result of long-term tobacco use. Since 2001, Maine’s youth smoking rates have dropped by 48 percent and adult smoking rates have decreased by 24 percent thanks in no small part to the work of the Healthy Maine Partnerships. This meant big savings because cigarette smoking costs $811 million annually in direct health care costs.
I first became involved in prevention after some years working with patients who had multiple chronic conditions, and the only recourse was to treat their symptoms with little time for counseling sessions to quit smoking or improve their nutrition or to provide increased opportunities for physical activity. I think we have an opportunity to decrease the costly impact of these preventable chronic conditions by altering individuals’ behaviors, and we have a trained public health workforce that is working diligently with limited funding to do just that. There is a role to play within the various health care settings, and no one entity can be the be-all and end-all for health care needs.
Forcing a choice between disease prevention and primary health care creates a false dilemma for policymakers. Investing in primary care to treat illness is important, but it should not be at the expense of community public health systems that help prevent tobacco use and substance abuse, support physical activity and healthy eating, provide education and health promotion programs, and encourage local policy and environmental change.
It’s not realistic or accurate to suggest that Maine’s primary care doctors can or will deliver the full range of critical disease prevention and health promotion programs currently being provided through Maine’s public health system. It’s irresponsible and unfair to ask primary care providers to take on functions best performed by community health networks.
Consider the proverb “give a man a fish, and you feed him for a day; teach a man to fish, and you feed him for a lifetime.” This proverb can be applied to individual health care: Treat a person’s symptoms and make him or her feel better for a moment; teach a person positive healthy behaviors and implement long-term public health policy and environmental changes, keep him or her healthy for a lifetime.
Keeping the Fund for a Healthy Maine working to prevent disease and promote good health is our best opportunity to support healthy families, lower costs for businesses and help young people stay in Maine. We don’t have to choose among keeping Maine’s public health infrastructure intact, helping kids resist tobacco and supporting primary health care. We can and must do all three.
Success is only possible through a comprehensive effort that includes prevention, early detection and treatment to improve public health and reduce health care costs. Let the Fund for a Healthy Maine work as it was intended — helping smokers quit, giving kids a healthy start, supporting new parents, helping families get active, teaching students about healthy choices and delivering community public health to every community in Maine.
We need to continue to utilize our Healthy Maine Partnerships to make the healthy choice the easy choice in Maine.
Robin Mayo of Milo is a registered nurse and a Penquis Public Health District Representative to Maine’s Public Health State Coordinating Council.