Tuesday, May 17, 2011

$100 million in Affordable Care Act grants

Today I received an e-mail from PHLP-Public Health Law Policy- proclaiming the benefits of the Community http://www.blogger.com/img/blank.gifTranformation Grants (CTG) that are set to award over $100 million in Affordable Care Act grants to government officials, bureaucrats, "health" advocates, community leaders and "non-profit" organizations at every level and in every state. There will be no escape -not at the federal level, not at the state level, and certainly not at the local level- from meddling do-gooders-with your money in hand-trying to coerce, I mean force you-and everyone that doesn't eat sprouts for breakfast (while refraining from tobacco, of course)- into living your life according to what they see as fit.

First, they came for the tobacco smokers. No one defended our right to be treated as adult citizens with free will because it did not affect them (directly). Oh, but fear not dear smokey friends, now the grant seekers have begun to move onto unprecedented grounds: Just as many of us in the blogosphere have predicted, we can now expect to see an onslaught of new and pesky ordinances that seek to further stick it to the little guy and whatever free will those of us who take up residence in the proletariat factions of society have left. I know, "it's for our own good".

..a few words from the HHS on how they plan on achieving their objective of a United States devoid of disease:

Consistent with the law, these grants will focus on five priority areas: 1) tobacco-free living; 2) active living and healthy eating; 3) evidence-based quality clinical and other preventive services, specifically prevention and control of high blood pressure and high cholesterol; 4) social and emotional wellness, such as facilitating early identification of mental health needs and access tohttp://www.blogger.com/img/blank.gif quality services, especially for people with chronic conditions; and 5) healthy and safe physical environments.



Notice how there is no mention of moderation or harm reduction with regards to tobacco use? Abstinence only is the only prescription available from the prohibitionists. Can you imagine a world where there existed only one option for treating and preventing disease? Is this a policy that purports to be in line with the reality that there are always going to be people who smoke? If your answer to this question is no, then one has to wonder aloud about how our tax money is being put to use with regards to the whole, rather than the sum of parts, when it comes to the issue of "over-hauling" health care in these United States.

Let's move on to point two: How does the government plan on getting us all to exercise and eat healthy without infringing upon the sovereignty of every individual in this country? If public officials are so concerned about Americans being active, then why have they been cutting physical ed classes from public schools across the nation? So, let's see....There is no money for gym glass, but their is money for this? Wouldn't it make more sense to fix the underlying problem (waste), so that there would be no need to make cut physical ed classes in the first place? As for encouraging (er, forcing) Americans to eat healthier via more NS (Nanny State) legislation, I am sure that we can expect a whole new barrage of taxtion (that will surely be used to give away more grants to wealthy recipients) on all foods and drink that are deemed to be "unsavory". Of course, these taxes will be paid out by the poorest of the poor, who will in turn have no choice but to surrender to the local bully (ie., insert your local city councilman here) who has been ordained by the righteous cardinals of neo-healthism to carry out the king's orders. Of course, the wealthy will still eat their high calorie, flour-less cake free of harassment and higher taxation. So much for being for the little guy.

Now let's take a gander at point # 4, which aims to tackle the very personal issue of social and emotional wellness. I'm sorry, but this has gotten downright creepy. Who gets to decide what a social and/or cultural norm is? Who gets to define the meaning of emotional wellness? I'm sorry, but it doesn't get any more Orwellian (or scary) than this. As a nation of individuals, there are many different cultural norms. Some of us like hip-hop, some of us work out everyday and down wheat-grass shots in the morning, some of us smoke (and enjoy it), some of us are clean-cut, some of us are gravitate to a more bohemian way of life...Me, I work out, do wheatgrass shots, drink red wine, AND smoke. I know, I don't fit in to what has now become the newly defined "norm", but that's the POINT; I'm an INDIVIDUAL and I know what's best for me, not some politician or bureaucrat. Ah, well, you get the picture..The point here is that the government has no place in instituting cultural norms; it has no authority to define happiness for me or for anyone else.

Here are a few examples of how some of the money for "prevention" has been allocated thus far:

In the state of California:

Since enactment of the Affordable Care Act on March 23, 2010, the Department of Health and Human Services has awarded approximately $42.7 million in grants to organizations in California through the Prevention and Public Health Fund to help improve wellness and prevention efforts, including:

Community and Clinical Prevention ($8,988,000): This funding supports prevention activities that have been shown to be effective in reducing health care costs and promoting health and wellness.

Communities Putting Prevention to Work ($3,600,000). Supports federal, state and community initiatives to address tobacco control, obesity prevention, HIV-related health disparities, and better nutrition and physical activity.
Primary and Behavioral Health Integration ($1,987,000). Assists communities with the integration of primary care services into community-based mental & behavioral health settings.
HIV Prevention ($3,161,000). Focuses on HIV prevention in high risk populations and communities by increasing HIV testing opportunities, linking HIV-infected persons with appropriate services, and filling critical gaps in data and understanding of the HIV epidemic.
Tobacco Cessation ($240,000). Strengthens California’s ability to move towards implementing a plan to reduce tobacco use. It also enhances and expands the national network of tobacco cessation quitlines to significantly increase the number of tobacco users who quit each year.

Public Health Infrastructure ($7,257,000): These grants strengthen state and local capacity to prepare health departments to meet 21st century public health challenges and support the training of existing and next generation public health professionals.

Public Health Infrastructure ($4,020,000). Supports state, local, and tribal public health infrastructure to improve information technology, workforce training, and policy development.
Epidemiology and Laboratory Capacity ($1,289,000). Builds state and local capacity to prevent, detect, and respond to infectious disease outbreaks.
Public Health Training Centers ($1,948,000). Improve the public health system by enhancing skills of the current and future public health workforce.

Primary Care Training ($26,457,000): These funds support the expansion of the primary care workforce.

State Health Care Workforce Development ($150,000). Helps California strengthen its comprehensive health care workforce planning and/or implementation of such plans.
Primary Care Residency Expansion Program ($18,240,000).Increases the number of residents trained in family medicine, general internal medicine, and general pediatrics.
Advanced Nursing Education Expansion Program ($1,056,000). Increases the number of primary care nurse practitioners and nurse midwives who graduate by expanding class sizes and accelerating graduation rates for part-time students.
Expansion of Physician Assistant Training ($4,054,000). Improves access to primary care by funding the training of primary care physician assistants and expanding the primary care workforce.
Nurse-Managed Health Clinics ($2,957,000). Provide primary care and wellness services to underserved and vulnerable populations through clinics that are managed by advanced practice nurses and provide valuable clinical training sites for primary care nurse practitioners.


...in the state of Louisiana:

Since enactment of the Affordable Care Act on March 23, 2010, the Department of Health and Human Services has awarded approximately $7.8 million in grants to organizations in Louisiana through the Prevention and Public Health Fund to help improve wellness and prevention efforts, including:

Community and Clinical Prevention ($316,000): This funding supports prevention activities that have been shown to be effective in reducing health care costs and promoting health and wellness.

HIV Prevention ($243,000). Focuses on HIV prevention in high risk populations and communities by increasing HIV testing opportunities, linking HIV-infected persons with appropriate services, and filling critical gaps in data and understanding of the HIV epidemic.
Tobacco Cessation ($73,000). Strengthens Louisiana’s ability to move towards implementing a plan to reduce tobacco use. It also enhances and expands the national network of tobacco cessation quitlines to significantly increase the number of tobacco users who quit each year.

Public Health Infrastructure ($1,889,000): These grants strengthen state and local capacity to prepare health departments to meet 21st century public health challenges and support the training of existing and next generation public health professionals.

Public Health Infrastructure ($200,000). Supports state, local, and tribal public health infrastructure to improve information technology, workforce training, and policy development.
Epidemiology and Laboratory Capacity ($289,000). Builds state and local capacity to prevent, detect, and respond to infectious disease outbreaks.
Public Health Training Centers ($650,000). Improve the public health system by enhancing skills of the current and future public health workforce.
Capacity Building ($750,000). Provides capacity building assistance to state, tribal, local and territorial health departments to ensure successful adoption of best or promising practices that address key areas of public health infrastructure investments.

Primary Care Training ($5,593,000): These funds support the expansion of the primary care workforce.

Primary Care Residency Expansion Program ($5,593,000).Increases the number of residents trained in family medicine, general internal medicine, and general pediatrics.


....in the state of Illinois:

Since enactment of the Affordable Care Act on March 23, 2010, the Department of Health and Human Services has awarded approximately $17.14 million in grants to organizations in Illinois through the Prevention and Public Health Fund to help improve wellness and prevention efforts, including:

Community and Clinical Prevention ($8,142,000): This funding supports prevention activities that have been shown to be effective in reducing health care costs and promoting health and wellness.

Communities Putting Prevention to Work ($5,800,000). Supports federal, state and community initiatives to address tobacco control, obesity prevention, and better nutrition and physical activity.
Primary and Behavioral Health Integration ($918,000). Assists communities with the integration of primary care services into community-based mental and behavioral health settings.
HIV Prevention ($1,308,000). Focuses on HIV prevention in high risk populations and communities by increasing HIV testing opportunities, linking HIV-infected persons with appropriate services, and filling critical gaps in data and understanding of the HIV epidemic.
Tobacco Cessation ($116,000). Strengthens Illinois’s ability to move towards implementing a plan to reduce tobacco use. It also enhances and expands the national network of tobacco cessation quitlines to significantly increase the number of tobacco users who quit each year.

Public Health Infrastructure ($1,324,000): These grants strengthen state and local capacity to prepare health departments to meet 21st century public health challenges and support the training of existing and next generation public health professionals.

Public Health Infrastructure ($600,000). Supports state, local, and tribal public health infrastructure to improve information technology, workforce training, and policy development.
Epidemiology and Laboratory Capacity ($724,000). Builds state and local capacity to prevent, detect, and respond to infectious disease outbreaks.

Primary Care Training ($7,676,000): These funds support the expansion of the primary care workforce.

Primary Care Residency Expansion Program ($4,750,000). Increases the number of residents trained in family medicine, general internal medicine, and general pediatrics.
Advanced Nursing Education Expansion Program ($1,426,000). Increases the number of primary care nurse practitioners and nurse midwives who graduate by expanding class sizes and accelerating graduation rates for part-time students.
Nurse-Managed Health Clinics ($1,500,000). Provide primary care and wellness services to underserved and vulnerable populations through clinics that are managed by advanced practice nurses and provide valuable clinical training sites for primary care nurse practitioners.



These are but a few examples, but there is one thing that seems to stand out to me when looking at the numbers: the money that is being allocated to tobacco control appears to pale in comparison to that of what is being allocated to other health disparity issues, such as AIDS for instance. I will say that this actually makes sense. Our government's approach to the issue of AIDS has been much more commendable, realistic, and pragmatic, as its template does not set out to bully those who take part in risky behavior with NS regulations and wasteful abstinence only programs; harm reduction (ie., education on how to protect yourself) has been the approach, unlike that of the tobacco control zealots, which tells me that there are a lot of inconsistencies within Obamacare. It also means that there is going to be a hell of a lot of waste.

What seems clear though is that tobacco control may be running out of steam, which is why I fear that they are going to be coming for an un-invited place at our dinner table next. There is only so much money to go around, and eventually the whole structure of the Nanny State will most likely crumble underneath its own impending debt. That's when I'll get my freedom to smoke in a bar back. In the meantime, expect further encroachments upon your freedoms to take place at lightening speed.

2 comments:

  1. Leave America, it is going to get worse before it gets better.

    ReplyDelete
  2. ...where would you suggest that I go?

    ReplyDelete

There was an error in this gadget