One of the most important lessons we should have learned from the COVID-19 pandemic is that as a state we have allowed our public health infrastructure to dwindle so badly it slowed our ability to respond. This must not happen again.
We have an opportunity to be better prepared. New Mexico will see an unprecedented revenue bonanza this fiscal year. Oil revenue and economic recovery from the pandemic have produced a billion-dollar reserve above currently budgeted spending. Furthermore, we still have $700 million in federal American (Rescue Plan Act) funds available.
Legislators are now suggesting “transformative” uses for these unprecedented revenues, projects that don’t just add to what already exists but could be genuine game-changers, projects future generations might look back on for the positive shifts they produced in our trajectory.
One such idea is for a School of Public Health, operated jointly by the University of New Mexico and New Mexico State University. It has drawn enthusiastic support from UNM’s new vice president of Health Sciences, Dr. Douglas Ziedonis, and from the leadership of both UNM and NMSU. Ziedonis was involved in creating a School of Public Health at UC San Diego and has seen firsthand just how powerful a tool such an institution can be in focusing on preventing and eliminating health threats – not just on medically treating illness once it occurs.
In the current state budget we spend $9 billion on treating disease, mostly through Medicaid. In contrast, expenditures on public health – before COVID-19 brought in huge amounts of federal money – was less than $100 million. Yet medical experts point out 90% of the gains in life expectancy we enjoy today come from public health initiatives like vaccination programs, clean air and water efforts, highway safety laws, prenatal and infant care improvements, environmental clean-up and similar attacks on social determinants of health.
We spend vastly larger sums on medical care. Improvements in surgical and pharmaceutical technology are impressive, but the gain in life expectancy from treating people once they get ill amounts to only about 10%. This is not an argument for reducing spending on medical care, but it suggests stepped-up spending on public health could see a far larger direct benefit to the populace.
Health policy formulation currently flies blind for lack of independent analysis of medical care outcomes. We simply don’t have the personnel or the resources needed to analyze the data being produced on expenditures, procedures, effectiveness and unmet need. The new school could take the lead in this – and do it largely financed with federal and foundation research grants.
Many states have created “government resource centers” at a major state research university. Finding a way to use academic research findings in developing legislation and programming in state government would create the possibility of rational, data-driven policies, perhaps for the first time in the health field.
Our new School of Public Health, by involving cross-disciplinary expertise from engineering, business, regional planning, communications and practically every other department on the campuses, would become our New Mexico Government Resource Center. An expenditure for it from this year’s surplus funds would be a win-win for the state for decades to come.