Kaitlin Lange, writing for State Affairs Indiana, has part one of a series on health care in Indiana. This part focuses particularly on Indiana’s public health funding. Like much of the rest of its public infrastructure, Indiana spends comparatively little on public health. County health departments rely heavily on local funding which varies wildly from county to county. This comes down to priorities and available resources.
You saw some of the most dramatic consequences of this in Scott County several years back. The county’s health department couldn’t offer HIV testing. For several years prior to an HIV epidemic, a Planned Parenthood provided that service. But when the Planned Parenthood shut down, there was no testing, and when the epidemic took hold, it was well underway before the County could react. They were eventually able to stem the tide, in part, with a syringe exchange program. (Subsequent study suggests that, had testing been available, the County probably could have reduced the number of infections from 215 to 10 or fewer.)
Treating 200 HIV patients is a lot more expensive than spending the money necessary to make early testing available. But that’s like so much of what good government does: spending money in ways that prevent problems, making the benefits of that spending largely invisible to the citizens. Citizens see the taxes but don’t see the HIV cases that don’t materialize. Or, my go-to is drainage. Spend a bunch of tax dollars on drainage tile and storm sewers; nobody realizes how much they benefit from the floods that don’t happen.
In any case, the Lange article is fairly long and covers a lot more ground than I’ve described. Definitely worth a read.