Blueprint for a Healthier America

Modernizing the Federal Public Health System to Focus on Prevention and Preparedness

October 2008

Even though the United States spends more than $2 trillion annually on health care, tens of millions of Americans suffer from preventable diseases and major vulnerabilities exist in the nation's preparedness to respond to health emergencies.

Some highlighted recommendations in the Blueprint include:

• Setting new, realistic short and long-term health goals for the country;
• Investing in disease prevention as a cornerstone of health care reform;
• Ensuring a stable and reliable funding stream for core public health functions and preventive services, such as immunizations and screening, public health emergency preparedness, and promoting physical activity, good nutrition, and smoking prevention.
• Creating an independent, science-driven National Public Health Board;
• Implementing a National Health and Prevention Strategy focused on lowering disease rates, including a strategy to combat obesity;
• Increasing accountability by tying tax-payer investments to improving the health of Americans and improving federal, state, and local coordination;
• Addressing the public health workforce crisis with stepped-up recruitment efforts;
• Clearly defining public health emergency preparedness and response roles and responsibilities;
• Establishing an emergency health benefit for use by uninsured and underinsured Americans during major disasters and disease outbreaks; and
• Fixing the food safety system.

The Blueprint contains an analysis showing a shortfall of $20 billion annually -- across state, local, and federal government -- in funding for critical public health programs in the U.S., based on research conducted by The New York Academy of Medicine and a panel of leading experts. Approximately $1 billion of this shortfall is due to cuts to the U.S. Centers for Disease Control and Prevention (CDC) budget from fiscal year 2005 levels.

The Blueprint calls for establishing a stable, reliable funding stream for public health and provides options for funding mechanisms to make up the $20 billion shortfall by increasing federal spending by $12 billion and state and local spending by $8 billion annually over the next four to five years. TFAH issued a report that found that an investment of $10 per person per year in proven community-based programs to increase physical activity, improve nutrition, and prevent smoking and other tobacco use could save the country more than $16 billion annually within five years.