A new report from the General Accountability Office suggests federal and state officials are mishandling a prominent prevention program under President Obama’s health care law, with taxpayers forced to pay for billions of dollars in health promotion programs which may do little or nothing to improve the health of citizens or lower health care costs.
Federal officials established the Prevention and Public Health Fund under President Obama’s health care law to distribute taxpayer money to each of the fifty states—funds earmarked for the broadly defined purpose of educating citizens on good nutritional habits. According to Republican Sen. Tom Coburn of Oklahoma, officials in the Department of Health and Human Services (HHS) provided very little transparency or accountability to taxpayers on the actual expenditures of the fund, which the GAO examined at Coburn’s request for a September report.
According to Coburn’s staff, the fund, which has cost taxpayers $1 billion thus far, has turned into a slush fund used for political purposes.
“The fund has instead become a slush fund for bureaucrats to fund their own priorities,” said Coburn spokeswoman Becky Bernhardt.
Tennessee Exemplifies Failings
HHS officials have allocated $15.1 million in Fund money to Tennessee’s Department of Health since the passage of Obama’s law in 2010. But the effectiveness of this spending is dubious, says Bernhardt. She notes 72 percent of the funding went to shore up existing state programs.
According to state health officials, the funds have been used to pay Tennessee smokers to use silly putty and breath mints to help them quit their smoking habits. The funds also allow state welfare recipients to receive double value on their Electronic Benefit Transfer (EBT) cards when they purchase fresh fruits and vegetables at farmers’ markets.
Murfreesboro Parks and Recreation officials use the money to subsidize a healthier menu at their facilities—though the facilities’ patrons said they had no interest in purchasing those types of foods.
Additionally, the Williamson County School System, located in one of Tennessee’s most affluent areas, received $20,000 through the program to fund a computer-based fitness program to test students’ aerobic capacity and upper-body strength. According to Ken Brooks, the Williamson County School Systems’ health and wellness specialist, the obesity rate among students in the school system was less than 24 percent.
Nationwide Slush Fund
Tennessee’s experience is hardly unique. California and New York are receiving far more funding ($90.6 million and $62 million, respectively) and are expected to spend it on similar programs. According to Bernhardt, the fund appropriates $500 million in 2010, $750 million in 2011, $1 billion in 2012, $1.25 billion in 2013, $1.5 billion in 2015, and $2 billion in 2016 and each year thereafter.
Bernhardt says this funding will be used for numerous programs with questionable outcomes or benefits, including nearly $20 million in media initiatives against childhood obesity and promoting healthy eating.
“The GAO report was initially requested due to a lack of information provided by the [Obama] administration on how the program was being administered,” Bernhardt said. “In the first year, it was used to supplement already established programs and did not focus funding on activities to increase access to care or reduce health care costs.”
The GAO report also faults HHS officials for not posting online information about how they allocate fund money.
“HHS officials told GAO they have no plans to be more transparent by posting a fuller accounting of spending in prior years,” Bernhardt said.
She remains skeptical of the power of government programs to alter people’s dietary habits to any significant degree.
“Doctors—not politicians or bureaucrats—are best equipped to influence behavior,” Bernhardt said.
Christopher Butler ([email protected]) is editor of Tennessee Watchdog and director of government accountability for the Beacon Center of Tennessee.
Government Accountability Office Report to Congressional Requesters: September 2012: “Prevention and Public Health Fund: Activities Funded in Fiscal Years 2010 and 2011.”