The Cost of Dismantling Public Health
Cuts to public health raise costs for everyone. Learn why prevention, vaccines, and family planning save money and protect New Hampshire communities.
By Tory Jennison, PhD, RN, Executive Director, NH Public Health Association
Across New Hampshire and across the country, public health is under siege. Pandemic fatigue, political attacks on vaccines and the CDC, cuts to family planning, and underinvestment in local health programs have eroded the very systems designed to protect our communities.
While many decision-makers have erroneously justified their actions as prudent cost-cutting or reducing waste, eliminating essential programs is not cost-neutral. It is a failure to recognize the real solutions we need, and over the long term will increase the cost of living for all of us.
Here are some real solutions for reducing health costs while also improving our public health:
Vaccination and Outbreak Prevention
Vaccines are one of the most effective tools we have in public health, and when immunization programs are weakened, the price tag is staggering. Just one preventable measles outbreak can cost public agencies hundreds of thousands of dollars in emergency response, treatment, and community impact.
Cuts to vaccine outreach and education will yield unclear guidance and ultimately vaccine hesitancy, resulting in significant costs within the healthcare system, which ultimately trickle down to all of us. These misplaced cuts also result in reduced trust in public health institutions.
As we head into flu season, getting the flu vaccine can help reduce the risk of severe health outcomes and lower the cost of medical care and hospitalization – for you, and for your whole community. Here in New Hampshire, a single pediatric hospitalization for influenza averages nearly $12,000, according to state health cost data. If that child ends up in the ICU, the bill can exceed $50,000. Every uptick in preventable disease means hospitals, insurers, and families will bear costs that could have been avoided with a fraction of the investment in vaccines and public outreach.
Family Planning Services
Investing in family planning offers significant cost savings by reducing healthcare expenses associated with unintended and high-risk pregnancies. For every dollar spent on family planning, more than $7 is saved in averted health outcomes and costs. When family planning programs are gutted like they have been here in New Hampshire, we can expect outcomes to worsen and costs to rise.
A single high-risk pregnancy or complicated birth can result in hundreds of thousands of dollars in medical expenses when pre-term health conditions and neo-natal care are involved. STD testing and treatment are similarly vital for public health because they prevent serious health complications like infertility and certain cancers and protect the community by reducing disease transmission. Again, these costs are borne by all of us, in higher insurance premiums and more money spent on Medicaid.
By contrast, access to preventive services dramatically reduces downstream expenditures for pregnancy and maternity care and Medicaid, lowers ER usage, and helps stabilize family finances. Until and unless we prioritize investments in these primary care services, which are proven for reducing healthcare costs, we will all be paying more for care.
Workforce and Infrastructure
Public health depends on people and systems. If we don’t invest in rebuilding our workforce and modernizing infrastructure, we’ll be left without the foundation to respond to the next crisis — whether it’s a flood, or a severe flu season, or another pandemic. Underfunding now leads to higher emergency appropriations later, as governments scramble to rebuild capacity after it’s already too late paying escalated costs.
History offers sobering lessons about what happens when politics eclipses science: delayed responses to HIV/AIDS, decades of denial on tobacco’s harms, and billions in costs that could have been prevented. Not only do people get sicker and even die, but we all pay the price.
Why it Matters for all of us in New Hampshire
The real question should not be whether we can afford to invest in public health, but rather which solutions have the best bang for the buck. Every cut today multiplies tomorrow’s costs: in ER visits, uncompensated care, insurance premiums, and lost workforce productivity. Prevention isn’t just better policy; it’s a better business model for New Hampshire – and it’s time to start asking who will pay the real costs for these cuts (Hint: it’s every Granite Stater).
At its core, public health is about trust, transparency, sound investment and science. New Hampshire families deserve leaders who put forward real public health solutions to strengthen, not sabotage, the systems that keep us safe. For every dollar we fail to invest today, we will pay many more tomorrow — in higher costs, lost productivity, and unnecessary suffering.
About the Author
Tory Jennison, PhD, RN is the Executive Director of the New Hampshire Public Health Association (NHPHA). She is a nurse, educator, and advocate with decades of experience in public health leadership, dedicated to improving health equity and ensuring that New Hampshire communities have the tools and resources they need to thrive.
