Public Health Division Takes a Serious Look at Budget Reductions

It’s too early to say how much revenue has been generated following the increased fees for medical marijuana cards, Dr. Mel Kohn told the Public Health Advisory Board

December 7, 2011 – With budget reductions looming as the February legislative session draws closer, Dr. Mel Kohn, director of the state’s Public Health Division, is being forced to take a hard look at making cuts.

 “There aren't a lot of places to go,” Kohn told the Public Health Advisory Board last Friday. “We're in a very difficult place, and it's going to be a very difficult session in February.”

 In October, fees for medical marijuana cards were doubled, to $200, to generate $7 million for programs such as emergency medical care and school health centers. Kohn said his department is just starting to see the data.

 “Are we going to have a huge surplus? I don't think so, but I don't know. Of course, the legislature will be very interested in that,” said Kohn, who admitted there are some ethical issues relying on medical marijuana as a source of revenue. 

In other news, the Board began discussing legislative priorities for the 2013 session, among them health impact assessments for projects that meet specific budget thresholds, incentives for wellness programs within coordinated care organizations, and a mechanism to allow re-investment of healthcare savings into public health. Another measure would require death certificates to list whether alcohol, tobacco or illegal drugs contributed to a person’s death. 

It’s unlikely the legislature will follow Washington’s lead and offer retail sales of hard alcohol, said Bill Perry, vice president of governmental affairs for the Oregon Restaurant and Lodging Association. Such an initiative would have to come from the voters, he said.

Finally, the board acknowledged the contributions of Thomas Aschenbrener to the public health community. Aschenbrener will step down as president of Northwest Health Foundation in June, and Friday was his last board meeting.

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This article has been corrected from an earlier version of the story, which quoted Dr. Mel Kohn as saying, "Are we going to have a huge surplus? I don't know. Of course, the legislature will be very interested in that," and which said the board was discussing legislative priorities for the February special session, not the 2013 session.

The reality is the vast majority of health care costs are public health issues. We have been able to address tobacco as a public health menace, but not processed, sugary, salty, fatty (hyperpalatable) foods. Try to get a 10 cent surcharge on sugary drinks and the lobbyists scream regressive tax! This is true for other "sin taxes" (both alcohol and tobacco). I would be so bold to say we need to add sin taxes on couch potato activities too, like all the video games and smart phone apps that spellbind kids to further their unnatural addictions. Dr. Kohn, we need your work more than ever! Kris Alman M.D.

Why do we have people pay a fee to have legal access to medicine? Just to pay for other programs, or as a way of limiting the medicine's use? Bad public policy.