Analyzing a Budget

Recall your experiences in budgeting for expenses, keeping track of your finances, and finding funding sources (income) for your personal life. Perhaps you recently purchased a car or are planning for an expensive vacation. What kinds of information did you have to gather in order to make a suitably informed decision? What trade-offs did you accept between the most desirable vs. the most affordable option? Though these activities are of course on a small scale compared to the financial and funding activities in the healthcare system, many of the same basic principles apply, and public health professionals must participate in similar decision-making processes regarding the budgeting and funding of public health programs.

Course Text: Public Health Administration by Lloyd Novick, Cynthia Morrow, and Glen Mays
Chapter 7, “Financing the Public’s Health”

Noting the complexity of the financing structure of public health services, this chapter describes variations in financing at federal, state, and local levels. It explains why public health professionals must integrate the financial process with program planning as well as gather and monitor data on cost efficiency. The chapter also highlights challenges that public health is currently facing, including finding stable funding for the public health infrastructure and developing skills among the public health workforce in financial management.

Article: Levi, J., Juliano, C., & Richardson, M. (2007). Financing public health: Diminished funding for core needs and state-by-state variation in support. Journal of Public Health Management and Practice, 13(2), 97 – ? 102.
Public financing of public health at federal and state levels has varied considerably and been unstable, with core functions being threatened. This article proposes changes in the financing arrangements for public health in order to assure a more stable funding stream for core public health functions and a more consistent approach to financing public health activities across the country.

Article: Sensining, A. (2007). Refining estimates of public health spending as measured in national health expenditure accounts: The United States experience. Journal of Public Health Management and Practice, 13(2), 103 – 114.

As this article observes, state and local public health agencies—the first link in the provision of public health services—are under increased financial pressures. While it is important to measure expenditures for public health services in the U.S., this can be difficult because there is no clear-cut, universally accepted definition of government public health care services.

Make sure to review the sample budget, provided in the introduction area of this week’s Discussion, which is for a hypothetical maternal health program.

Essay questions:
What are the strengths and weaknesses of this budget?
Is there anything that surprises you about in this particular budget? Would you add or delete any items in that budget? Or does it seem in line with your expectations of what a good budget for this kind of program would be? Support your responses with references from above!


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