Op-Ed: Prevention is the Key

We are all familiar with the saying, “an ounce of prevention is worth a pound of cure.” When it comes to health care in America, it shouldn’t be just a saying, but a rule to live by. Type 2 diabetes rang up $174 billion in costs in 2007. Obesity has direct and indirect costs of $123 billion each year. Heart disease and stroke take the lives of nearly 2,400 Americans each day, with a projected cost of $448 billion in 2008. The unfortunate reality of these statistics is that much of the $2.3 trillion that America spent on health care in 2007, not to mention the potential loss of life, could have been averted through preventive health care.

To borrow a quote from my colleague Senator Ron Wyden, we do not have a health care system in the United States; we have a sick care system. Chronic disease affects some 133 million Americans and accounts for 70% of all deaths and more than 70% of all health care costs. In 1996, America spent $1 trillion on health care; in 2006 we spent $2.1 trillion. If we continue to ignore the importance of prevention-focused health care, we will be faced with sicker patients, a more costly health-care system, and insurance premiums that price individuals, families, and employers out of the health insurance market. That is something this nation cannot afford.

In looking to preventive health care, the Southcentral Foundation in Alaska deserves recognition for centering its health care model on prevention and coordinated primary care. The Southcentral Foundation is an Alaska Native-owned health care organization serving Alaska Native and American Indians. Their Patient Centered Primary Care model gives patients the ability to directly contact their provider via phone or email and to make same-day appointments. The doctor and clinical team provide the expertise, keep track of preventive matters, and provide health care options, but it is the patient-owner who is in control and makes the decisions. This program has achieved considerably high success rates: a 40% drop in urgent care and emergency department utilization, and a 30% drop in days in the hospital. They have increased childhood immunizations by 25% and diabetes care is in the 95th percentile for national standards, not to mention a reduction in asthma care and HIV care admissions to one-third the numbers experienced in the past. This all amounts to a 91% patient satisfaction rate.

With the significant rise in health care costs, employers are utilizing wellness and preventive care and are achieving success. For example, Merrill Lynch provides on-site clinics in its home office location that offer services such as preventive screenings, fitness facilities, flu shots and primary medical care. In its smaller branch offices, employees can partake in free smoking cessations programs and discount memberships at local fitness centers. Employers, such as FedEx and Caterpillar, Inc. are using incentives to keep health care costs at a minimum and the results show that it’s working. Caterpillar Inc. provides “Lunch for Less” in their cafeteria by offering employees nutritious, lower-cost foods such as a chicken sandwich for $1.99 or a four-vegetable selection for less than a dollar. Incentives have helped reduce diabetes costs for FedEx, where they actually pay diabetic employees $50 to participate in diabetes disease management programs and take two exams. Thanks to the financial incentive of the employees in the program, emergency room visits related to diabetes dropped 13 percent, inpatient admissions dropped 7 percent and the cost of a diabetic episode dropped 75 percent.

Preventative health care is working in the private sector. We can make it work for federally funded programs as well. The Centers for Disease Control and Prevention should be applauded for its WISEWOMAN prevention program, as well as its early detection screening program which provides chronic disease risk factor screening, lifestyle intervention and referral services to prevent cardiovascular disease. The program has been incredibly successful throughout the U.S.; 3 out of 4 women screened by this program were diagnosed with at least one risk factor for heart disease and stroke. When we look to the rising expenses associated with programs like Medicare and Medicaid, it is in everyone’s interests to look to preventative health care measures to bring costs down.

Many House and Senate Members, including the entire Alaska delegation, have signed the “Divided We Fail” Campaign sponsored by AARP, Business Roundtable, Service Employees International Union, and the National Federation of Independent Business, to pledge their commitment to providing access to health care for more Americans. If we want to truly make health insurance affordable and reduce the number of people falling victim to chronic disease, we must combat these costs through better prevention and by rewarding physicians who provide quality care and achieve positive outcomes. By reforming our health care model to focus on prevention, individual budgets will stretch farther, more lives will be saved, and the total costs of providing health care in American can be reduced.

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