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Saving healthcare costs through prevention may prove elusive | Timi Gustafson, R.D.
About 75 percent of healthcare costs in the United States come from treating chronic diseases such as heart disease and diabetes. More than half of Americans suffer from one or more of these health problems largely caused by poor eating and lifestyle choices. Overall life expectancy in America is in decline. It is estimated that for the first time in our nation’s history future generations will be less healthy and die younger than their parents.
These are the findings of a recently published report by Trust for America’s Health (http://healthyamericans.org) (TFAH), a health advocacy group, titled “A Healthier America 2013: Strategies to Move from Sick Care to Health Care in Four Years.” In their report, the authors recommend to prioritize prevention measures to improve the health of millions of Americans.
“America’s health faces two possible futures,” says Dr. Gail Christopher, president of TFAH’s board and vice president for health at the W.K. Kellogg Foundation . “We can continue on the current path, resigning millions of Americans to health problems that could have been avoided, or we invest in giving all Americans the opportunity to be healthier while saving billions in healthcare costs. We owe our children to take the smarter way,” she added.
Taking the smarter way would require implementing additional public health programs and restructuring existing ones with focus on disease prevention as well as ensuring that insurance providers cover costs for such programs both inside and outside the doctor’s office. Employer-based wellness programs in the private sector were also included in the recommendations.
“Prevention delivers real value as a cost-effective way to keep Americans healthy and improve their quality of life,” says Dr. Jeffrey Levi, TFAH’s executive director. He believes that efforts to improve public health must start at the local level. When neighborhoods become healthier, everyone wins. “People live longer, healthier, happier lives,” he says, and “healthcare costs go down.”
The latter may be wishful thinking, however, some health economists say. In fact, there is little evidence that preventive medicine would cost us less than our existing system.
“It’s not plausible to think that you can cut healthcare spending through preventive care. This is widely misunderstood,” says Dr. Austin Frakt, an economist at the Health Care Financing & Economics Department (http://www.hcfe.research.va.gov/austin_frakt.asp) (HCFE) at VA Boston Healthcare System, in an interview with Reuters. One of the reasons for this is that medical procedures for the prevention of illnesses are more or less the same as those applied for treatment, such as physical checkups or cancer tests. There may be benefits for individual patients in terms of early detection but not when it comes to saving costs. That may strike us as a paradox, but it’s the reality of healthcare as we know it.
“Prevention itself costs money, and some preventive measures can be very expensive, especially if you give them to a lot of people who won’t benefit,” says Dr. Peter Neumann, professor of medicine at Tufts University.
In other words, when people get tested for diseases they don’t have, just to rule out the possibility of them getting sick later, a lot of money is spent for nothing.
A better solution would be to look for preventive steps outside the hospital or doctor’s office. This goes back to some of the recommendations issued by the TFAH report. Investments in wellness programs, health education and counseling could yield better results. Much could be achieved by grassroots movements and community-based initiatives if done the right way. That would still require financing, but the dollars spent could go a whole lot further.
Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com. For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com). You can follow Timi on Twitter (http://twitter.com/TimiGustafsonRD) and on Facebook (http://www.facebook.com/TimiGustafsonRD).