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Prevention's place in health care now
David Lazarus
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While I am sympathetic to Mr. Whitley's observations as to what is "the single largest reason our health-care costs are so high", I do not quite agree. As a nation we have let the medical technology and pharmaceutical companies convince us that disease-care is a proper commodity to be brokered on Wall Street. This in spite of the relatively dubious value of their products. Therefore, they have to beat us over the head with massive marketing and media blitzes, including hospital TV dramas, to convince us that these heroic medical interventions are worth the costs in increased premiums and many times the lives of those who are subjected to such interventions. True wellness care would be a partnership involving safe,physiologically sound, cost effective measures which employ the laws of natural science.Of course, there would not be much to patent and profit from in this regard.Preventative care on the other hand would mean you would have to take on the agri-food business community, the sugar and beverage companies, the toxic petro-chemical industry, the tobacco companies,the video/computer game industry and the anti-sun lobby.Most of all you would have to break the back of "Big Pharma" who invests billions of $$ in convincing people they are sick because of a "drug deficiency".We will never be able to afford even the cost of administering disease care via the insurance, managed care and medical information technology companies. No one should expect we will ever be able to deliver real health care to Americans.Better go back to watching TV's medical marvel- House.Just pray he won't be showing up at your bedside.
As long as we have for profit medical insurance companies prevention will be prevented. That's because if a medical plan that funds prevention will lose if and when the insured switch plans. In effect they end up subsidizing their competitors that do not do this or do it as much. That's why prevention is left to individuals.
Unless medical insurance plans are forced to offer prevention and the same prevention programs there will be no prevention. This is yet another case where market mechanisms fail to provide what is clearly for the common good.
This is analogous to the so-called Progressive era at the beginning of the 20th century regulation was needed to prevent a race to the bottom and eventual bankruptcy for most companies in competitive markets such as meat packing. Without government intervention in the form of regulation competitors would have destroyed themselves.
The latest health care reform is primarily about preventing corporate health care interestes from devouring each other both through runinous competion and from an ineluctable backlash by their victims, the American people.
Mr. Whitley,
Healthcare is not (or at least should not be) political just as the for-profit medical business has little to do with healthcare. The litigation excuse has already been debunked and fraud is a result of the for-profit medical system we now have.
It's all those technical advances you tout that have primarily caused the price of medical care in the US to skyrocket without helping the public health.
Consider the effectiveness of all these medical tests, especially cancer tests. Dr. Richard Ablin of the University of Arizona, developer of the PSA test called the prostate test a 'public health disaster' and a news report of a new ovarian cancer test showed 64% false positives. New studies show even breast cancer screening does not save lives. Estimates are that CAT scans, which have radiation dosage rates of ~400 times a chest x-ray are causing an estimated 18,000 cancer deaths yearly.
Does anybody care that the results of these tests are wrong most of the time and cause massive personal suffering for the profit of the medical business?
The "for profit medical biz", including health insurance companies, drug companies, medical device suppliers, and for-profit hospitals is to blame. They should consider whether they are going to be the next financial bubble, facing a meltdown as their business eats up almost 20% of the US economy yet we have one of the least healthy populations who are rapidly losing the ability to pay the ever-escalating costs.
It's beginning to look like the housing bubble to me. And when the system fails, the government bailout will give us what we needed all along - a single-payer healthcare system.
PS: The "for-profit junk food biz" is another culprit!
Partnership for Prevention has been working to make prevention the central building block of health reform for years.
CEO members of Partnership for Prevention's Leading by Example CEO-to-CEO Roundtable were creating "health reform" inside their own companies long before the legislation passed. We joined with the U.S. Chamber of Commerce to describe and disseminate outstanding corporate practices in the area of employee health management. Our publication on this subject is called Leading by Example. It documents shining examples of employers that are investing to keep their employees healthy. The macro goal of Leading by Example is for CEOs to influence the American healthcare system to emphasize prevention rather than just paying for treatment.
Last Friday I presented to business leaders in San Diego helping them understand the business case for workplace wellness, describing CEO best practices for community health improvement. These business leaders, who are part of Community Health Improvement Partners, are creating a workplace wellness coalition for San Diego County.
To learn more about Leading by Example companies, visit www.prevent.org/LBE
I was under the impression that if there was a lack of complying with the preventative approach that penalties would be levied. Of course, you could say that there is a stronger approach to preventative care or you could say that if people continue to live their carefree lives then health care costs will continue to skyrocket. This story is just an example of selling only one side of the argument. I expect more from NPR.
I really love the program but take with a grain of salt some on-air pieces given your affiliation to NPR and its definitive left-leaning slant. With all due respect to Mr. Lazarus, whom I am completely unfamiliar with, asserting that our per-capita health-care costs are higher than the rest of the world's due to a lack of preventive care is at best ludicrous and at worst dangerous. The U.S.'s health-care costs are higher primarily due to the following: 1.)technological advances in equipment and pharmaceuticals AND their availability to the masses 2.)excessive costs related to litigation and litigation-prevention (interesting that you did not compare our costs of these two items to other countries' (see left leaning above) 3.)excessive waste and fraud in the entire health-care system. Finally, look around you at all the fat, unhealthy, smoking, drug-taking and/or drinking slobs and therein you will see the single largest reason our heath-care costs are so high. So forgive me for almost laughing at your assertion regarding preventive care and also for not being a willing participant in funding the care of the above-mentioned laggards who do not deserve it! We should be helping the helpless, not the clueless!
