Wednesday, May 2, 2012

A Primary Care Doctor Explains Why Attacking Prevention Is Not Fiscally Sound

This weekend, Speaker of the House John Boehner (R-OH) defendeda GOP bill that offsets the costs of extending lower interest rates on federal student loans by eliminating the Prevention and Public Health Fund, a provision of the Affordable Care Act that seeks to bolster public and preventive health. Other opponents of the Prevention fund have maligned it as a “slush fund.”

As a practicing physician, I see investments in prevention and public health quite differently. Engaging in preventive care in my primary care practice allows for the early detection of disease, which eases the treatment of so many illnesses. Obtaining a mammogram, considered preventive care, allows for the early detection of breast cancers. Catching a breast cancer at its earliest stage allows for a cure, whereas detecting breast cancer at a late stage often means engaging in chemotherapy and radiation in an effort to extend survival without hope for a cure.

But we are not just talking about funding prevention at the individual level. We need to shift the focus of our health care system from one that only treats disease, to a more sensible system that prevents disease and encourages wellness.

Diabetes is a disease that is exploding in our nation. Two million new cases a year are being diagnosed in America. Twenty five million already have diabetes, and another 79 million have the precursor of diabetes: an elevated blood sugar. This one disease alone may cost America$200 Billion dollars annually. However, diabetes is distinctly preventable, even more so than most other conditions. By eating a healthier diet, getting daily exercise, and avoiding sugary beverages, many can avert diabetes completely. To attack the American diabetes epidemic, we need to focus on preventive health and public health. Better walking trails, nutrition education and coordinated care – all provided for in the Affordable Care Act – will be needed to stem the tide of new diabetes diagnoses.

In the United States, we spend a paltry 3 percent of all of our health care dollars on public health. For this, we trail the industrialized world in infant mortality rates and life expectancy. We can do better as a nation. We can do better as a health care system. My prescription: invest more in public health and preventive health – it will lead to a healthier country that can be more productive and significantly reduce our exploding health care costs.

In my home state of Virginia, $6 million has been allocated to bolster public health projects including tobacco cessation programs. In Colorado, funds went to improving the nutrition in public schools. In Ohio, funds were used to ensure that 4,000 additional students could safely walk to school. This is not a slush fund. This is investing in America’s health and wellness. To see how the prevention fund is being used in your state, check here.

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