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Preventive care a major component of health reform

Updated: 2009-06-17 20:47:52 CST Category: General Health

by Laurent Castellucci

In the ongoing debate over heathcare reform in the U.S., many options for structuring insurance coverage, payment plans and control over medical decision making are being considered. One element is virtually a constant in all the proposals - however, a call for a greater focus on preventive medicine to avoid disease or catch and treat it at an earlier time.

"That starts with each of us taking more responsibility for our health and the health of our children," said President Obama in a meeting with the American Medical Association. "It means quitting smoking, going in for that mammogram or colon cancer screening. It means going for a run or hitting the gym, and raising our children to step away from the video games and spend more time playing outside."

Virtually every rival plan under debate includes some greater spending on preventive care and greater testing. Study after study has shown that people who have access to diagnostic tests tend to do better because diseases can be caught earlier when they are more treatable.
These prevention efforts are mostly being sold as cost-savings.

"Five of the costliest illnesses and conditions - cancer, cardiovascular disease, diabetes, lung disease, and strokes - can be prevented," Obama told the AMA, "And yet only a fraction of every healthcare dollar goes to prevention or public health."

A research team from the Harvard Business School recently developed an algorithm for calculating the savings from a given preventive care program. In their test case, they applied it to the Family Van program, which provides screening, testing and education in areas such as nutrition, weight management, diabetes, heart disease, pregnancy and sexually transmitted diseases to poor areas throughout Boston.
For that program they found that every dollar spent on the program returned $36 in benefits.

Besides cost savings however, early testing increases the likelihood of survival for many diseases, since treatment can begin when the disease is less severe.

A study in 2005 found that increased screening for HIV would increase life expectancy of the entire U.S. population by 5.48 days.

Due to its proven benefits, the American Cancer Society recommends various screening tests for numerous forms of cancer. Breast and colon cancer are both extremely responsive to early treatment and far more difficult to treat if detected after the disease has progressed. It estimates that almost 50 percent of all cancers can be avoided, many of those by early intervention and lifestyle changes by people who find themselves at risk.

The CDC reported in January that they got 1.1 million reports of sexually transmitted chlamydia in 2007, mostly in women 15-25 years old. The number is a new record. Chlamydia often shows no symptoms, but is easily treated once detected. However, the CDC reported that more than 50 percent of young, sexually active U.S. women still do not get screened.

If left untreated, chlamydia infection can lead to pelvic inflammatory disease, chronic pelvic pain, ectopic pregnancy and infertility.
Syphilis rose for the seventh consecutive year. It is also easily detected and easily treated, but can appear with no early symptoms. If left untreated it can seriously damage both the brain and the cardiovascular system.

The CDC reports that in 2005, a total of 652,091 people died of heart disease, just over half of these were women. Heart disease accounted for 27.1 percent of all U.S. deaths. Screening for cholesterol levels allows those at greater risk due to borderline levels of blood cholesterol to get treatment through lifestyle change or statins which can dramatically reduce the risk of the disease.

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