An article in today’s Washington Post questions whether increasing our investment in prevention will bring down health care spending.  The article focuses on cost when a better yardstick for health care spending is value.

The goal of America’s health system should be to keep people healthy, not just to provide treatment after they become sick.  Unfortunately, our current treatment-focused system does not hold the line on costs, nor does it provide the value that Americans seek.  Despite outspending every nation by a wide margin, the U.S. ranks 37^th in the world in health status, below all other OECD countries and even some developing countries.

 Let’s set the record straight about prevention.  Here are some talking points for you to consider and use, if you wish.

• Prevention improves health at good value.  A recent study by Partnership for Prevention found that increasing the use of just five clinical services to 90 percent of the target population would prevent 113,000 premature deaths each year. (For more information, click here). 
• Our current, back-loaded system has perverse incentives that cause 95 cents of every health care dollar to be spent to treat disease after it occurs. We keep spending but we can’t get ahead of the problem, so our health care costs keep rising, to $2.1 trillion and 16.5% of gross domestic product, threatening the competitiveness of U.S. industry and the sustainability of the health system. 
• Some clinical preventive services do save money (such as counseling about aspirin use to prevent heart disease, smoking cessation assistance, childhood immunizations, and vision screening for seniors). 
• Many other clinical preventive services do not save money but are very cost-effective, i.e., they provide a substantial health benefit for the dollars invested. We need to support health services researchers who are evaluating the cost-effectiveness of these services.
• Preventive services should not be held to a different standard than treatment services. When we ask insurers to cover medical services, do we ask them only to cover those services that save money? Of course not.
• Some of the highest value preventive strategies are put into action outside of clinical settings, in our communities.  Many population-wide services and policies to improve health are in fact cost-saving. Some, such as higher tobacco taxes, even generate revenue.
• Prevention works. That’s why employers, who tend to be more careful about spending money than the government, are shifting their employee health care investments upstream. They know that productivity losses account for about three quarters of the costs associated with poor employee health, while only about a quarter of the costs are for health care claims. They’ve learned that keeping employees healthy keeps the bottom line healthy.

Let’s not discount prevention because it doesn’t solve all of the problems of our troubled health system. Rather, let’s embrace prevention for improving health and well-being and for increasing the value of our investments in health.

John M. Clymer, President
Partnership for Prevention^®