Chronic Disease Prevention and Management: The Key to Lower Health Care Costs and Higher Quality of Life

By Richardson, William "Bill" B. | American Journal of Health Education, January-February 2008 | Go to article overview

Chronic Disease Prevention and Management: The Key to Lower Health Care Costs and Higher Quality of Life


Richardson, William "Bill" B., American Journal of Health Education


It is an old saying that an ounce of prevention is worth a pound of cure. Unfortunately, the American health infrastructure has not maintained an adequate focus on prevention--and now we are paying the price. The United States spends more on health care than any other industrialized country, but falls behind when it comes to health status. Why? It is because too often we attempt to address people's health concerns only after they become sick. It is time to transform the way that America thinks about health care: it is time to focus on prevention. While our nation needs a robust prevention infrastructure to defend us against a broad range of health problems, from infectious diseases to injuries, nowhere is the need for prevention more apparent than in the realm of chronic diseases.

Some three-quarters of the $2.2 trillion our nation spends annually on health care goes toward care for chronic diseases like diabetes, heart disease, and cancer, many cases of which are preventable. The high and rising cost of health care increasingly is squeezing individuals and families, placing far too many at risk of financial ruin if they become ill. The cost of treating chronic diseases also strains the public purse: the share of Medicare funds spent on obese beneficiaries tripled between 1987 and 2002, and over 76 percent of all Medicare funds are spent on individuals with five or more chronic conditions. Diabetes care alone costs the federal government $80 billion per year--one out of every eight federal health care dollars.

Despite this, the government spends less than $4 billion on diabetes prevention each year. Indeed, less than five percent of our federal health care dollars go toward prevention. This is unwise and unacceptable.

My plan for universal health care will reorder these misplaced priorities. It will forge an American health care system that is smart and focused, one that saves money and leads to a healthier America.

I believe that the key to help every American utilize preventive services is to get every American covered. Research shows that people without insurance coverage are much less likely to obtain the preventive services they need. For example, less than half of uninsured women between the ages of 50 and 63 received a mammogram in the last two years, compared to 75 percent of those with coverage. (1)

My plan would ensure affordable, high quality coverage for every American by building on existing programs, offering choices of affordable coverage without creating new bureaucracies. Every American would have the choice to keep his or her current coverage or obtain the same coverage as members of Congress and the President have. A refundable, sliding-scale tax credit would help families who cannot afford coverage otherwise. My plan also would allow older Americans between the ages of 55 and 64 to join Medicare. Through this commonsense approach, Americans 55 and older would have better access to the appropriate preventive care that will allow them to live healthier, longer lives. For example, mammograms and colon cancer screenings are proven, cost-effective preventive measures that save lives. Without good health coverage, however, Americans between the ages of 55 and 64 often miss out on the life-saving preventive measures recommended for their age group and are more likely to die at younger ages than those with insurance. (2) Recent research suggests that allowing older adults to join Medicare not only could improve their health, but also could reduce Medicare costs by increasing access to preventive care. (3)

Health care coverage also must be focused on prevention. My plan ensures that every American gets the preventive services he or she needs by requiring all health plans to cover a standard set of proven preventive services, including well-child visits, cancer screenings, and chronic disease management programs. An independent board of physicians, medical researchers, and patients will update the standard set of preventive services each year, using models already in place to evaluate and prioritize preventive care.

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