Reducing chronic diseases in the United States through more prevention programs could offer long term financial benefits and cut down on future health care spending.
Health expenses grew to $2.7 trillion in 2011, averaging $8,680 per person, according to the Center for Medicaid and Medicare Services. Over the next ten years health spending is projected to grow by more than $2 trillion.
“Preventing disease is key to improving America’s health and keeping rising health costs under control,” stated the Center of Disease Control and Prevention, CDC, on its Gateway to Health Communication website.
Chronic diseases make up 75 percent of health spending in the United States. Heart conditions, cancer, diabetes and hypertension, were all among the top-ten contributors to national health care cost.
These chronic health conditions are often related to certain health decisions including, diet, smoking and sedentary lifestyles choices.
Chronic health outcomes often present risk indicators that can be identified before the onset of a disease or in early stages when treatment is more manageable and cheaper. However, most chronic illnesses are not addressed until patients need advanced medical treatment.
Preventative Health Practices
“A 1 percent reduction in weight, blood pressure, glucose, and cholesterol risk factors would save $83 to $103 annually in medical costs per person,” reported the U.S. Department of Health and Human Services, in its National Prevention Strategy.
The Patient Protection and Affordable Care Act supports prevention practices through a Prevention and Public Health Fund, which provides financial incentives to improve and grow evidence-based prevention and public health programs. The ACA will also increase coverage of some preventative treatments under new insurance requirements.
Though the ACA provides financial incentives and new legislation to increase coverage of some preventative medical programs, doctors still will not receive reimbursement from insurance companies for a majority preventative care treatments. Doctors cannot file for insurance reimbursements for certain practice, like consulting a patient on improving his or her weight or exercise.
Only under very specific terms can doctors get reimbursements for preventative practices, because many insurance codes are written for easy to measure medical treatments.
Despite the cost saving that many health organizations relate to prevention programs, the United States’ current healthcare system is not set up to take on the extra upfront cost and increased volume of patients that many preventative medical programs would create.
“We think of health care as an expense, but we really should be thinking of health care as an investment. We want to invest where we have the greatest return. I would put prevention in that bucket. But the way we do it now, no one has an incentive to invest in things with a long-term return,” said Dana Goldman, director of the Schaeffer Center for Health Policy and Economics at the University of Southern California, in an interview with The New York Times.
The current healthcare system is based on insurance returns and incentives to reduce costs and increase profits. This system does not encourage large amounts of spending with delayed returns on the investments.
Only 1 percent of the $1.9 trillion spent on health care in the United States in 2009 was used for health protection, illness prevention and injury prevention programs, reported the National Business Group on Health.
Prevention programs rely largely on health education and awareness of the public to be effective. “A better gauge of the value of preventive medicine is bang for the buck; that is, not whether it reduces healthcare spending but whether it buys more health than treating the disease does,” reported Sharon Begley a senior health and science reporter for Rueters.
Instead of looking for doctors or health professionals to implement preventative health programs, community leaders and organizations are being used to provide support and training for community health leaders.
“Evidence-based preventive services are effective in reducing death and disability, and are cost-effective or even cost-saving,” the National Prevention Strategy stated, “While preventive services are traditionally delivered in clinical settings, some can be delivered within communities, work sites, schools, residential treatment centers, or homes.”
Preventative programs can be good financial investments if the programs are properly carried out by accessible outlets that will create effective relationships with the patients being served.