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Government Prevention Does Little to Reduce Illness

As health reform heats up, many lawmakers agree that the government
should take a larger role in preventing disease. However, the Wall Street Journal
reports that "many previous government prevention efforts aimed at
costly chronic diseases have had little success in reducing illness or

The paper notes: "The problem is that when testing
becomes too widespread, or heavy investments are made in monitoring
people with chronic diseases, the rewards often fail to match the
costs... The results are striking because of the broad consensus in
Washington that it is cheaper to invest in keeping people healthy than
it is to treat them once they are sick." However, "the Congressional
Budget Office, in a December report, concluded that greater use of
preventive care would at best generate modest reductions in costs over
10 years, and might even result in increases."

The Wall Street
Journal also points to other research. "A report published in the New
England Journal of Medicine last year examined 279 spending ratios in
published studies of health-oriented prevention measures, and another
1,221 on treatments for people who were already sick. Some measures
clearly saved money, like screening men in their early 60s for
colorectal cancer. But the report concluded that most preventive
measures reviewed didn't save money. For instance, screening all
65-year-olds for diabetes would cost $590,000 for every healthy year of
life it adds over just screening people that age with high blood
pressure. Medicare has conducted seven pilot programs in the past
decade testing the theory on some of the most costly chronic diseases.
Each showed little if any cost savings or measurable improvement in
patients' health."

"Nonetheless, private health insurers are
placing bets that prevention can lower their costs," The Wall Street
Journal reports. Meanwhile, "some experts point out that focusing on
savings is the wrong way to think about prevention" while others point
out possible hurdles such as the difficulty of creating lifestyle
changes and that money spent on disease prevention often goes to people
who aren't sick" (Adamy, 6/12).

reports on the relationship between life expectancy and preventive
health in the U.S. CNN notes: "Despite spending more money than any
other country on health care, the United States does not lead the world
in life expectancy, a long-known fact that some experts say could raise
more questions in the health-care reform debate. The United States
ranks 50th out of 224 nations in life expectancy, with an average life
span of 78.1 years, according to 2009 estimates from the CIA World
Factbook. Some argue part of the problem stems from the privatized
nature of the U.S. health care system, whose reform is being vigorously
debated on Capitol Hill." CNN also notes that in countries where
individuals pay for their own care, people often don't get treatment
until their symptoms have become serious and that there is less
emphasis on preventative care in those countries (Landau, 6/11).

Meanwhile, the New America Foundation
reports that hospitals are cutting back on infection prevention
efforts, which have been seen as a major goal of the health care
quality movement. It reports: "the recession is forcing some hospitals
to cut back on their infection control budgets... Some of these
infections can be mild; others are fatal. The CDC estimates that about
1.7 million people acquire some form of infection in the hospital each
year; nearly 100,000 die. They also add billions of dollars to our
health spending. In a survey of 2,000 infection preventionists -
conducted by the Association for Professionals in Infection Control and
Epidemiology - 41 percent reported cuts in funding for
infection-prevention efforts in the past 18 months due partly to the
struggling economy ... Half saw reductions in overall budgets for
infection prevention, including money for technology, staff, education,
products, equipment and updated resources" (Mazerov, 6/11).


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