What is all the fuss about disease prevention?

A recent study by the Trust for America's Health, a Washington-based nonprofit group, shows that spending only $10 in prevention per person may save billions of dollars in medical treatment of disease. This study found that simple community measures to get people to eat right, get more exercise and stop smoking can have huge benefits. Nationally, the study calculates that the savings in healthcare dollars from prevention could be $2.8 billion in the first two years and $16.5 billion over five years. For Florida alone, patients as well as government-backed and private health insurers could save $1 billion over five years.

These findings provide hard numbers for what experts have been saying for years: that simple measures to promote wellness and control health problems early can prevent costly visits to emergency rooms. For example, two-thirds of Americans are overweight, one in five does not exercise at all and one in five adults are smokers. These conditions can lead to significant health issues including high blood pressure, diabetes and cancer.

One study used a model developed by researchers at the Urban Institute and a review of evidence-based research from the New York Academy of Medicine to arrive at their findings. They looked at dozens of other studies, including studies of communities that added after-school recreational programs for children in parks or increased the number of bike paths and walkways to promote exercise.
In Des Moines, for example, a program to give parents and their children information about healthy lifestyles and weight management resulted in an average weight loss of five pounds for elementary students and ten pounds for those in high school.

In California, revenue from a 25-cent tax increase on a pack of cigarettes was used to discourage smoking and to pay for more parks, recreation and healthcare for those who could not afford it. After ten years, the study found that per capita cigarette consumption in the state had fallen by more than 50 percent. To arrive at their figures, researchers hypothesized that weight loss and exercise could prevent certain conditions, and then used this to create expense models. The researchers found that if the country reduced type II diabetes and high blood pressure rates by five percent, it could save more than $5 billion in healthcare costs. Other research has also found a link between preventive programs and better health.

In January, the Centers for Disease Control and Prevention (CDC) looked at the Silver Sneakers program, which offers free gym memberships to seniors enrolled in Medicare programs operated by Humana (a publicly traded company known on the New York Stock Exchange as HUM) and CarePlus. The CDC study found that after two years of membership, Silver Sneakers members had "significantly fewer inpatient admissions and lower healthcare costs" than those who were not members.

Recently, a study by the Commonwealth Fund showed that children in Miami-Dade, where many are uninsured, have a 46 percent higher rate of hospitalization for asthma than children in Massachusetts, where far more children have insurance. Experts believe all asthma hospitalizations should be viewed as preventable with proper preventive care.

Bernd Wollschlaeger, a primary-care doctor in North Miami Beach who is president of the Dade County Medical Association, said that "small investments have a large savings, but a disproportionate amount of money is spent on tertiary diseases rather than preventive care." Medicare and private insurers pay doctors comparatively little for dealing with high blood pressure or diabetes, but pay a lot for treating complications, such as open heart surgery. "Primary care is getting meager reimbursements" from insurers, Wollschlaeger said, which means that medical school students are turning to higher-paying specialties, leaving primary-care doctors "with a tremendous workload" and less time to talk to patients about preventive measures.