The Current Health care system directs most of its resources in direct medical services and treatment. Prevention has limited scope. Not all diseases are preventable and some of them may still occur even with all preventive measures and care taken. Hence it is important to focus on the glaring issues at hand and work to resolve them. It would be unfair to direct resources on prevention when the sick and the ailing need them.

Preventive science is still evolving as a science , what with BRCA gene screening for breast cancer , something can be done about the fact that you are at high risk of developing the disease. But this screening may not work for all, may even be wasteful in many who qualify for it. Many other diseases appropriate screening methods are yet to be established.

Another component of Health care preventive services is the health behaviours. A lot of misery can be saved by changing health behaviours and improving attitudes for healthier lifestyles. Programmes designed for these are in practise but they necessarily do not need redirection of health care dollars.

The current health care policy which directs more to actual diagnosis and treatment rather than preventive services is probably fine.

The Worst Approach

     I definitely do not think it's wise to only be spending 5% on prevention. Too many people rush themselves to the hospital over symptoms such as sneezing, runny noses, and coughs and avoid going to the doctor for more serious conditions because seeing a doctor takes too long. If people were educated on how to prevent getting minor sicknesses in the first place, they won't waste the doctor's time and the doctor can focus on more important patients. Furthermore, educating people on how to stay healthy can help them avoid developing serious conditions such as hypertension, diabetes, heart disease, etc.

     I found an article from 2001 discussing how much it cost the state of Minnesota for the inactivity of the people living there. Approximately 60% of the adults are overweight and another 17% are obese. Because of the inactive lifestyles these citizens are choosing to take, they are developing other serious illnesses such as colon cancer, breast cancer, stroke, osteoporosis, and the aforementioned disorders. 

The study showed that if these people would have just been more active, the state of Minnesota could have saved $495 million just in one year from health care costs necessary to treat these diseases and conditions which could have been prevented with an active lifestyle. This is a perfect example of why preventative measures are necessary. If these people were taught that just being more active could save them from developing these disorders, millions of dollars would have been saved. This money could have been used for the prevention of disease rather than on fixing a disease.

Link to article: http://www.health.state.mn.us/news/pressrel/inactivityfs.html

Royalties?!?!

I believe that preventative medicine has always been a part of the way in which our health care is delivered. The reason why I believe it accounts for such a small piece of the health expenditure pie is because preventative medicine mostly deals with the creation of these measures/practices. Once they have been discovered, they are adopted by the other fields of medicine that actually implement them. For example, lets talk about vaccine X that prevents disease Y. The vaccine itself may have been created from that 5% piece of the pie, but to produce it we need to pay pharma, to create the container in which it is delivered/stored we need to pay some lab company. We then need a medical doctor to determine if the vaccine is appropriate and a nurse to administer the vaccine. I can go on and on with this example, but I think I have made my point. If there was some way for royalties to be paid on every preventative measure/idea/product, maybe we would see a larger piece of the pie being taken up?!?!

When it comes to Policymaking

Like Ivett said, “If it isn’t broken, then why fix it?”  I think a lot of people have this mentality.  I, however, am not one of these people.  My education makes me more aware of what is out there and I feel like I am really big on prevention.  I mean the slightest symptom of a cold, I am taking my vitamin C, cold drops, soup, extra rest, etc. 

I think that society and the government should place a huge emphasis on prevention. If people were to keep up with their yearly physicals and/or listen to their gut feelings if something was wrong, then they would potential prolong their lives and increase their quality of life.  For example, today on Oprah, this woman had a 140 pound tumor in her stomach that was growing over the course of five years.  She went to see the doctor and he just told her to exercise more and lose weight.  He never did any blood work or any MRIs or any other tests.  It wasn’t until she was admitted into the hospital for “flu like symptoms” did they realize she had a huge tumor.  This whole time, this woman was had a gut feeling that something was wrong.  Yet she ignored her intuition. I guess the whole point of this story is that this woman could have prevented this whole situation had she listened to her gut and also if her primary care doctor gave care.

I think that the government should increase spending on preventative medicine which would ultimately decrease spending on direct medical services and thus saving the government more money.   This is all very idealistic and will probably not happen in the near future.  Even if policy was passed, it would take a very long time for the policies to actually be supported by the lucrative business of medicine.  

In order to reduce health disparities policy makers need to focus on policies that prioritize preventative medicine and providing need-based care. Preventative medicine has been proven to be cost effective in the long run, unfortunately insurance companies and individuals don't understand this cost/benefit analysis and current policy is outdated. Insurance companies have no reason to prioritize preventative medicine because they aren't guaranteed to cover an individual long enough to reap the benefit. The average lay person doesn't understand the value of preventative medicine, and even if they do they often brush it off or have issues of access. And today's policies are outdated and need to be updated to demand higher levels of preventative medicine as a standard of care. 

Policies that mandate need-based care are necessary in order to reduce health disparities. The health needs and healthcare access of different communities are highly varied. Unfortunately this means that addressing disparities demands community based solutions that are more difficult to implement than standard policies. 

When It Comes to Policymaking...

America is sick. We live lifestyles that make us sick. Had we paid attention to what would prevent such illnesses we wouldn’t see things like obesity rising to the extent that it has thus far. We need treatment and we need it quickly. The health care system, from my limited knowledge of it, seems to work on a fix-it mentality. So, if its not broke...don’t fix it. If it is broke, well then fix it really quickly before people die and there is major controversy.

Policy can dictate that money is invested in prevention but the question is: how fruitful is that investment? Prevention is up to individuals. It’s up to society. It’s fine and dandy to have charts and seminars and ad campaigns, but if the individual refuses to utilize the knowledge and continues to live lifestyles that are unhealthy and ultimately requires treatment, we better have someone on the other side preparing the dosages. There’s only so much policy can do to enforce certain lifestyles and when it does, there are often cries of injustice and infringement on consumer independence. Just like forest fires, only you can prevent illness. Unfortunately we’re choosing to dig ourselves into an early grave.

I’m honestly not sure what the answer is, but that discrepancy does seem very large. Ideally it would be great for it to be an equal split, but I don’t see that being realistic seeing how we have more diseases and illness then we know how to cure let alone understand how to prevent from occurring in the first place. There’s so much that science hasn’t answered yet and so many challenges that come with prevention. In light of how many people are sick, it’s hard to encourage that policy cut down on curing those people to invest in telling people not to do things that, trends have shown, they’ll probably just do anyway. This is a crude argument but it’s the essence of the issue. Unless we come up with more effective ways for prevention to work on a societal level, there are just too many dangerously ill people out there to shift gears right now. We obviously need a new method of prevention, not just more money.

The Potential of Prevention

There's only so much that we, as soon-to-be health officials, researchers, doctors, pharmacists, dentists, etc., can do on the prevention front. We are all well aware of the impact of smoking on lung cancer, but how effective have campaigns targeting tobacco control actually been? People haven't stopped smoking and they won't stop. So then the question becomes: Why should we invest millions upon millions of dollars into something like that when it may only turn away a small percentage of individuals?

Similarly, eating healthy and exercising is a known way to prevent obesity. When was the last time you've seen an obese individual? How many people actually take into account the preventive measures that are known to be helpful and effective in avoiding certain health outcomes? There are a few reasons that 95% of money is being spent on the treatment and just 5% on prevention: ignorance and apathy.

Americans, in particular, have become quite ignorant of known science and repeated studies that have been done to pinpoint factors relating directly to health epidemics. The facts aren't very hard to find and they are headlining the news day and night, but they tend to go unnoticed. Here's my point: How many people heard of Chris Brown's assault on his girlfriend Rihanna pre-Grammy's, resulting in both artists to cancel their performances? I'm sure everyone heard that within hours. On the other hand, how many people heard about the interview in which Papa John's founder, John Schnatter, openly said in a BBC interview that he wouldn't recommending eating more than two slices of pizza at a meal? This directly influences his business, but he is aware that even if he says that, not much will change and people will continue to devour slice after slice. Think back to Super Bowl Sunday. How many slices of pizza did you eat? How many glasses of soda? How many bottles of beer? Chips and salsa? The facts are out there. It's up to the public to decide what to do with them.

That being said, I feel that there's only so much money that can be put into preventive medicine before it all just feels like nothing but a wasted effort.