Prevention vs. Treatment

The U.S. healthcare system has been notorious for allocating funds towards treatment rather than prevention. We rather fix what has already been done rather than halting disease and injury in the first place. We are inclined to cure, medicate, and alleviate pain and illness; we tend not to place attention to health promotion. The flawed U.S. healthcare system's reliance on direct medical treatment fails to uphold the United Nation's vision of what being "healthy" is- which is not merely the absence of disease, it is not merely the cessation of sickness, but instead "healthy" encompasses the mental, physical, spiritual, and emotional well-being of a human. And in order to achieve that state, providers need to shift away from solely prescribing, medicaitng, and treating, they need to focus more on educating the public on overall healthy lifestyles that could prevent sickness and promote overall healthiness.

However, policy makers may not agree to this utopian vision of healthcare service delivery. For instance, I work at the Maternal & Child Adolescent Center at HSC which is a special clinic for HIV positive mothers and their families. I worked for a program within that research center which provided health education risk reduction services to incarcerated youth. The health courses aimed to educate these minors on HIV/STD transmission. The goal of the intervention was to prevent these high risk youth from being infected from HIV/AIDS and STD's. The program is contracted through the CDC as an "HERR"- health education risk reduction" intervention which contrasts "Counseling & Testing" interventions. Due to the fiscal crisis, all funding for HERR contracts were reduced by 9% and policy makers are now moving funds to counseling and testing programs. As a result of this, many public and private HIV/AIDS and STD prevention programs shut down. The defense was that...it's not that prevention is not helping halt the HIV/AIDS epidemic, but that these programs were not identifying HIV positive individuals as much as counseling and testing centers were. But if we allocate more funds towards testing, we can halt the epidemic by finding and treating those people...however the high risk groups for HIV/AIDS and STD's may perpetuate high risk behaviors if there are no preventative services available for them.

Some others reasons why only 5% of medical services is spent on prevention is due to the fact that it is difficult and complex to measure outcomes of preventative interventions and programs. It is tricky to evaluate if preventative programs are successful in healthy behavioral change. So policy makers may favor treatment and curative services since it consists of more hard evidence-based criteria of how people are getting treated, where patients are being seen, what type of services are needed etc. whereas most preventative models aim for long-term behavioral changes which may not be measurable or seen until later.