Prevention strategies that cost little and save significant dollars are paramount in this era of skyrocketing health care spending in the U.S.
There have been a few articles published in the mainstream media during the past month focused on health care utilization and where we should prioritize our health care dollars. Is it on purchasing and expanding use of advanced technological equipment such as MRI and Cat Scan machines? On widespread preventive screenings such as prostate cancer screenings and mammograms? Or on lifestyle change programs targeting at obesity or smoking?
In the Wall Street Journal article, The Myth of Prevention, Abraham Verghese dispels the idea that all prevention makes economic sense. However, he does state that behavioral changes such as eating better and losing weight do make economic sense. Atul Gawande discusses health care overutilization in The New Yorker article, The Cost Conundrum, using McAllen, TX, a city with one of the most expensive health care markets in the U.S., as an example. While the article focuses on physician incentives and unnecessary testing, visits and surgeries, it also reports the city’s 38% obesity rate and heavy drinking rate that is 60% higher than the national average. Might there be a link between these poor behaviors and high health care costs in McAllen?
When we consider the growing evidence that the economic return from performing more of certain imaging tests and disease screenings is no better, or even worse, that not performing these tests in the first place, we realize that this is not the area to focus the bulk of our health care spending. To answer the question posed above, it certainly makes sense to prioritize low-cost prevention strategies above other measures as we try to lower health care costs. The key is to target the right programs and the right health conditions to achieve the maximum return on our health care dollars.