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Report touts value of preventive care: nearly a six-fold return on investment
Wednesday July 16, 2008
By Rep. Diana DeGette (D-Colo.)
It sounds like a no-brainer: prevent illness, save money. You would spend less money on medicine and doctor co-pays, have increased productivity at work and wouldn’t have to take as many sick days.
Right now, America is not only suffering from an economic downturn; we’re also experiencing a health slump due to a workforce crippled by an overwhelming tide of chronic disease. Currently, two-thirds of Americans are overweight or obese, one in five Americans does not engage in physical activity, and one in five adults smokes.
We spend more than $2 trillion a year on healthcare — more than any other nation on earth. Now is the time to shift the paradigm, investing money on the front end to keep people healthy, rather than spending trillions trying to cure the nation’s preventable ills.
America could save billions of dollars by reducing the need for expensive medical care. We don’t have a healthcare system in this country; we have a sick care system. Less than four cents of every American healthcare dollar is currently spent on prevention; the balance is spent on medical care.
One group did the math and its report is being released today. The premise is simple, but the findings are extraordinary. According to the Trust for America’s Health’s (TFAH) report, “Prevention for a Healthier America: Investments in Disease Prevention Yield Significant Savings, Stronger Communities,” if we invested just $10 per person in creating healthier communities — exercising more, eating better and kicking our nicotine addiction — we could save $16 billion in only five years. That’s a return on investment of almost $6 saved for every dollar spent.
Some states are doing better than others. My home state of Colorado holds a record we should be proud of — in the midst of a growing obesity epidemic we are the slimmest state in the union. One of our homegrown advantages is that Colorado is home to some of the most successful “community interventions” in America.
These interventions disrupt the cycle of costly chronic conditions like obesity, diabetes and heart disease, with programs that make it easier for people to make healthier choices. They promote physical activity with public projects like bike trails; and promote diets full of fresh fruits and vegetables with farmers markets and accessible supermarkets for city dwellers.
In fact, TFAH calculated just how effective prevention can be to keep healthcare costs in check. It found that many effective community-level prevention programs cost less than $10 per person and lower rates of diseases without medical care. The evidence shows that implementing these programs in communities would reduce rates of Type 2 diabetes and high blood pressure by 5 percent within two years; reduce heart disease, kidney disease, and stroke by 5 percent within five years; and reduce some forms of cancer, arthritis, and chronic obstructive pulmonary disease by 2.5 percent within 10 to 20 years.
In Colorado, the savings would be enormous — we could save over $232 million annually within five years. Nationally, that number soars to $16 billion saved every year. Now that’s a smart investment — we could help people stay healthier and get back more than $5 for every dollar invested.
Those who argue that America’s health and America’s economy are at odds with each other should take a look at this report. It turns out that the way to secure America’s financial future is very much tied to making our workforce healthier. As policymakers we can start by looking at simple ways to improve individuals’ health as well as how we fund healthcare in this country.
For example, I recently introduced a smoking cessation bill with Rep. Todd Platts (Pa.), the Quit Smoking for Life Act, which provides Medicare and Medicaid coverage for tobacco cessation treatments with proven effectiveness and defines tobacco cessation as part of quality services under the Maternal and Child Health Program.
Tobacco use is the leading cause of preventable death in the U.S., resulting in $96 billion in annual health costs and 14 percent of all Medicaid expenditures. Tobacco cessation is extremely cost-effective, yet few state Medicaid programs cover the range of proven-effective tobacco cessation interventions. This is just one example of how Congress could invest in prevention to both improve health outcomes and save money in the long term.
It is also time we rethink how we score healthcare legislation here in Congress. Because we must pay for anything we do, the Congressional Budget Office looks at all outlays and savings in determining the budget impact of any legislation. Unfortunately, some of the savings we could see as the result of prevention are not tangible or readily defined, thereby making it difficult for CBO to incorporate them into the “score” (or budgetary impact). So, we end up in a situation where we cannot institute preventive measures that would save money in the long run, simply because there is an easily defined, tangible, up-front cost.
The greatest healthcare debate our nation has had in 15 years has already begun. This time we need to think outside the pill box by investing in fresh solutions for healthy living.
Right now, America is not only suffering from an economic downturn; we’re also experiencing a health slump due to a workforce crippled by an overwhelming tide of chronic disease. Currently, two-thirds of Americans are overweight or obese, one in five Americans does not engage in physical activity, and one in five adults smokes.
We spend more than $2 trillion a year on healthcare — more than any other nation on earth. Now is the time to shift the paradigm, investing money on the front end to keep people healthy, rather than spending trillions trying to cure the nation’s preventable ills.
America could save billions of dollars by reducing the need for expensive medical care. We don’t have a healthcare system in this country; we have a sick care system. Less than four cents of every American healthcare dollar is currently spent on prevention; the balance is spent on medical care.
One group did the math and its report is being released today. The premise is simple, but the findings are extraordinary. According to the Trust for America’s Health’s (TFAH) report, “Prevention for a Healthier America: Investments in Disease Prevention Yield Significant Savings, Stronger Communities,” if we invested just $10 per person in creating healthier communities — exercising more, eating better and kicking our nicotine addiction — we could save $16 billion in only five years. That’s a return on investment of almost $6 saved for every dollar spent.
Some states are doing better than others. My home state of Colorado holds a record we should be proud of — in the midst of a growing obesity epidemic we are the slimmest state in the union. One of our homegrown advantages is that Colorado is home to some of the most successful “community interventions” in America.
These interventions disrupt the cycle of costly chronic conditions like obesity, diabetes and heart disease, with programs that make it easier for people to make healthier choices. They promote physical activity with public projects like bike trails; and promote diets full of fresh fruits and vegetables with farmers markets and accessible supermarkets for city dwellers.
In fact, TFAH calculated just how effective prevention can be to keep healthcare costs in check. It found that many effective community-level prevention programs cost less than $10 per person and lower rates of diseases without medical care. The evidence shows that implementing these programs in communities would reduce rates of Type 2 diabetes and high blood pressure by 5 percent within two years; reduce heart disease, kidney disease, and stroke by 5 percent within five years; and reduce some forms of cancer, arthritis, and chronic obstructive pulmonary disease by 2.5 percent within 10 to 20 years.
In Colorado, the savings would be enormous — we could save over $232 million annually within five years. Nationally, that number soars to $16 billion saved every year. Now that’s a smart investment — we could help people stay healthier and get back more than $5 for every dollar invested.
Those who argue that America’s health and America’s economy are at odds with each other should take a look at this report. It turns out that the way to secure America’s financial future is very much tied to making our workforce healthier. As policymakers we can start by looking at simple ways to improve individuals’ health as well as how we fund healthcare in this country.
For example, I recently introduced a smoking cessation bill with Rep. Todd Platts (Pa.), the Quit Smoking for Life Act, which provides Medicare and Medicaid coverage for tobacco cessation treatments with proven effectiveness and defines tobacco cessation as part of quality services under the Maternal and Child Health Program.
Tobacco use is the leading cause of preventable death in the U.S., resulting in $96 billion in annual health costs and 14 percent of all Medicaid expenditures. Tobacco cessation is extremely cost-effective, yet few state Medicaid programs cover the range of proven-effective tobacco cessation interventions. This is just one example of how Congress could invest in prevention to both improve health outcomes and save money in the long term.
It is also time we rethink how we score healthcare legislation here in Congress. Because we must pay for anything we do, the Congressional Budget Office looks at all outlays and savings in determining the budget impact of any legislation. Unfortunately, some of the savings we could see as the result of prevention are not tangible or readily defined, thereby making it difficult for CBO to incorporate them into the “score” (or budgetary impact). So, we end up in a situation where we cannot institute preventive measures that would save money in the long run, simply because there is an easily defined, tangible, up-front cost.
The greatest healthcare debate our nation has had in 15 years has already begun. This time we need to think outside the pill box by investing in fresh solutions for healthy living.
DeGette is the Vice Chair of the House Energy and Commerce Committee.