Health Care Reform: Paying for Prevention, not Procedures

With health care reform in the news every day, it’s so hard to sort all the hype and lobbying spin from the real issues. It’s a giant blame game, tinged with a threat of socialism, that has the media and the public all distracted and confused. If we peel all that confusion away, what is really at the root of the health care problem in the United States? (And it is a problem—the most expensive and least effective in the world.)

The problem is that we (the public, the government, and insurance companies) pay doctors—thus rewarding them and incentivising them financially—for doing procedures, not for preventing disease in the first place. Hospitals and insurance companies make their money from CT scans and MRIs, not yoga classes or massage sessions. Doctors make their money from ordering tests, not from teaching people how to exercise and eat right. Prevention is an afterthought that’s considered a little bit hokey, rather than the thing that keeps you out of the hospital or doctor’s office to begin with.

It’s an old story, one that goes back to the 1950s, when my grandfather launched Prevention magazine. But at least now there are thousands of studies that show preventing diseases works best, and tons of financial evidence to support the fact that preventing disease is financially more effective than treating it. And the people who make fun of prevention are in the minority now, not in the majority, as they were in my grandfather’s day.

It’s a bold move to try and figure out how to turn an intricate and entitled financial-reward system upside down, and make money from keeping people healthy rather than fixing them once they are sick. But somehow, we have to figure that out.

We will always need doctors and hospitals. People will always get sick and injured, and women will always have children (we hope). I am personally grateful that doctors and hospitals got me through three difficult childbirths and once saved my daughter’s life. But I also see how my mother has had a better quality of life and is living longer than expected by NOT going through aggressive treatments for cancer.

Rethinking the reward system takes a whole different mindset. But it’s a mindset we need to find, and learn to live in, if we want to live longer, healthier, happier, and more affordable lives.

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6 Responses to Health Care Reform: Paying for Prevention, not Procedures

  1. Anonymous says:

    I agree. I see people who do get health problems even though they’re doing everything right. Those people I truly feel sorry for. But I am so tired of paying for smokers drinkers and binge eaters and their myriad of health problems because of poor lifestyle choices. I eat pretty well, exercise (not as much as I’d like but I work 12 hour shifts on my feet) quit smoking almost 20 years ago and only have an occasional glass of wine. I only take a thyroid medicine and I will be 50 in October. Do I get any “reward” besides my good health for practicing prevention? No, and I should and so should anyone else that is truly trying to maintain a healthy lifestyle. One company I worked for in the 90′s did give you money off your health insurance cost by maintaining a healthy cholesterol level, being a non smoker, having a certain fitness level and body fat percentage and good blood pressure. I don’t think they do that any more but it was the equivalent of 2 free months of health insurance for me and my family. They should rethink the system and thank you for bringing it to attention

  2. Paula says:

    It seems so obvious to me that if you eat foods that nature meant for you and get some exercise several times a week, you don’t get the diseases that are so prevalent in the United States. Our mainstream medicine is very good at bringing people back from the brink of death in acute situations such as car accidents, heart attacks, chokings, etc., but not so good when it comes to returning people to health following chronic diseases such as cancer, heart disease, diabetes. They are good at treating the symptoms of the disease, but not curing the disease itself. The body itself does a good job of curing disease.
    My uncle is a good example of how the body will heal itself if allowed to. He was in his 50s and suffering from a severe intestinal disorder. He was a stubborn man and did not want to go to the doctor. He ordered Prevention Magazine and began reading it cover to cover. He began eating less junk and more whole foods and took supplements. He began to walk around his neighborhood every day. Within a few months he was feeling better. He is now 98 years old. He not only saved himself a lot of suffering; he imparted knowledge that went to his children, their cousins (myself included), and now grand and great-grandchildren.
    I would love to see a health care program put in place that rewarded people for practicing good health. Some of the research that now goes into creating new and better MRI and CT scan machines could go into teaching people how to change their lifestyles. Maybe that could be the foundation of the new health care system in this country.

  3. Kittye says:

    I definitely agree that we need to redefine what is rewarded in the health care industry. But let’s not forget that we are human and have the freedom to make choices – sometime good and sometimes bad. Sometimes we make poor food choices because eating healthy is more expensive than eating junk – at least on the front end. I acknowledge that poor food choices will cause us to pay in the form of poor health on the back end. My hope is that the food supply industry and consumer demand will eventually make eating healthy an affordable alternative. The movie “Food Inc.” also makes this point.
    As far as exercise is concerned, even though I believe most people know the benefits of exercise, many choose not to engage because they just don’t feel like it or don’t enjoy it. No matter what the benefits are, there are some aspects of human nature that may never change if a choice is involved.

  4. Paula says:

    You are so right about people knowing the benefits of exercise but not wanting to engage themselves in it. I know what helped me tremendously was getting a pedometer and logging the 10,000 steps a day. I’m somewhat of a bean-counter and attaining the numbers appeals to me, so I’m exercising in spite of myself!

  5. diane says:

    I have read each of the recent posts this evening. As a result, I am now planning on ordering Prevention magazine. I suspect wheat is causing digestive and IB isses and should find alternative food products i love the smell of the earth as you work it, the satisfaction in growing vegetables and flowers, reading when focus is possible, road trips not taken often enough, good wholesome food, being sexual, the good sleep that follows, the smell of fresh ground coffee in the morning… Oh, and I may even read a romance novel. Thanks for being here.

  6. Jailen says:

    Furrelaz? That’s marvelously good to know.

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