Sally C. Pipes offers a dangerously misleading diagnosis in her Aug. 30 column, "An ounce of prevention is no cost-saving cure." Citing a recent CBO analysis, Pipes wrongly concludes that preventive health care raises costs by increasing utilization.
In fact, today's clinically based prevention reduces utilization and can potentially save billions in health care costs. The CBO analysis misses the mark by focusing solely on health screenings and subsequent medical interventions without addressing wellness programs, which represent a major portion of cost savings.
Numerous studies document the benefits of wellness programs. Studies by Dr. Dean Ornish and Highmark Blue Cross Blue Shield showed that people with severe coronary heart disease could stop or reverse their condition without drugs or surgery by making healthy lifestyle changes.
Almost 80 percent of patients eligible for bypass surgery or angioplasty were able to safely avoid it, saving almost $30,000 per patient in the first year. In a second study, lifestyle changes reduced total health care costs in coronary heart disease patients by 50 percent after one year and by an additional 20 to 30 percent in years two and three.
"An Unhealthy America: The Economic Burden of Chronic Disease" by the Milken Institute estimated that modest reductions in avoidable factors -- unhealthy behavior, environmental risks, and the failure to make modest gains in early detection and innovative treatment -- would lead to 40 million fewer cases of illness and gain over $1 trillion annually in labor supply and efficiency by 2023. This represents a 27 percent reduction in total economic effect.
The CBO analysis also neglected to include advanced practices that reduce health screening costs. Today's preventive health care programs narrow the scope of testing by incorporating risk-based targeting and clinical recommendations.
They combine simple blood tests with online health history and lifestyle questionnaires to identify each individual's top risks and then recommend an action plan to address only those risks. Excluding next-generation preventive health care programs from an assessment that guides policy decisions is like basing modern military strategy on weapons from World War II.
Any objective assessment of prevention must include recent advances in risk-based targeting, as well as the myriad wellness programs in reducing health care costs.
The United States can no longer afford a system where 70 percent of deaths and nearly 80 percent of health care costs stem from the same preventable chronic conditions. At this crossroads in health policy, we have a rare opportunity to nurture a movement that can save hundreds of billions, make our workforce more competitive and improve the quality of our lives.
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