How To Improve American Health Care: Focus On Prevention
How To Improve American Health Care: Focus On Prevention
When we take a long view on improving health, we usually find reasons to celebrate. In the last century, for example, infant mortality dropped by 90 percent and maternal mortality decreased 99 percent. Yet today, despite scientific advances, we face the fact that we are not a healthy nation:
– Our children’s life expectancy may be shorter than our own.
– About 70 percent of deaths and health costs in the U.S. are now attributable to chronic diseases (e.g., cardiovascular disease, cancer) — many of which are preventable.
– More people die from obesity or tobacco than from homicide.
Our health care system has gravitated toward quick fixes rather than the persistent actions with lifetime rewards. Proven clinical and community preventive services go unused. Two out of three adults fail to get a flu vaccine or recommended colorectal screening. Millions of lives are lost needlessly. As a nation, we dedicate only three percent of our health dollars on health promotion — but over 20 percent of costs to the last year of life.
A new approach is needed. As part of its overall plan to fix the fundamentally flawed health system, the Center for American Progress proposes a Wellness Trust. The Wellness Trust would:
– Deliver prevention outside of the bounds of the health system by paying for services wherever they are delivered, in pharmacies or supermarkets, workplaces or senior centers.
– Use its pooled financing to create incentives for providers, employers, schools and individuals to prioritize prevention.
– Operate independently like Social Security, with expert Trustees.
The premise of the Wellness Trust is that disease prevention is more like homeland security than health insurance: everyone needs it, no one notices if it works, and it depends on persistent, strong leadership and systems. While change will come at a cost, this cost would be dwarfed by the lost lives, productivity, and public resources that will result from a failure to act.
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48 Responses to “How To Improve American Health Care: Focus On Prevention”
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I'm anxious to see all the conservatives -- who constantly complain that we are too negative on ThinkProgress -- flock to this post and praise us for proposing solutions.
I won't be holding my breath, however.
October 11th, 2006 at 2:25 pmUntil the United States has universal health care for all citizens, like in Canada, we the people will be screwed over medically! Every member of Congress must give up their tax payer funded health care!
October 11th, 2006 at 2:27 pmJudd,
You are wise not to hold your breath.
It is more likely conservative commenters will lambast the plan as unoriginal, as an unneeded "entitlement", and accuse you of trying to replace the "forces of the market" and the "invisible hand" for an unAmerican socialistic idea.
There is no pleasing that crowd unless you praise the Dear (mis)Leader above everything else.
October 11th, 2006 at 2:33 pmWhat? Still no discussion of Habaes Corpus? Gods! TP, can't you do any better than this?
October 11th, 2006 at 2:36 pmThere's not enough profit in wellness or prevention.
October 11th, 2006 at 2:36 pmscrew flu vaccines. they trigger auto immune disorders in people who have a family history.. . disorders like diabetes, MS, lupus, and scleroderma. i'd rather take my chances about getting the flu.
October 11th, 2006 at 2:37 pm[...] Original post by Guest Read More… [...]
October 11th, 2006 at 2:39 pmI always wondered why the powerful Fitness Gym Lobby Group never pushed lawmakers for paid membership through health insurance if people attend gyms three times a week. I mean they are so much more powerful than the drug companies. Sigh.
October 11th, 2006 at 2:47 pmPrevention is good, but smoking tobacco would have to be outlawed! Smoking cigs, cigars, or chewing the stuff causes massive health problems! Cutting that poison out of America would lesson the cost of health insurance for everyone, plus would make it easier to impliment universal health care for everyone! Cancer caused by smoking represents the greatest costs in providing health care!
October 11th, 2006 at 2:49 pmfolks get off the meds. the pharm companies make you sick with unknown shit because of the chemicals in the drugs. start doing herbal remedies and have a BALANCED diet. and the number one killer in all of us is stress. stress brings/breeds illnesses. so here ya go with the alphabet diseases and the ones that have no names yet.
i recommend mangosteen to everyone.
and read natural cures 'they' don't want you to know about.
October 11th, 2006 at 2:53 pmkevin trudeau.
American health woes explained in 5 simple words:
The
October 11th, 2006 at 2:56 pmAmerican
diet
is
shite.
and not to mention when you go in for one illness and get meds you're back for another one to combat the side affects. the government and pharm companies and doctors want you sick. folks ought to know this by now.
October 11th, 2006 at 3:01 pm"and read natural cures ‘they’ don’t want you to know about.
kevin trudeau."
The same Trudeau who:
-was sued for making false claims about medical cures despite having absolutely no medical background.
-promotes Scientology as an alternative to psychiatrists
-falsely claimed that his products cured cancer
-won't grant TV interviews because the networks are "owned by the drug companies"
and
-has yet to have his "cures" independently medically verified
You follow him
October 11th, 2006 at 3:08 pmWow, I think that is the first joke post I have seen Judd make. My apologies if there have been others.
I like it though.
October 11th, 2006 at 3:15 pm#9- You can't MAKE people stop smoking and eating donuts.
Sure, prohibition, that'll work. Always does, right?
You CAN (try to) make food companies stop using certain ingredients though.
HF corn syrup
October 11th, 2006 at 3:15 pmtrans fat
aspartame
etc
Ahh... delicious corn syrup.
October 11th, 2006 at 3:22 pmFor every smokers out there:
http://www.whyquit.com/
October 11th, 2006 at 3:33 pmThere is a series currently running on PBS entitled "Remaking American Medicine." The first part ran last week. Worth a watch.
http://www.pbs.org/remakingamericanmedicine/
October 11th, 2006 at 3:37 pmMy company actually has a "Wellness Benefit" that gives us a discount off our medical insurance if we participate in certain programs that promote good health (eating recommended veggies / exercising for a few weeks, free blood screenings, fun-runs, etc.)
Healthcare providers make more money treating illnesses than in preventing them - so a "free market" health care system will eventually end up with most people sick or on drugs (like today?). However, we may be able to try to market this to medical insurance providers, who (along with employers) have a financial interest in keeping people healthy (and productive).
October 11th, 2006 at 4:00 pmHmmm... make everyone stop smoking. Education and encouragement has done wonders over the past 20 or so years to promote non-smoking. However, I am against any and all efforts to have the government force people to stop, whether with laws or the outright prohibition of all tobacco products. We are supposed to be a country of freedom, of choices, of individual liberty.
Here's a little food for thought. How many of you live and/or work daily in a city, like New York, for example? Do you realize just how much toxins and other caustic materials come from car and truck exhaust? Read a little about Benzene, a cancer causing agent. How about carbon monoxide? Do you realize the colorless, virtually odorless soup you interact within each and every day? In the winter you drive with your car windows closed and the heater on to stay warm. Well, guess what, your breathing this toxic mess of chemicals and by-products every time you do so. Ever wonder why you seem to have that slightly sleepy feeling during or after driving for a while with the heater blasting to keep you warm? Crack the window a little for better ventilation.
Cigarettes and other tobacco products are not the only cause of cancers. You don't have to believe me. Just take the time to read a little about what actually comes out of the tailpipe of your car.
Some examples:
Benzene
Nitrogen dioxide
Nitrogen monoxide
Sulphur dioxide
Formaldehyde
Polycyclic hydrocarbons
Happy breathing.
October 11th, 2006 at 4:07 pmJersey Joe (post #18)--
I saw that on PBS last night. Great points, especially about hospitals that show concern for patient safety rather than bottom line profits. It also recognizes that doctors are not infallible gods (something that many patients and doctors need to realize).
But it misses one thing -- how to handle the middle class (like myself) who get hosed with thousands in medical bills, even after paying thousands in premiums. We're almost bankrupt due to my pair of back surgeries, yet we make damn good money. It's just not right.
The only solution seems to be a one-payer system. I'm just not so sure doctors and hospital administrators will go for it -- seriously ... have you ever seen either one of those types of people driving a used Kia?
Fixing our health care system will require a massive effort. But not just in $$$ or programs or laws.
It will take a societal change wherein patients are more active in their own care, where more doctors actually show they give a damn about those patients, and where hospitals and insurance companies worry less about making profits and more about providing an absolutely-necessary public service.
Until those things also change, the rest will just be window dressing that overlooks an infected societal landscape.
October 11th, 2006 at 4:17 pmSo does this mean all of congress is giving up their health care coverage that the your taxes pay for.
October 11th, 2006 at 7:42 pmBut hideous disease is such a great money maker...
October 11th, 2006 at 9:55 pm#13
they are not HIS cures. but his opinions. take a look at lyour ancestors and what they did when they were sick. he is providing alternatives that have been around for ages. and frankly go pop a pill for your cold and wonder why you'll end up with cancer instead of putting your whiny ass in bed with some honey tea and a sqeeze of lemon. old time remedies that is what it is about.
October 11th, 2006 at 11:25 pmthis lame healthcare proposal is just more typical fakeLeft/cryptoright nonsense. Any political organization that promotes this nonsense instead of taxing the upper class more in order to raise money to provide healthcare for all, well, that organization is not leftist, but fakeleftist. And the democratic party and every crummy, lousy, stinking, traitorous "progressive" website aligned with the Dems is just more fakeLeft. THe fakeleft is the alter ego of the overclass. The rightwing takes in the white lower middle class that is pushed away and alienated by the democratic fakeLeft.
Let me restate my thesis for the sheeple here. This miserable little healthcare proposal of yours is for and by the upper class. I am of the working class. You AND the GOP are my enemies.
October 11th, 2006 at 11:43 pmWell if you are dealing with healthcare, maybe the person you are visiting would like a gift to cheer them up. I have a lot of funny gift ideas that will surely cheer them up.
October 16th, 2006 at 1:39 pmFirst let me say that I am totally for helping people that need help which is why I believe wealth that is taken from the people should be give back to the people in the form free healthcare. We take care of the government financially and it in turn should take care of it's people. It's greed that destroys the whole system. Politics is Power and Power creates money. How much does it take to satisfy one's money hunger?
October 17th, 2006 at 10:18 pmI watched a program on Monday night on PBS about the little girl who died in Johns Hopkins Hospital from dehydration. Do you have a copy of the 6 things that would improve hospital care? They were mentioned on this program. Thank you in advance, Sally Logan
October 18th, 2006 at 12:32 pmNurses are glossed over in this model, and yet, nurses provide the vast majority of direct public healthcare in community settings and nursing care in schools. School nurses, mentioned in the proposal, have had their positions stretched so thin that they no longer have anything near a managable case load. Many school nurses oversee three or more schools and up to 3000 students, staff and faculty.
My fear is that until universal healthcare is introduced in some iteration, that this "new layer" of preventive care will languish.
In the interim, may I suggest that interested people contact their local municipal or country department of health and volunteer to serve as a community advisor? You will learn first hand what the primary community health issues are that face your community and impact you directly.
Grassroots volunteer activism with public health and community health agencies is deperately needed. You will be able to support school health, community mental health services, address safe and accessible venues for community exercise and activity, support community nutrition programs, help to address safe housing supplies and serve as a vital link between healthcare providers and citizens.
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