Preventive Health Care: An Ounce of Prevention

When people talk about the dire state of health care in this country, fingers point in every direction. At hospitals and HMOs (health maintenance organizations) that make treatment decisions based on cost-benefit analysis. At drug companies whose profit margins have been described as obscene. At insurance companies that won't insure people who've been treated for depression or acid reflux.

Clearly, there's plenty of blame to go around. So let's not overlook another influential group--patients like you and me, especially the ones who have insurance. While thousands of Americans do without medical care that they need but can't afford, an even larger number of insured people ignore health services that will cost them a little and could save everyone a lot.

What's the story?

A recent study found that, of the people who have preventive care benefits available through their medical plans, only 10% actually use them. The other 90% don't get routine exams like mammograms and prostate screenings, don't get lab work to check their cholesterol and blood sugar, and don't get their children vaccinated. They don't enroll in an exercise class or a disease management program. Not even when their plans cover all or most of the costs.

Some of these people may not know the benefits exist and don't think to ask. A lot of them, though, are in denial, believing that "it"--heart disease, cancer, diabetes, or stroke--won't happen to them. Some of them may be right, but the odds don't favor them. The U.S. spends $240 billion a year treating diabetes, obesity, and tobacco-related diseases. That figure represents a lot of very sick people whose diseases could have been detected and managed by preventive care.

The pound of cure

These people may be making a risky and expensive mistake, because preventive care saves lives and money. So if you belong to the 90% majority that is choosing to go without preventive care, here are some reasons to consider joining the minority.

Preventive care is inexpensive long-term care because it protects your future health. Medical and pharmaceutical advances have only a small effect on our overall health. In fact, 25 of the 30 years added to life expectancy in the past century are due to advances in preventive medicine and public health.

Even when you're feeling well, the first signs of a critical disease may be present. Only blood tests, X-rays, and other procedures can detect those early signs. Doctors now are better educated about doing routine screening and knowing what to look for. In the meantime, advances in routine tests have made them remarkably accurate. For example, a new type of MRI (magnetic resonance imaging; note that this test is not available everywhere) can diagnose heart disease as much as 10 years before the person is at risk for heart attack. Think how the death rate from heart attack might drop if more people took advantage of that one test.

Detecting a chronic or acute disease in its early stage puts you ahead of the curve. It also saves you a lot of money. Instead of working to combat an advanced disease and its complications, your doctor can focus on keeping a small symptom from becoming bigger. Usually, the earlier you start treating a condition, the better your chances of surviving. For example:

When doctors can diagnose heart disease before symptoms occur, they can treat and even reverse the progress of most conditions with outpatient care--and patient compliance. Because colon polyps grow slowly, routine colonoscopies could prevent more than 90% of deaths from colon cancer. Several studies show that routine mammograms after age 40 lower a woman's risk of dying from breast cancer.

Regular preventive care means better overall care from your primary doctor. When you receive regular preventive care, your doctor can track your health over a period of years. He or she then is more likely to notice small but telling changes in your weight or blood pressure, sleep patterns, or appetite. Your doctor also can help you manage behaviors that contribute to heart disease, diabetes, and cancer. Walking 20 minutes a day, cutting back on fat in your diet, or stopping smoking are manageable changes that literally can save your life.

Routine immunizations give you and your children immediate protection. Pediatric vaccinations protect children from serious infections including polio, chicken pox, and meningitis. And among older Americans, the annual flu shot can prevent the flu and other, more serious complications including heart attack, pneumonia, and stroke.

Bottom line--preventive care could lead the way to health-care reform

Everyone, including you, saves money when more people make an effort to stay well. And we could be talking about a lot of money. According to the National Congress on Pre-Symptom Medicine, regular use of preventive care by Americans could cut projected health-care costs by 50% over the next 10 years.

Think about what that means. If there's any truth in that statistic, a large part of the solution to the health-care crisis is in our control. The financial impact of the preventive care that you and your family members receive in the coming years can reach far beyond your paycheck. It can have a strong and salutary effect on the health-care industry and even the economy. With rising health-care costs undermining the profitability of businesses and the health of millions of people, that possibility is worth exploring and acting on.

So find out what coverage your medical plan has for wellness and preventive care. Make an appointment now for a routine physical or a bone density test. Take your children in for their vaccinations, or get a flu shot at a health fair. Grit your teeth and schedule a mammogram, colonoscopy, or prostate exam. Take care of yourself now and protect the health you hope to enjoy 10 years from now. You'll save money that you can spend on more pleasant pastimes. You'll also be doing your part to resolve the health-care crisis.

It can only do you good!

Published April 29, 2005