More people are valuing prevention

By Tom Newton

Iowa's summer isn't the only thing heating up. In Washington, the air waves are hot with discussions about health reform, now on the congressional fast track. Much of the attention has been focused on health insurance coverage.

Before the summer's end, our elected leaders will need to answer an abundant number of questions: Will the current employer-based system remain intact? Will there be a parallel public insurance system? How can we pay for the reforms? And who will pay for them?

When it comes to the top health reform priority, our political leaders have heard from the voters. A recent poll from Trust for America's Health and the Robert Wood Johnson Foundation found that Americans rank prevention as the most important priority and overwhelmingly support increased funding for prevention to reduce disease and keep people healthy. This key component can make the essential shift from a sick care to a well care system.

The crisis of chronic disease is harming Americans' health and driving up health spending. This needs to change because:

l Besides the heavy loss of life, patients with chronic diseases account for 75 percent of the nation's health care spending. In public programs, the treatment of patients with chronic diseases constitutes an even higher portion of spending - 96 percent in Medicare and 83 percent in Medicaid. The Centers for Disease Control and Prevention says the United States cannot effectively address escalating health care costs without addressing the problem of chronic diseases.

l Costs have risen to treat these diseases. Two-thirds of the increase in health care spending is because of increased prevalence of treated, chronic disease.

l The vast majority of cases of chronic disease could be better prevented or managed. The World Health Organization estimates that at least 80 percent of all heart disease, stroke, and type 2 diabetes, and more than 40 percent of cancer would be prevented if only Americans were to do three things: stop smoking, eat healthy and keep in shape.

Americans have become very savvy about health reform. Seventy-two percent believed that even if prevention doesn't save us money, it will prevent disease and save lives. The new emphasis on prevention represents a significant shift in public opinion.

Clearly, if voters have their way, public health, often unseen and underfunded, will play a significant role in expanding the years of healthy life and productivity. Wellness and prevention programs will make America the healthiest nation.

Tom Newton is director of the Iowa Department of Public Health.