Prevention Matters

Sen. Tom Harkin, D-Iowa, used a White House regional forum on health reform this week to make a strong case for prevention and wellness initiatives and then elaborated on his plans in a meeting with editors for the Des Moines Register.

Harkin, who is helping write wellness portions of the Senate version of the health-reform bill, said at the Iowa forum that the government should provide better foods in schools and should build walking paths to encourage exercise. He also said doctors should be rewarded for keeping their patients well, as opposed to the current system in which they are paid mainly for treating them after they become sick.

In a meeting Monday with Register editors and reporters, Harkin added that he would favor charging higher health-insurance premiums to people who smoke or are obese. Such people also ought to receive help and encouragement to improve their habits, he said: "I think there ought to be both a carrot and stick."

"Harkin brushed aside reports questioning whether wellness programs would provide savings to the system," the Register reported. He acknowledged that his proposals would add some costs, but he predicted savings would start quickly: "'I don't mean in 10 years, I mean in the next two or three years, we'll see this start to decline.'"