Wednesday, November 4, 2009
From the November issue of The Nation's Health:
Prevention, a touchstone of public health, has landed in the crosshairs of the national health reform debate, with cost-effectiveness pitted against the sometimes incalculable value of a healthy life....
...With such questions coming to the forefront, the task ahead is to reframe the prevention debate, said Rob Gould, PhD, president of the Partnership for Prevention. Focusing on how much money prevention costs or saves the federal budget is the wrong question, Gould told The Nation’s Health. Instead, the discussion should focus on questions of value, he said, whether the money being spent is a good investment.
"We should not be apologizing for helping people live longer and healthier lives, especially when we can deliver that life at the right cost," said Gould, an APHA member. "The good news is that the public wants prevention in health care, even if it costs more, so we’re starting from a good place in terms of public support. But we have to answer the economic questions, and we need to talk about cost in terms of value."
In September, the Partnership for Prevention released and sent to policy-makers a report on the "Economic Argument for Disease Prevention: Distinguishing Between Value and Savings," which stated that "health is a good, and goods — whether they are national security, clean water or a new car — are not purchased to save money. They are purchased for the nonmonetary benefits they provide. Shoppers do not buy groceries to save money, but they do ‘save money’ by shopping wisely."
The report noted that prevention can result in other benefits that usually go unmeasured in studies on cost-effectiveness, such as improving "work force productivity and corporate competitiveness," as well as the ripple effects good health can bring to households and children, educational attainment and crime rates. A similar report released in August by the Robert Wood Johnson Foundation, "Cost-Savings and Cost-Effectiveness of Clinical Preventive Care," found that even while clinic-based preventive care, such as cancer screenings, do not usually result in cost savings, such services "offer good value for increasingly scarce health care dollars."