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Is Prevention Better?
Search and you'll find a famous quote for every occasion. Relevant here is, "An ounce of prevention is worth a pound of cure." It's always faintly surprising that this was said by Benjamin Franklin. You always tend to think of someone's grandmother sitting on the stoop one night offering this as the thought of the night. Handed-down wisdom always sounds like cracker-barrel philosophy with that folksy ring. Well, this has a presidential quality about it so we ought to take it more seriously. So, thinking about what it means, let's cut down the amount of money we spend on treating and nursing those who are seriously ill by either preventing the illness or slowing it down through early treatment. Not that you will want to hear it, but this is the approach in many other countries. They all have routine screening programs for all the major diseases and disorders. All adults are encouraged to visit their doctors for wellness testing. It being largely a free health care service, this means the majority of people have problems diagnosed early. Life expectancy is rising sharply in other developed countries. We are dropping down the rankings. ...
... Why is this?
The problem is that the US medical services industry is for profit. To be brutal, this means hospitals, clinics and all the health care professionals employed in them are out to make their profit. This does not happen if people stay fit and healthy. The idea of prevention is therefore discouraged. Doctors want you to fall ill, delay and then come into hospital when you justify a major bill being presented to your insurance company. Then they want to put you through every last test they can think of. Some call this defensive medicine, i.e. they don't want you to sue them alleging they didn't make every effort to diagnose your problem. In reality, they are padding the bill, often testing you for its own sake. In Europe they have an evidence-based approach. No professional is allowed to use public funds on drugs or a form of treatment that has not been proved cost-effective. Insurers can pay for whatever test the patient wants. In most cases, the patients go with the public option and have only the treatment proved to be the best.
Under the Affordable Care Act, there are now some free options for preventative services. So, depending on your age, you may now be entitled to free tests for blood pressure, diabetes and metabolic disorders. Most cancer screening should be free, and there are local counselors offering advice on how to lose weight, quit smoking and other health-related issues. Your local state insurance department will have details available if you contact them. In this small way, President Obama is attempting to encourage the US medical profession to move in the direction of their European colleagues. There are signs the health insurance industry may be moving in this direction as well. If preventative treatment keeps you healthy for longer, more of your health insurance premiums is profit. This makes investors and senior officers on performance-related bonuses happy people.
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