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Prevention Could Reduce Costly Care, But Not Eliminate It

July 10, 2009 – 12:03 pm

I found a pretty provocative editorial on CNN yesterday from Fortune contributor Matt Miller at the Center for American Progress.  “Why Prevention won’t cure health care” seemed a little shocking. Judging from the healthy debate he started–21 comments, the lucky guy!–he and his sources touched a few nerves.

Miller quotes Uwe Reinhardt, a health economist at Princeton, as saying that “I have never seen any analysis that shows that in the long-run a society that uses a lot of prevention will have lower health care costs.”

This point runs counter to many I have made about how patient-focused packaging can encourage adherence with chronic illness treatments, which can in turn prevent costlier care. I firmly believe this with chronic conditions like lung, heart, and neurological diseases. If kept chronic, patients could forestall invasive procedures and costly hospital stays.

OK, I used the word “forestall,” which Miller might say supports his point that “heroic medicine” is paid for in “the last five years.” I cannot dispute this. But let me share a personal example.

My mother has chronic obstructive pulmonary disease and takes a ton of drugs. If she misses any, inflammation could set in. So what, then? Reduced lung function reduces her oxygen intake, which could lead to confusion and gait instability. Think of what a fall resulting in a broken hip costs.

In addition, she could be more susceptible to infections that could lead to pneumonia. Her last hospital ventilated stay for pneumonia was well over $100,000.

Bottom line to my story? Drugs are keeping my mother healthier. Her doctor wants her to avoid or at least reduce infections, and following prescribed treatment helps her do just that. Not only will it help keep her out of hospitals, it will protect her from the hospital-acquired infections that could lie in wait. And we all know no one wants to pay for those these days.

I agree with Miller that prevention may just delay inevitable healthcare expenditures. But prevention may also reduce the frequency of costly treatments. Believe me, I don’t want to see my mother in and out of hospitals for the rest of her life. How about just 30 years from now?

Daphne Allen

  1. One Response to “Prevention Could Reduce Costly Care, But Not Eliminate It”

  2. Just found this story on why preventing oxygen deprivation is so important: “In order for patients with COPD to maintain independence, cognitive abilities are necessary for being adherent to complex medication regimens, such as inhalers and oxygen, and to manage other chronic diseases often associated with COPD, among other daily tasks made more difficult by activity limitations due to COPD.” Source: (

    By dallen on Jul 10, 2009

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