LETTER TO EDITOR: Preventive myth-busting

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While I would never assert that prevention can pay for all of health care reform, there is strong evidence that when it's done right, it can improve health and save money ("The myth of preventive care," Editorial, Tuesday).

To tackle rising health care costs in a sustainable way, we must control cost-drivers. Three-quarters of what we spend on health care is linked to patients with preventable chronic conditions such as diabetes and heart disease. Clearly, we need to do something to stem this crisis.

Your editorial focuses on screenings (detection) - the form of prevention that is most likely to cost money in the short term - but it overlooks programs that save money by preventing the onset of these diseases in the first place or managing them effectively to avoid costly complications. For instance, a yearly investment of $10 per person in programs promoting physical activity, nutrition and smoking cessation could yield nearly $16 billion in medical savings annually within five years. Likewise, $100 billion to $300 billion is lost every year because people don't follow their doctors' orders, suggesting there is great opportunity for realizing savings through investment in programs to coordinate care and help patients follow through on their prescribed treatments.

Prevention is not a magic potion and shouldn't be leveraged as a political miracle. However, it is a necessary and integral part of comprehensive reform to our health care system that, if done right, promises to deliver better value per dollar spent.

KENNETH E. THORPE

Executive director

Partnership to Fight Chronic Disease

Professor and chairman

Rollins School of Public Health

Emory University

Atlanta