Wednesday, August 08, 2007
An ounce of prevention could save lives
by Miriam Falco
Managing Editor, Medical News

I've prepared a lot CNN segments on preventing illness over the last seven years as a medical producer. But according to a new study, not enough of us are getting the message. Not even some doctors. Our health-care system is not necessarily geared toward prevention. But what if it were? (Watch Video)

The Centers for Disease Control and Prevention commissioned a report to determine which preventive measures would have the biggest impact in saving lives. The non-profit health policy group "Partnership for Prevention" (PFP) found that simply increasing the number of people who follow 5 existing prevention recommendations would save more than a 100,000 lives each year. That's more than the population of Green Bay, Wisconsin or Cambridge, Massachusetts.

So what exactly are these five recommendations?

** Right now less than half of Americans who should be taking aspirin daily to prevent heart disease do so. If that number went up to 90 percent, 45,000 additional lives would be saved --at a cost of pennies a day.

** Only about a quarter of all smokers are advised by health care professionals to quit smoking and given tools to do so. If that number were raised to 90 percent of smokers, then 42,000 additional lives would be saved each year.

** Less than half of Americans older than 50 get screened for colon cancer - get that number up to 90 percent and 14,000 additional lives could be saved.

** Each year the CDC says get your flu shot - but only 37 percent of adults older than 50 actually get one. Raising that stat up to 90 percent would save 12,000 more lives.

** Finally, only two-thirds of women older than 40 get screened for cancer every 2 years - if that number increased to 90 percent, almost 4,000 lives would be saved annually. (Full Report).

So why aren't more of us taking aspirin, quitting smoking or getting cancer screenings?

Maybe it's because many of us don't think about going to the doctor when we are healthy, but go only when we're sick. According to the PFP report, many doctors and nurses lack a system to track the patients who need preventive care. And when it comes to telling patients to quit smoking, some doctors aren't always comfortable doing so.

Another hurdle is the cost of preventive services. In many cases, high deductibles have to be met before preventive medicine is covered by insurance. Those who don't have insurance are even more likely not to go to the doctor if they aren't sick. They probably can't afford it. Something has to change. One of the study's authors, Ashley Coffield says it's important to remove financial restraints in order to increase demand for more preventive services.

But Coffield says lawmakers need to make prevention the cornerstone of America's health-care system. "Too many people are dying prematurely or living with disease that could have been prevented," Coffield says. "We could get more out of our health-care dollars if more preventive measures were taken. We can pay now or pay a lot more later."

Have you been screened for cancer? Can you afford to go to the doctor when you're not sick? What preventive measures do you take to stay healthy?
Because of my age and health, most of those don't apply to me, but I can comment on the flu shot. Many people aren't given access to them, including me for the last several years. I signed up several times to get one at work and with my doctor, but I was told each time that they were giving preference to risk groups, the elderly, young children, and so on. The only other option I had was to go to a store on a day they would have lines for them, and I, like most people, don't have a free day to stand in line for hours for a chance at a flu shot. It was only really annoying because I know that they throw so many out at the end of the year because they can't be used next year. At this point, I'll trust my body to defend itself until I don't think it can anymore.
I TOTALLY agree - time and money should be spent on prevention. MOST people don't go to the doctor for two reasons: (1) they can't afford to go and (2) don't feel sick. Insurance companies (and health care professionals) need to come up with a program where for a flat fee, maybe $100-150 (even less pending on your income), a patient can go for their yearly physical and get the broad range of tests needed to detect any abnormalities in their bodies - blood tests, urinalysis, even CT scans (get rid of the old fashioned xrays for your lungs, stomach, etc. already! They're obsolete unless you break a bone! It will save money in the long run by doing CT scans right away). If CT scans were part of the yearly physical, can you imagine how many things would be caught early on? Which in the grand scheme of things, will save everyone time, money and most of all their health.

It's like a big maze when you go to the doctor these days because this doctor doesn't do this, and that doctor doesn't do that so they send you off to more doctors - all collecting your $20 co-pay!! Your primary care dr should do all of it! If somethings comes up in the tests, THEN go see the specialists.
I don't find it surprising that many people don't take the time to go to the Dr. to get their screenings when many don't bother to do things to keep themselves healthy that are even easier. I know so many people who just refuse to exercise, drink plenty of water, eat the proper foods, take vitamins, reduce stress, etc. Folks I work with seem to strive on coffee, burgers (eaten at their desk) and stress. It's scary! They'll say "I know I'm being bad but...insert excuse here."

I make a conscious effort to get my 64 ounces of water everyday (32 ounces before I drink any caffeine), walk regularly, and eat a variety of healthful foods. Of course, I'm subject to the occasional splurge now and then (potato chips are just too good to avoid forever!), but I try to stay on track to make sure I stay healthy...and I get my annual screenings, as "un-fun" as those are!
I've been working in my own business for several years and am having to go back to full-time work at a major employer just to get health care. I've only carried major medical and have forgone mammograms, colonoscopies, dental work, and other preventive measures because the cost is more than I can afford. Having had excellent health insurance up until a few years ago, I was complacent about medical care. Now I'm much more aware and concerned for those who simply do not have the option of getting the care they need. The situation is frightening!
At 35 I haven't been screened for cancer however if I wanted to, I highly doubt my HMO would pay for it without a basis for the test. Outside of catching a cold or a flu, I couldn't afford to see a doctor if I was to get cancer or some other life threatening disease. I like thousands of other americans would have to file for bankruptcy if I was to get cancer etc.
Questions for everyone,

How can we keep saying that we should take an aspirin a day when people are bleeding out from there ulcer (which was most likely due to the aspirin to start with)?
How many lives could we save if we told people about anti-inflammatory diets? It is a fact that atherosclerosis is not the problem it is the inflammation of the artery that causes occlusion.

I do agree that more medical professionals should help get smokers of the cancer sticks, but why would they? Would you if you had $20 billion paying for your great lifestyle.

If it was not a circus just to get a colonoscopy and you didn't have to spend two weeks of hard earned pay if you don't have GOOD insurance just to have the "recommended" procedure that would be life saving and changing!!!

How long is it going to be before we wake up and realize the dangers of vaccinations? Why by the 6th grade does a child get over 70 "life saving" shots? Just two of the ingredients make me sick (mercury and aborted fetus tissue) and the list is to long to type but you can look it up yourselves. Does the body have any defense system or is it weak and defenseless so it needs vaccinations to live?

Finally, I agree that more women need to get screened for breast cancer, how about men for prostate? But a better question would be, this was asked of a head American Cancer Society spokes person in a meeting a few weeks ago when she was talking about decreasing cancer rates, when will we stop giving estrogen therapy that is a proven cause of breast cancer?????

Anyone who wants to be healthier should start from the inside out not outside in. Start with healthy eating habit and exercise 30 min. a day (walk around the block) and find ways to manage stress which will lower your blood pressure naturally without unproven drugs!!!!

Take care of yourselves because Medicine will not.
What about simplier preventative measures such as proper hygiene, weight loss and exercise, proper nutrition in schools etc, extended maternity leave so as to prevent and limit expensive childhood illnesses and stress for parents, drug counseling, birth control and STD education for kids... The list goes on and on... And the costs are astronomical compared to the few you mentioned. We live in a society that wants to fix problems, why not have a system that prevents the problems instead... It's way cheaper...
Hi Miriam,

Preventive medicine and health education is an important one for early detection. Most of it gets funded though Grant money through non-for-profit organization. Hospitals which focus on outreach, early detection and screening receive their fundings also through non-profit Grants. It is not covered through health insurance. A good thing to know!
Miriam:
Exercise. Exercise. Exercise.
** Finally, only two-thirds of women older than 40 get screened for cancer every 2 years - if that number increased to 90 percent, almost 4,000 lives would be saved annually.**

Excuse me... "Screened for cancer"--can we be a bit more clear about what this entails??? There are many, many kinds of cancer and from what I can tell, most involve specific tests. Many of those will not be allowed by insurance companies unless there is some symptom or extreme risk.

Other than mammograms, which seem to be readily available, all other tests are very limited unless there's some specific cause.

Even getting a colonoscopy is difficult unless you reach a certai age and have family risks.

I think my doctor would laugh if I asked if I could be "screened for cancer." Is there really such a thing that can be requested???
I'm quite glad we're not saving these extra lives each year. The world is a bit too populated as it is, and much of modern medicine hasn't worked to assist that fact.

Then again, I haven't really got any concept of self-preservation. Maybe I'd feel differently if I did.
There is no doubt that preventative health care should be the cornerstone of America's wellness strategy.
The biggest barrier to it is cost.
As long as our country insists on equating health care with health insurance, we will never surmount this barrier.
The for-profit insurance industry is in business to make money and deny care which costs them money.
Health insurance adds 30% to 40% to the actual cost of care delivery. That is money that could be better spent on patients.
This country needs to establish a single-payer system where everyone is covered, from birth to death. The current hodge-podge patchwork benefits only stock holders and paper pushers.
Health insurance is bankrupting many businesses, both big and small. There is no doubt that this trend is contributing to overseas job outsourcing and overall decrease in America's standard of living.
People scream, "Not my tax dollars" or "That's communism" or "I want choice", but do they realize that the reason why they do not get the important preventative care that they need is because it does not benefit the health insurance companies?
Heatlh is a "common good", just as are education, transportation and defense. Lining the pockets of the insurance industry and pushing jobs overseas are the reason why we are sacrificing needed care.
I firmly believe in preventative medicine, I eat well, try to exercise, don't smoke and drink in moderation. However, due to change in employment and consequently health insurance, I can no longer afford all of these tests that Dr. Gupta mentioned. No more cancer screening of ANY kind for me, never mind any tests for conditions such as cardiovascular.. I know I will wind up in a crisis care situation and will refuse treatment of any type as long as I am able. I will most likely die of something treatable. That is my choice,as I cannot afford anything else. But that is just the way it is. And I know I am not alone in this situation. Who can afford health care nowadays?
You are so right about our health care in the u.s.a. If you have no insurance and are sick , you still can't afford to get help . And no-one care's . I'm 57 and have been faced with this now for year's. My only child serves in the Army and is deployed for the third time . At a time when I need help ,my goverment say's "The hell with me .But we will take your child and use him . We don't care that you need help ". GOD help us all .
Since when has early detection become synonymous with prevention? In my opinion, receiving yearly check-ups/screenings is great for early detection. But what are our options for prevention of developing sickness/disease in the first place? Healthcare in the US should be deemed "Sick-Care." Aside from life-threatening emergencies, I see no reason for Americans to be spending as much money as they are on a system that is just not getting them healthy. I also see no reason why we should be pumping our liver full of aspirin or any other drug for that matter on a daily basis. Something has got to change. Health is a state of optimum physical, mental, and social wellbeing. It's not merely the presence/absence of sickness and disease.
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