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Time for the "ounce of prevention" health care delivery system

January 18, 2013
David Houle
(photo credit: Mark Hines)
From the January 2013 issue of HealthCare Business News magazine

By David Houle

As children, most of us heard that proverbial chestnut “an ounce of prevention is worth a pound of cure,” probably from our mothers. It has always been common sense: You understood if you ate an apple a day you would keep the doctor away. That if you exercised and ate healthy foods you would be healthier. That if you got a flu shot you wouldn’t get the flu — common sense.



It is now the time for us to bring this common sense to all of medicine and health care.

Right now in America we have a “pound of cure” health care system. We wait until we get sick, get injured or develop a condition before we see a doctor. That means that we go to the health care system to be treated for an ailment. Treatment and tests are expensive. If we go to a hospital, the impact is even greater: the hospital is the most expensive place to dispense health care in our country.

While doing research for a book I wrote on the future of health care in America [The New Health Age, Sourcebooks 2011] several things became clear:



  • The United States has the most expensive health care per capita of any country in the world.


  • The United States does not have the highest quality of health care compared to other countries based upon numerous metrics.


  • Ten percent of the U.S. population consumes 70 percent of health care costs due to co-morbidities that are largely preventable: obesity, high blood pressure, heart disease, type 2 diabetes and joint disease.


  • More than 80 percent of Americans answered “yes” to the question “Do you lead a healthy lifestyle?” at a time when 65 percent of adult Americans are overweight and 34 percent clinically obese.


But we are moving toward the future of health care, a time of transformation when this is all starting to change. Insurance companies and employers are realizing that having healthy people and healthy employees lowers health care costs. “Carrot and stick” payment plans are creeping into the marketplace. Lose 50 pounds and get a bonus check for doing so. Refusing to lose the weight? You’ll need to pay higher premiums for being a higher actuarial risk. We all know that economic incentives can work. They are now occurring here.

In the future of health care, we are moving from treating sickness to promoting wellness. We are moving from ignorance to understanding, treatment to prevention, and procedures to performance. All the great innovations we expect in the roughly 80 percent of America’s GDP – connectivity, price competition, transparency and digital records — is now coming to the 20 percent of the GDP that is health care.

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