Rx Small price for a big payoff

John Dorschner

Jul. 18, 2008 (McClatchy-Tribune Regional News delivered by Newstex) -- Spending only $10 in prevention per person may save billions of dollars in cures, according to a national study released Thursday.

Echoing the centuries-old wisdom of Ben Franklin, researchers at the Trust for America's Health, a Washington-based nonprofit group, found that simple community measures to get people to eat right, get more exercise and stop smoking can have huge benefits.

Nationally, the study calculates the savings could be $2.8 billion in the first two years and $16.5 billion over five years. For Florida, patients, and government-backed and private health insurers could save $1 billion over five years.

The findings provide hard numbers for what experts have been saying for years:

Simple measures to promote wellness and control health problems early can prevent costly visits to emergency rooms.

Two-thirds of Americans are overweight, one in five doesn't exercise at all and one in five adults smoke, the survey reported. Those conditions can lead to massive health problems, including high blood pressure, diabetes and cancer.

The study used a computer model developed by researchers at the Urban Institute and a review of evidence-based studies from the New York Academy of Medicine to come up with their findings.

They looked at dozens of studies, including communities that added after-school programs for children in parks or increased the number of bike paths and walkways to promote exercise.

In Des Moines, a program to give parents and their children information about a healthy lifestyle and weight management resulted in an average weight loss of five pounds for elementary kids and 10 pounds for those in high school after 12 weeks.

In California, a tax increase of 25 cents on a pack of cigarettes was used for health education to discourage smoking and to pay for more parks, recreation and healthcare for those who couldn't afford it. After 10 years, a study found that per capita cigarette consumption in the state had fallen by more than 50 percent.

THE MODEL

To arrive at their figures, researchers estimated how much such things as weight loss and exercise can prevent certain conditions and then looked at expense models.

"The researchers found that if the country reduced type 2 diabetes and high blood pressure rates by 5 percent, it could save more than $5 billion in healthcare costs," the authors noted.

Other research has also found a link between preventive programs and better health.

In January, the Centers for Disease Control and Prevention looked at the Silver Sneakers program, which offers free gym memberships to seniors enrolled in Medicare programs operated by Humana (NYSE:HUM) and CarePlus.

The CDC study found that after two years of membership, Silver Sneakers members had "significantly fewer inpatient admissions and lower healthcare costs" than those who weren't members.

A FAN

One big fan of the program is Hyacinth Chung, 69, a West Dade resident who uses a Bally gym. "I've been going about two years now to Silver Sneakers, and it has really helped me a lot. It used to be I couldn't get up from a sofa and walk because my knees were so stiff, and I couldn't climb a stairs without running out of breath. Now I can. And my doctor says my health is excellent."

Last month, a study by the Commonwealth Fund showed that children in Miami-Dade, where many are uninsured, have a 46 percent higher rate for hospitalization for asthma than children in Massachusetts, where far more children have insurance.

Experts believe all asthma hospitalizations should be viewed as preventable with proper preventive care.

Bernd Wollschlaeger, a primary-care doctor in North Miami Beach who is president of the Dade County Medical Association, said: "Small investments have a large savings, but a disproportionate amount of money is spent on tertiary diseases rather than preventive care."

Medicare and private insurers pay doctors comparatively little for dealing with high blood pressure or diabetes, but pay a lot for treating complications, such as the need for open heart surgery.

"Primary care is getting meager reimbursements" from insurers, Wollschlaeger said, which means that medical school students are turning to higher-paying specialties, leaving primary-care doctors "with a tremendous workload" and less time to talk to patients about wellness and preventive measures.

Using another old saying, Wollschlaeger summed it up this way: "We have a penny-wise and pound-foolish healthcare system."

Newstex ID: KRTB-0123-26754903