South Florida Hospital News
Sunday May 31, 2020

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October 2008 - Volume 5 - Issue 4




President Needs to Focus on Prevention

Last year 12-year-old Deamonte Driver died of a toothache that an $80 tooth extraction would have prevented. The $250,000 of healthcare he received after the related brain infection was diagnosed did not save this little boy from a condition that threatens few in the developed world.

The $2.5 trillion a year Americans spend on healthcare is the largest per capita spending of any nation on earth and almost 20% of GDP. Despite this more than 45 million Americans are uninsured and the nation lags behind most industrialized nations in almost every measure of health, including life span.

Nowhere is this failure more troubling than its impact on children. Thirty-five other nations have infant survival rates that are better than or equal to that of the United States, including the Czech Republic, France, Germany and Spain. These facts have ensured that both candidates for president are proposing significant changes to healthcare coverage.

Obama’s plan would require children to have healthcare coverage and would provide subsidies to make insurance affordable, among other things. McCain's plan would eliminate the tax break employees get for employer-sponsored coverage and replace it with tax credits for people to buy their own coverage. These positions are carbon copies of the failed positions each party held 16 years ago when Clinton fruitlessly battled a Republican Congress for health reform.

Obama’s camp argues that McCain’s model leaves 40 million people uninsured; McCain’s team argues Obama’s model will bankrupt the country. The great tragedy of these arguments is that in an election billed as America’s first chance for profound change to healthcare since the 1950s is that both parties fail to address the heart of the issue: It’s about prevention, Stupid!

Each candidate is reacting to a perfect storm of conditions that are driving up costs for consumers at a rate four times faster than wages since 2002; threatening to bankrupt Medicare; and forcing many employers to stop providing coverage. However, both McCain and Obama fail to substantially endorse a real solution -a serious and genuine commitment to public health, health education, and disease management measures.

The old adage about an ounce of prevention has never been truer. The effective control of hypertension during the next two decades could reduce health care spending by $890 billion. Taxpayers lay out an additional $39 billion every year for obesity-related diseases that play untold havoc on the health of the 32% of American schoolchildren who are overweight or obese.

Adding to the toll of preventable disease, are millions of preventable traumas. At Broward Children’s Center we see a never-ending parade of children whose bodies are broken beyond repair from a multitude of preventable injuries. These are not uncommon tragedies: More than four children die each day from car accidents, 75% of these deaths are the result of the children being incorrectly restrained.

Traumatic brain injuries kill close to 3000 children each year and result in 435,000 emergency department visits; American ERs treat almost a million unintentional poisonings annually; and ten children die each day from drowning in this country. These are just some of the lives comprehensive preventative public health policies could save, not to mention the 11,000 Americans who sustain a Spinal cord injury each year (at a cost of $10 billion annually).

Consider the further savings, reductions in crime, and support of a crumbling prison system that a reasonable and rational national disease management program for drug addiction would have.

Regardless of the moral obligations of such an investment it also makes clear economic sense. Prevention measures not only reduce healthcare spending and improve quality of life but also offer American businesses a very real lifeline in an increasingly competitive global economy. General Motors’ struggle to pay its $6 billion in annual healthcare costs is a clear example of how American businesses can not compete on a global stage while handcuffed by healthcare costs.

Health and Human Services puts the return on each dollar invested in health promotion programs between $1.49 to $4.91. These returns would be a huge boon for public and private bottom lines alike. In fact an investment of $10 per person, per year in proven community-based disease prevention programs could yield net savings of nearly $18 billion annually in 10 years (in 2004 dollars).

If Obama and McCain really want to bring about their much heralded change and maverick approach to healthcare they will adopt a plan that pays more than lip service to a public health investment and ignores the reactionary lobbyists and legislators’ self-serving agendas. Profound change is needed and will pay off today and tomorrow. Our next President owes it to our children to ensure there will never be another senseless death like Deamonte Driver’s.

Thor Barraclough, Executive Director of the Broward Children's Center Foundation, can be reached at (954) 410-4410 or
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