Did you know that the U.S. spends about 75 percent of the annual healthcare budget on treating diseases, while 70 percent of diseases are connected to one or more preventable conditions? With only 3-5 percent of the $2.8 trillion budget going to prevention, we are not hitting the problem where it hurts the most – prevention of diseases.
As compared to other developed nations, the U.S. spends twice the average of other nations on healthcare, and we still are way behind in life expectancy. Most of the factors associated with low life expectancy are tobacco use, alcohol abuse, poor diet, STDs, and motor vehicle accidents. Motor vehicle accidents by themselves chalk up $99 billion in medical and productivity costs. The common aspect among all of these deterrents is that they are preventable, and, fortunately, prevention can be the key to eradicating all deterrents.
A major contributing factor to prevention can be minor adjustments to the lifestyle of the American population. In the past, public health interventions have improved the prevention statistics and have stopped diseases in earlier stage. Other than these advantages, these prevention programs have also delivered economic benefits to the nation. Taking a page from this book, the Affordable Care Act has implemented certain measures that will move the nation from a cure stance to a preventive stance. Let’s take a look at some mandates & implementations of the ACA that have the potential to move U.S. from a reactionary mode to a preemptive mode.
• The ACA has established a Prevention and Public Health Fund that will pay for prevention research, initial health screenings, immunization programs, high-risk community education programs and public health readiness. The fund is currently valued at $18.75 billion and would be operational from 2010 to 2022. The fund supports several community based prevention programs, pushing clinical prevention activities, strengthening public health infrastructure, and expanding workforce & research efforts to strengthen preventive measures in the country.
• The Interagency National Prevention, Health Promotion and Public Health Council is an endeavor initiated by the ACA to govern and guide prevention and wellness programs throughout the country. Currently, the council is working on a National Health and Prevention Strategy that is designed to keep prevention as the primary concern while implementing any health policy and outreach efforts.
• The United States Preventive Services Task Force under Department of Health and Human Services has received an additional push under the law for mobilizing their prevention activities for public health.
• ACA has made a special addition of preventive services to Medicare coverage for all.
• A separate mandate has been issued to private health insurance providers operating under the new health insurance exchanges. According to these mandates, health plans are required to provide a benefits package that provides the essentials of preventive services for all age groups. The mandate covers vaccinations recommended by CDC for all adults and mandatory screening for blood pressure, cholesterol, diabetes, colorectal cancer, HIV, alcohol abuse, obesity, depression, and tobacco use.
• The ACA mandates also deliver certain special privileges for specific age groups and demographics. Under this, women can screen for cervical cancer, breast cancer, urinary tract infections, STDs, and osteoporosis. The mandate also covers preventive medications for high-risk women.
• For children, ACA provides a benefits package that covers vaccinations and screenings for psychological problems, developmental delays, obesity, etc.
• The ACA also expands the coverage of smoking cessation medications and treatment of pregnant women enrolled in Medicaid.
Through these methods and mandates, the ACA has laid the path for complete coverage of preventive services through clinics. However, we are still far away from a collective preventive revolution. To tackle that, the ACA has implemented an incentives program that rewards individuals, families, businesses and communities for preventive steps taken by them. Through these endeavors, the health system might be turned around to a preventive. Today, the U.S. is ranked 24th out of top 30 nations in life expectancy. With momentum building behind preventive practices, it shouldn’t be too long before we emerge leaders in this field too.
Research estimates that for every $10 per person spent on preventive interventions, the healthcare budget stands to save $16 billion in five years. It’s not just about money; it is about providing better healthcare to individuals for making a healthier America, and ACA is already making headway toward this goal.