Here it is… the long anticipated interview about chronic disease with Dr. Richard Carmona, 17th Surgeon General of the United States. I asked him 5 key questions and will split the Q&A into 5 posts. Enjoy!
Dr. Val: What do you say to those who argue that disease prevention is critical for quality of life, but does not ultimately reduce costs?
Dr. Carmona: The real value of prevention is best captured by some of the simpler interventions that have little or no cost to implement, such as smoking cessation. The returns on these prevention strategies are huge, and the only “cost” is in educating people to change their behaviors. Another great example is childhood vaccination – it costs pennies per child but protects them from polio and other deadly diseases.
In the recent past there have been a number of editorials where learned individuals have cited examples such as the cost of treating hyperlipidemia in the population at large. For every heart attack that lipid-lowering drugs prevent, it costs hundreds of thousands of dollars to provide the drugs to the population with high cholesterol. I guess if you’re the one with the heart attack it is worth it. But not withstanding that issue, I think the argument is a misapplication of the concept of prevention.
If you look at prevention in the appropriate light, you can make the business case for it. Health itself and quality of life are priceless things. We need to provide the right drug for the right person at the right time. But better yet, lifestyle interventions like physical activity and healthy eating behaviors can eliminate the need for many medications.
The real issue here is how to attain optimal health and wellness through appropriately vetted prevention strategies that will reduce the cost of care while improving the quality and quantity of life. That is the challenge we have before us and I’m working to answer as chairperson of the Partnership to Fight Chronic Disease.
The Surgeon General series: see what else Dr. Carmona has to say about…