Interview with Dana Goldman, director of the Schaeffer Center for Health Policy and Economics at the University of Southern California and founding editor of the Forum for Health Economics and Policy, on the need for greater emphasis on prevention. Some quotes:
… imagine the way we reimburse. I was talking to a doctor, and he said, “Look, I am dealing with this obese person and they have a constellation of conditions — high cholesterol levels, high blood pressure, diabetes. The best thing I can do is take them for a walk. But I don’t get reimbursed for that.”
Well, why doesn’t the doctor come over and take you for a walk? Why can’t we reimburse for prevention? We think of health care as an expense, but we really should be thinking of health care as an investment. We want to invest where we have the greatest return. I would put prevention in that bucket.
But the way we do it now, no one has an incentive to invest in things with a long-term return.
(Things with a long-term return) Obesity, smoking and diabetes prevention. With obesity, a lot of people who are overweight do pretty well, and we don’t have a good intervention to prevent obesity. So I would target people with obesity and other problems, like high blood pressure or diabetes. And for sure I would target the morbidly obese, people with a body mass index above 40.