Care or cure?

by Cal Thomas | April 3, 2012 12:01 am

The debate isn’t new, but as the country awaits the U.S. Supreme Court’s decision on the constitutionality of the Patient Protection and Affordable Care Act, commonly called Obamacare, suppose the conversation switched from a health care system devoted primarily to caring for the sick to one that gives top priority to finding cures for disease? A healthier public would sharply reduce expenses associated with catastrophic illness.

There is also the issue of prevention so that while cures are pursued through research, people might order their lives in ways that give them the best chance of avoiding sickness altogether.

A useful starting point is a paper published in 2009 by Partnership for Prevention (www.prevent.org), “A nonpartisan organization of business, nonprofit and government leaders working to make evidence-based disease prevention and health promotion a national priority.” The paper was titled “The Economic Argument for Disease Prevention: Distinguishing Between Value and Savings.”

The authors — three doctors and an executive consultant with an MBA — write, “There are three kinds of prevention. Primary prevention can be accomplished by modifying unhealthy behaviors (e.g., smoking, physical inactivity), which cause many diseases and account for 38 percent of all deaths in the United States, administering immunizations to prevent infectious diseases, and reducing exposure to harmful environmental factors. Secondary prevention can reduce the severity of diseases, such as cancer and heart disease, through screening programs that detect the diseases or their risk factors at early stages, before they become symptomatic or disabling. Tertiary prevention — the effort to avoid or defer the complications of diseases after they have developed — is the current focus of medical care.”

That focus on tertiary prevention is the driving force behind rising health care costs.

As baby boomers age, the cost of treating the rising number of diseases and common illnesses attributable to aging will increase. Finding cures is the most logical approach to keeping health care costs in check.

Take Alzheimer’s disease. Because of medical advances, more people are living longer, and more will likely contract this slow progressing, eventually fatal disease. According to the Alzheimer’s Association (www.alz.org), “Medicare and Medicaid will spend an estimated $140 billion in 2012 on people with Alzheimer’s and other dementias.” Worse, it says, “Caring for people with Alzheimer’s disease will cost all payers — Medicare, Medicaid, individuals, private insurance and HMOs — $20 trillion (in today’s dollars) over the next 40 years. The overwhelming majority of that will be spending by Medicare and Medicaid.”

It would cost far less if we found a cure for Alzheimer’s.

The three leading causes of death in America remain what they have been for some time. According to the Centers for Disease Control and Prevention, they are: heart disease, cancer and chronic lower respiratory diseases.

What is needed is political leadership, not unlike John F. Kennedy’s vision of putting a man on the moon by the end of the 1960s. If the forces of technology can be marshaled to achieve a major task in space, why can’t medical and political forces, working together and without the polarization that divides Washington, find cures for diseases here on Earth? Disease does not discriminate. Democrats and Republicans get sick. Where is the downside to cooperating to find medical cures?

Especially if the Supreme Court overturns part, or all, of Obamacare — but even if it doesn’t — finding cures to diseases that kill is a worthy objective that will produce dividends for millennia to come and contribute to human happiness. It will also substantially reduce the federal deficit and national debt.

It is rare when an issue has no political negatives attached to it and finding cures for diseases is one of them. Working together might even improve the political health of Washington, which, according to opinion polls, is in critical condition.

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