Docs won’t benefit from prevention cuts

The just-released House Republicans' payroll tax plan aims to increase doctors’ Medicare reimbursement by dramatically cutting the Prevention and Public Health Fund by more than two-thirds. We must address the rates that Medicare pays doctors, but doing so by raiding the prevention fund is a short-sighted solution that will cost money, not save it. Quality, affordable medical care and community prevention work hand-in-hand. Congress must find another way.

Every dollar we divert from prevention will cost us as much as five dollars down the road. By reducing expenditures and reducing need in the first place, investments in comprehensive prevention bend the cost curve and stem the rising tide of expenditures on preventable chronic diseases.

By supporting local communities through $15 billion over the next ten years, the Fund advances our nation beyond a focus on sickness and treatment to one of ensuring health and well-being through innovative, evidence-based community prevention. Communities are already putting these strategies to work in their neighborhoods, addressing the chronic diseases that place the heaviest cost burdens on our health care system.

Prevention works. A recent Gallup poll found that U.S. businesses suffer $153 billion in annual lost productivity due to chronic diseases, including those resulting from lack of access to healthy food and opportunity for physical activity.  Since Johnson and Johnson implemented workplace wellness programs in 1995, the percentage of employees who smoke dropped by more than two-thirds. The number who have high blood pressure or who are physically inactive declined by more than half. Johnson and Johnson’s wellness programs saved the company $250 million on health care costs over the past decade. In times of great economic need, our businesses, our communities and our health care system will all benefit from more prevention funding—not cuts.

Public health is not separate from health care delivery. In fact, in a new national survey from the Robert Wood Johnson Foundation, 3 out of 4 physicians surveyed wished our current health care system would cover the costs of addressing their patients’ social needs, the very needs community prevention resolves–such as lack of safe open spaces for physical activity and lack of meaningful access to affordable housing and nutritious food. Furthermore, 85% of physicians reported that it was as important to address these unmet social needs as medical conditions.

Using the Fund as an offset for the “doc fix” takes our country backward, stifling the opportunity to build a health care system where public health and health care are fully integrated. We will advance the health and well-being of our nation by helping public health and health care work together better, not by pitting them against each other.

Cohen is founder and Executive Director of Prevention Institute, a national non-profit dedicated to improving community health and equity through effective primary prevention.

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