Safeway emphasis on preventive care a model for nation

Our nation offers the best healthcare in the world. As a Maryland senator, I take pride that my state is the home to some of the world’s most renowned medical facilities, including Johns Hopkins University Hospital, the University of Maryland Medical Center and the National Institutes of Health. Although we have done a remarkable job of treating illness, we have not done enough to prevent disease and promote wellness.


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Today, more than half of all Americans live with at least one chronic condition, accounting for 75 percent of all healthcare spending each year. Specifically, five chronic diseases — heart disease, cancer, stroke, chronic obstructive pulmonary disease and diabetes — are responsible for more than two-thirds of all deaths in the United States. All of these conditions can either be prevented or better managed if patients stop smoking, lose excess weight and increase their level of physical activity.

A study by the Trust for America’s Health found that by investing $10 a person per year in programs that increase physical activity, improve nutrition and prevent smoking and other tobacco use, within five years the U.S. could save more than $16 billion annually.

Another study by the U.S. Diabetes Prevention Program found that more than half of the new cases of Type 2 diabetes could be avoided by shedding excess weight and walking more. Just consider that today the federal government spends approximately $65 million on diabetes prevention, yet the yearly cost of treating diabetes and its symptoms was estimated at $174 billion in 2007.

 Safeway, one of the nation’s largest employers, has built a culture of health and fitness and it has made a difference. Its innovative approach, called “Healthy Measures,” offers reduced healthcare premiums to employees based on four criteria: tobacco usage, healthy weight, blood pressure, and cholesterol levels. Obesity and smoking rates among Safeway employees are 30 percent lower than the national average, and the company has been able to keep healthcare costs constant over a four-year period.  That’s a real achievement, and one that should be emulated nationally.

With healthcare costs continuing to outpace inflation, and health premiums outpacing working families’ incomes, a key goal of healthcare reform must be to bend the cost curve. Nationwide, between 2001 and 2008, the cost of healthcare increased by 78 percent, much faster than wages increased. Per capita, we spend twice as much on health services as the next most expensive nation. It has reached a staggering 18 percent of our GDP. Consider that in 2006, the annual health insurance premium for a Maryland family averaged $12,000; by 2016, it is estimated that the cost will more than double to more than $23,000, placing coverage out of reach for many employers and workers. We cannot continue this way.

To bend the cost curve, we need to reduce the onset of chronic diseases before they become much more expensive to treat. Knowing what we do now about the importance of prevention, it seems hard to believe that before 1998 Medicare did not cover cancer screenings or other preventive services. As a member of the House, in 1997 I helped secure the first package of preventive benefits in traditional Medicare. Last year’s Medicare Improvements for Patients and Providers Act gave HHS the authority to expand the list of covered services so that as new, highly effective procedures are discovered, they can be made available to beneficiaries.

We should build on this precedent and ensure that all Americans have access to these lifesaving and cost-saving services.

The HELP Committee bill answers my constituents’ requests for these services, creating an infrastructure to make preventive services available to everyone. It would establish a national strategy for prevention, including educational and outreach campaigns, increase access for uninsured people until we achieve universal coverage, expand authority for employers to create programs similar to Safeway’s, and more.

Earlier this year, I fought to ensure that the Children’s Health Insurance Program Reauthorization Act included guaranteed dental coverage. No child in America should die from tooth decay, which is what happened two years ago to a 12-year-old child from Prince George’s County, Md. Basic oral healthcare is an essential element of wellness, and we can improve our nation’s overall health by improving access to dental providers. The HELP Committee bill makes a good start, by establishing at the Center for Disease Control and Prevention (CDC) an oral healthcare prevention campaign that is focused on prevention and targeted toward underserved groups.

Healthcare reform gives us an opportunity this year to set new priorities for our nation, priorities that encourage prevention and wellness. Today, we spend more than $2 trillion on healthcare each year, but only four cents out of every dollar is invested in prevention and public health. It’s time to reverse that trend and put our healthcare dollars where they can do the most good.

Cardin is a member of the Senate Budget Committee.