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Prevention: Saving seniors, Medicare — and a trillion dollars

Ryan and his friends are laser-focused on cutting over a trillion dollars, but their myopic view prevents them from seeing the innovative and responsible way to get there—not by making your grandma search for a health insurer on the open market, or by having your dad cover close to 70 percent of his own medical costs by 2030, both real scenarios under the Ryan plan.

Older adults, like the entire population, need multiple interventions to protect their health and save money. Eliminating medical mistakes, better utilization of health information technologies, and reducing costs and increasing efficiencies of care are all important elements—and prevention is crucial.

California is facing a $59 billion obligation for state retiree health costs. State Controller John Chiang’s response? We must make “prevention and chronic disease management a priority to reduce the demand for healthcare.” Chiang said, “If we can reduce the assumed rate of healthcare inflation by 1 percent, that could cut our unfunded liability by $7.4 billion.”

Our nation can achieve that same 1 percent reduction—and save just under a trillion dollars over ten years—not by leaving our elderly sick and untreated, but by making them healthier, stronger and more independent.

Falls, one of the leading causes of injuries to seniors, cost our country more than $19 billion a year in direct medical costs and lead to a cascade of debilitating and avoidable medical complications. Similarly, unhealthy eating cost our country $147 billion in medical bills in 2008, double what it was a decade ago. Much of that was financed by Medicare and Medicaid.

We need simple changes like curb cuts, increased crosswalk safety, access to fresh fruits and vegetables for our parents and grandparents, and opportunities for them to get out and be physically active—safely and easily. These strategies show a 5-to-1 return on investment—a better value, and a better outcome, than anything the Ryan plan has to offer.

Ryan’s plan wouldn’t start for another 10-plus years, when today’s 54-year-olds turn 65. During that time, a prevention focus would save money for seniors, start to lower the costs of those now aged 55-65, and provide a 10-year down payment on prevention for the younger generation.

Seniors prefer the current Medicare system by a 2-to-1 margin—62 percent vs. 30 percent—when compared to Ryan’s plan, according to The Kaiser Family Foundation’s April Health Tracking Poll released this week. They know what we know: saving money can’t come at the expense of the frailest members of our society.

We can take on Medicare as a means to address the budget deficit—but we have to do it effectively and compassionately. The right approach is to invest now in prevention.

Larry Cohen is founder and executive director of Prevention Institute, a national non-profit that focuses on prevention and wellness strategies to save lives and build equity.


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