The Real Benefits of Prevention

Unfortunately, Charles Krauthammer's Aug. 14 op-ed column, "The Great 'Prevention' Myth," perpetuated more myths than it debunked.

The recent Congressional Budget Office letter to which Mr. Krauthammer referred focuses solely on screening and diagnostic testing, known as secondary prevention. While early detection is cost-effective for some diseases, it is not designed to save money.

On the other hand, there is a growing body of evidence showing that investing in primary prevention to avert chronic disease (such as preventing smoking and obesity) and tertiary prevention to manage chronic diseases (such as by coordinating care) improves health outcomes and saves money.

For example, Medicare beneficiaries with multiple chronic illnesses see an average of 13 different physicians, fill 50 different prescriptions annually and are 100 times more likely to have a preventable hospitalization than someone with no chronic conditions. Care coordination programs such as the Veterans Administration's Home-Based Primary Care Program have reduced hospital stays by 62 percent, nursing home stays by 88 percent and costs by 24 percent for high-cost chronically ill patients.

Prevention won't pay the entire bill for health-care reform, but the CBO and the media ought to recognize that primary and tertiary prevention programs will do more than pay their share.

ERIC J. HALL

President and Chief Executive Officer

Alzheimer's Foundation of America

New York