An Appeal for Universal Preventive Care

21 08 2008

It’s campaign time and no matter who you’re voting for, you’re bound to see some change in Washington following this November’s election. I’ve never delved too deeply into public policy, but I’d like to suggest a public policy for universal health care. Not the uber-expensive, tax-you-50%-of-your-income version that guarantees full health care at any health facility (as in Germany, where they spare no expense to make sure you get the absolute best treatment but tax income heavily).

Rather, I suggest a universal PREVENTIVE CARE plan that guarantees every citizen will be afforded a personal regimen of preventive care treatment. Preventive care has a whole host of benefits, not least of which is reducing the ultimate cost of health care by eliminating high-cost failures before they happen. Preventive care is essential to providing individuals with the regular health guidance they need to make more accountable health choices and achieve early identification of potentially dangerous conditions. A national preventive care program could also push individuals to augment the national preventive care program with private emergency care insurance that could more accurately reflect the costs of riskier health choices – further encouraging individuals to recognize the high cost of smoking, overeating, and other dangerous health habits.

One doctor from the University of Virginia’s hospital recently briefed MBA students at the Darden Graduate School of Business about her concept for starting a preventive clinic for women. She struggled to put together a financial model that supported ongoing operations due to the expensive nature of the medical professionals required to staff such a clinic and the unreliability of patients making and keeping appointments. As she pointed out, it is often the individuals at the highest risk that are least likely to seek preventive care. But she spoke convincingly about the need for addressing obesity-related illnesses like diabetes and heart conditions and providing care in an environment targeted at the needs of a specific group – in this case, women. In order to make her dream come true and support the development of a nationally-guaranteed preventive care program, I recommend the federal government specify programs of preventive care at guaranteed rates that can be financed through the existing employee insurance benefit channels and individual insurance plans with federal incentives to spur the creation of a preventive medicine industry.

My national preventive care plan calls for funding a new vocation of PMDs – preventive medicine doctors – that are trained more heavily than nurses but less so than surgeons and other MD specialists. Such preventive care specialists would function much more like counselors or, as I prefer, “health coaches” than surgeons, providing individual care and guidance through a regular pattern of interaction and accountability. Earning potential could likely mirror the moderate educational requirements – more than nurses, less than emergency room MDs, further enabling a lower cost of health care in this country.

This would spur the creation of new jobs, new educational positions, and innovative new business models as preventive health clinics begin operations. States would be empowered (as they are currently) to license practitioners and regulate the industry. The United States would continue its position of leadership in medicine as it explores the most effective means of preventive care, offering an example to other nations of how to care for the individual without commandeering services by the state.

Since this is not a nationalization of all health care risks but only the transfer of use-it-or-lose-it basic preventive care, this should amount to a financial risk sharing instrument between the federal government, which would indicate essential standards for qualified preventive care, and private health insurance which would continue to underwrite the risk for additional emergency care. The private insurance companies would gain regular checkup information through preventive care visits, allowing the insurance companies to more accurately price the risk of a patient’s future care.

I’m no expert in health care but I’ve come to believe in the sensibility of federal guidelines for preventive care and financing to create the industry of practitioners, so I’d be curious to hear your thoughts on this idea of universal preventive care guaranteed for citizens.




2 responses

3 03 2009

There is a program already. It is located at Loma Linda University, School of Public Health. It’s a doctoral program that focuses on preventive care. It trains students to examine the root causes of the disease and promote ways to prevent, reverse or minimize risk. I would disagree with you regarding trying to convert physicians into “preventive medicine doctors” or preventive care specialists. Physicians by definition treat disease not prevent it. This program is only offered at LLU and at another school in the Philippines.

20 11 2009

There is no need to “convert” physicians. Rather, if training for these PMDs were more widespread, there could be a new generation of health care professionals. Just like its stated in the article.

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