Stanford Medicine Newsletter Updates For the Local Community

 

Health-care reform needs to focus on prevention

Discussions about U.S. health-care reform have largely focused on broadening insurance coverage. That’s unfortunate, says a Stanford researcher, because we should spend more time looking for ways to truly improve health.

In a recent New England Journal of Medicine article, Randall Stafford, MD, PhD, professor of medicine at the Stanford Prevention Research Center, said the health-care system needs to be re-engineered to help people stave off conditions like obesity and diabetes.

“Increasing health-care coverage has the potential to make the inefficiencies of the current system more visible and worsen the current financial stresses in the system,” he said. “We need to think about more fundamental changes in the way that health care is delivered.”

The current model for medical care arose 100 years ago when people didn’t live as long and infectious diseases caused large numbers of deaths. Laboratory research helped develop treatments and technologies to combat these diseases, and a payment structure evolved that compensated doctors for prescribing pills and procedures to treat the conditions.

But the picture has changed drastically today. More Americans are living longer and are dealing with the results of progressive, chronic diseases brought on by factors such as smoking and obesity. Yet the health-care payment structure hasn’t adapted. Strategies for preventing disease — such as coaching patients on how to make meaningful changes that will enhance their health — may be cost-effective, but they can’t be patented or made profitable, which gives researchers little incentive to explore the field.

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