Wednesday, January 24, 2007

What's a Pound of Prevention Really Worth?

As another example of what is wrong with the current US health care system, here is an article from today's New York Times describing how insurance companies would sooner pay for an expensive coronary stent than for a patient to sit down and talk with their healthcare provider about low cost changes in diet and exercise.
"We have made major improvements in prevention," Dr. Gregg W. Stone, the director of cardiovascular research at Columbia University, says. "But it's difficult. It takes frequent visits, a close relationship between a physician and a patient and a very committed patient."

Which is exactly the atmosphere Dr. Agatston's practice tries to create. Nurses there give patients specific cholesterol goals to meet and help them deal with the side effects of the drugs they are taking. A nutritionist, Marie Almon, meets with patients frequently enough to discuss real-life issues like how to stick to a high-fiber Mediterranean diet even on a cruise or a business trip.

There is only one problem with this shining example of a medical practice: it is losing money.

What's a pound of prevention really worth?

To a primary care doctor, it is the difference between vitality and disability, between having happy and healthy patients vs. long medication lists and repeated hospitalizations.

To a patient, it could be the difference between seeing your grandson's wedding vs. not living to see your daughter's 1st day at school. It could be, to quote a well-known commercial slogan, priceless.

But to many insurance companies, it ain't worth squat.