Last month, the House of Representatives made headlines with their vote on a 2012 budget developed by Representative Paul Ryan. The budget would, among other things, make significant changes to Medicare and other entitlement programs. Paul Ryan’s budget would replace Medicare as we know it with a voucher system, offering subsidies to seniors to purchase private plans. While some reports have suggested that House Leadership is abandoning the significant changes to Medicare, reports this morning indicate that House Majority Leader Eric Cantor remains in support of the Ryan budget and its changes to Medicare. Those changes to Medicare are now at the center of the controversy surrounding the 2012 budget. The controversy has ushered critical questions into the national conversation: How do we control rising health care costs? What is the government’s responsibility when it comes to health? Missing from the conversation, however, is any substantial discussion about the need to invest in strategies that can prevent some of the most costly conditions in the first place.

Prevention strategies focus on the population as a whole; this is an excellent time to hone in on how prevention strategies reduce health care costs, and can show particular benefits amongst our older adults. This week, we are providing a selection of the many analyses and opinion pieces that have responded to the potential Medicare changes, as well as some concrete ways that you can ensure that prevention remains a part of the conversation.

The Stories

Several commentators commented on the Ryan budget in relation to rising health care costs. David Brooks, of the New York Times, suggests that the Ryan Plan is a starting point for conversations about rising health care costs in the US: “Just about every expert agrees with the following proposition: We can’t afford to have Medicare pay for every new procedure that medical technologists devise.” Brooks does not mention any potential savings associated with keeping the American populous healthier in order to control these expenditures. A Forbes blogger also tackled the issue of out-of-control health care costs, suggesting alternative changes to the insurance model as a solution.

This NPR piece, “Remaking Medicare: Saving Money or Shifting Costs?” suggests that the Ryan plan does little to address the issue of rising health care costs and thus is likely to simply shift the costs from the federal government to older adults.

Dr. Donald Berwick, administer for the Centers for Medicare and Medicaid Services, wrote in his op-ed for the Wall Street Journal: “we all agree that we need to reduce our deficit and debt. Reforming Medicare and reducing health-care spending is crucial to meeting that goal. But there's a right way to reform Medicare and a wrong way.”

Prevention Institute brings prevention into the conversation, in an opinion piece published in TheHill.com. Larry Cohen writes that our federal government can take on Medicare as a means to address the budget deficit, but that cutting coverage for our older adults is not the right solution: “The Ryan plan doesn’t focus on any of the drivers of health costs, and it doesn’t make anyone less sick…. If, instead, we reduce the number of people injured and ill in the first place, we won’t just save money. We will save lives.”

Tips to guide your conversation:

Having a productive discussion about controlling soaring health care costs requires that we talk seriously about prevention. By preventing costly, preventable diseases in the first place, we will save money and lives. Prevention advocates must ensure that conversations about health care costs in America carefully consider the value of investing in prevention.

We can make our health care system healthier with prevention. Prevention provides a landmark opportunity to create a system that truly promotes health. The US spends more per capita on health care expenditures than many other developing countries yet consistently lags in health outcomes. Prevention promotes health care, not sick care.
Healthy people live in healthy, safe and equitable communities. Almost nothing affects our health as profoundly as the places we live. People thrive when they have jobs and live in communities with safe affordable housing. They thrive when they have easy access to parks, playgrounds, and grocery stores selling nutritious food. Healthy communities provide the foundation and context for healthy behaviors and outcomes. Community prevention makes that possible.
The public wants prevention. Prevention was one of the earliest implemented parts of health reform because there is a groundswell of public support for prevention. 73% of Americans support investing in prevention.

Here's what you can do:

Any conversation about health care costs presents and opportunity to incorporate prevention messaging. Write a blog, op-ed, letter to the editor of your local paper or comment online in response to a news story or blog posting.
Have a successful example of community prevention in action? Please share it with us so we can include it in our talking points.
Visit our Health Reform Advocacy page for more information.
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