03/18/2010 05:12 am ET Updated Nov 17, 2011

Prevention: Popular Provisions Have Been Largely Overlooked in Health Reform

On Friday, we at the Trust for America's Health (TFAH) released a new public opinion poll with the Robert Wood Johnson Foundation (RWJF) that found that the disease prevention and public health aspects of health reform are among the most popular proposals on the table.

From the poll, it was clear that a majority of Americans see a real payoff for investing in disease prevention in terms of lowering disease rates and reducing health care costs. In addition, we found Americans strongly favor specific proposals that focus on keeping Americans healthier in the first place, instead of only treating them after they've become sick.

More than 70 percent of Americans favored an increased investment in disease prevention, and nearly two-thirds of Americans ranked investing in prevention between an eight and 10 on a scale of zero to ten, where zero means not at all an important health care priority and 10 means very important.

Support for prevention was only second to a proposal to prohibit insurance companies from denying coverage because of age, medical history, or pre-existing conditions, among a range of health reform proposals we tested. Some of the other proposals we tested included providing tax credits to small businesses and requiring all businesses to provide health care for their employees or contribute to a fund to help pay for their coverage.

We also found prevention was popular across the political spectrum (85 percent of Democrats, 59 percent of Republicans, and 68 percent of Independents) and across the country (72 percent in the Northeast, 73 percent in the South, 71 percent in the West, and 69 percent in the Midwest).

By nearly a three-to-one margin (70 percent to 24 percent), people think prevention will save money rather than cost money. Sixty percent of Americans believe investing in prevention is worth it at a cost of $34 billion out of the $900 billion total proposed health reform spending proposals. Sixty-five percent of Americans say they would either be more likely to support a member of Congress who votes for the proposal to invest in prevention or that it would make no difference to their vote.

Majorities of Americans were found to favor specific key disease prevention reform proposals, including:

• 82 percent of Americans favor a proposal to ensure that public health workers are well trained, have up-to-date laboratories, and are adequately equipped to communicate with the public about health threats. 51 percent of Americans strongly favor this proposal;
• 73 percent of Americans favor a proposal to provide for education loan repayment to make sure we have enough public health professionals to combat shortages in health departments and meet health needs. 42 percent of Americans strongly favor this proposal;
• 72 percent of Americans favor a proposal to establish a Public Health Investment Fund that would dedicate annual funding to prevention. This would be used to invest in improving nutrition and physical activity in our schools and communities, expand access to immunizations, and test new approaches to staying healthy so people have the information to make their own best decisions about how to be healthy and prevent disease. 45 percent of Americans strongly favor this proposal;
• 58 percent of Americans favor a proposal to create a National Prevention and Wellness Strategy to coordinate our efforts by assessing the health of our country, establishing priorities, and setting health goals. All community programs would be held accountable to rigorous evaluation to ensure we are investing in things that work. 29 percent of Americans strongly favor this proposal; and
• 58 percent of Americans favor a Preventive Services Task Force, an independent entity that reviews scientific evidence and cost-effectiveness of prevention programs, which recommends ways to improve prevention programs and provide local community health services with key information to help people make healthier choices. 28 percent of Americans strongly favor this proposal.

The poll, which reflects the responses from 1,008 registered voters, was conducted by Greenberg Quinlan Rosner Research and Public Opinion Strategies from November 2 to 5, 2009, and is available on TFAH's Web site at The margin of error was +/- 3.1 percent.