08/13/2009 05:12 am ET Updated Nov 17, 2011

Health Care Reform: Paying for Prevention, not Procedures

With health care reform in the news every day, it's so hard to sort all the hype and lobbying spin from the real issues. It's a giant blame game, tinged with a threat of socialism, that has the media and the public all distracted and confused. If we peel all that confusion away, what is really at the root of the health care problem in the United States? (And it is a problem -- the most expensive and least effective in the world.)

The problem is that we (the public, the government, and insurance companies) pay doctors -- thus rewarding them and incentivising them financially -- for doing procedures, not for preventing disease in the first place. Hospitals and insurance companies make their money from CT scans and MRIs, not yoga classes or massage sessions. Doctors make their money from ordering tests, not from teaching people how to exercise and eat right. Prevention is an afterthought that's considered a little bit hokey, rather than the thing that keeps you out of the hospital or doctor's office to begin with.

It's an old story, one that goes back to the 1950s, when my grandfather launched Prevention magazine. But at least now there are thousands of studies that show preventing diseases works best, and tons of financial evidence to support the fact that preventing disease is financially more effective than treating it. And the people who make fun of prevention are in the minority now, not in the majority, as they were in my grandfather's day.

It's a bold move to try and figure out how to turn an intricate and entitled financial-reward system upside down, and make money from keeping people healthy rather than fixing them once they are sick. But somehow, we have to figure that out.

We will always need doctors and hospitals. People will always get sick and injured, and women will always have children (we hope). I am personally grateful that doctors and hospitals got me through three difficult childbirths and once saved my daughter's life. But I also see how my mother has had a better quality of life and is living longer than expected by not going through aggressive treatments for cancer.

Rethinking the reward system takes a whole different mindset. But it's a mindset we need to find, and learn to live in, if we want to live longer, healthier, happier, and more affordable lives.

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