Save lives, save money and improve quality of life

Save Lives, Save Money and Improve Quality of Life

Education, early diagnosis and intervention for disease prevention and wellness promotion.

Stephen Holt MD, LLD (Hon.) ChB., PhD, DNM, FRCP (C), MRCP (UK), FACP, FACG, FACN, FACAM, OSJ
Distinguished Professor of Medicine

HOW DO WE GET THE GENIE OUT OF THE MAGIC LAMP?

CLOSER INSPECTION OR DIFFERENT ANGLES CREATES NEW PERSPECTIVES OR TRUTH

DISEASE PREVENTION
PRIMARY PREVENTION- political initiatives,e.g. prohibition.
SECONDARY PREVENTION-early diagnosis with intervention to e.g. screening. Under-funded, Ignored?
TERTIARY PREVENTION-disease rehabilitation. The bulk of the cost.

REALITIES
Major cost of healthcare is chronic disease management where limited recovery prevails.
U.S. healthcare is not portable.
Disease prevention saves money.
Political, economic, medical and social opinions continue to pay “lip-service” to preventive medical strategies.
Wellness promotes fraternity, happiness and quality of life which enhances productivity.

FACTOIDS
Disenchantment with conventional medical practices, e.g. overuse of drug prescriptions and poor healthcare delivery have lead to:

Greater self-reliance of patients to self-diagnose, self-medicate, often with uninformed judgment. EDUCATION
Patients seek what they perceive to be safer, simpler and gentler options for treatment (advent of DSHEA 1994 and “alternative medicine”). EDUCATION

ROLE FOR SECONDARY PREVENTION
Lifestyle is a major factor in premature death and disability.
Identification of adverse lifestyle or risk factors for disease with appropriate interventions have been shown often to reduce the prevalence of chronic disease.
Disease risk remains “occult” or “hidden” in many circumstances, despite the obvious.

EXAMPLE: ALCOHOL PROBLEMS: THE TIP OF THE ICEBERG
$ ESTABLISHED ALCOHOLIC: TERTIARY PREVENTION

SUPER-SIZING AMERICA
Americans exude complacency about their overweight status
Obesity is part of a metabolic syndrome
Syndrome X is under diagnosed and often mistreated by conventional and alternative medicine

SUPERSIZING THE WORLD

EARLY DETECTION OF DISEASE SAVES LIVES AND MONEY
American Cancer Society, Common Facts and Figures, 2002

EARLY DETECTION OF DISEASE SAVES LIVES AND MONEY
SCREENING: use para-professionals, self administered questionnaires or assessments, novel screening methods e.g. computer assisted testing of lifestyle.
INTERVENTION: screening is useless without the correct intervention.
SECONDARY PREVENTION is useless without education.

EDUTHERAPY
The most important, least expensive initiative to save healthcare costs is patient education.
Secondary prevention must be combined with a wellness program that can promote good health through education.

TARGETS AND OBJECTIVES
Improve wellness among subscribers to healthcare programs: social and medical benefits to membership with greater contentment, quality of life and productivity.
Increase “benefits” for health without increasing cost. This involves leveraging the value of early diagnosis, efficient medical screening and cost effective intervention.

SOLUTIONS: CASE STUDY
Local Union 1,250 families, 3,000 participants.
Blue Cross: fiscal intermediary for the self-insured union fund by providing $35m/y in services. (a hypothetical value)
Union pays only $14m/y claims with $3m co-pay because Blue Cross has an overall 50% discount.
How do we reduce the real cost ($14m/y)?

SOLUTIONS: CASE STUDY
The union budgets $250/person/y for wellness
Take this 750k budget and use it properly.
Recruit an organization that can provide cost effective secondary prevention and education, with options for discount of wellness promoting items or products e.g. nutrition, exercise, substance abuse counseling etc.
Triage health problems toward the most cost effective interventions. ALL involve education.

ANTICIPATED OUTCOME
Patient education, early diagnosis and intervention saves lives and costs.
Case study: guesstimate savings $2-4m/y, based on reduced cost of screening (c.f MD screening), more-cost effective utilization of medical services and long-term cost savings from reduction in chronic disease prevalence.
Wellness programs often involve self management, evidence-based, non-allopathic interventions which match changing treatment paradigms-the new consumer demand!

THE GENIE IS OUT OF THE LAMP!

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