Nip Disease in the Bud for Best Health Care Fix

In the debate over health care reform, the lack of substantive legislation for the prevention and early detection of disease is a concern.

Amid all discussion over insurance and government programs, we have completely glossed over the fact that more than 80 percent of American illnesses are preventable. Real health care reform must include strong incentives and redirection of funds for health promotion and disease prevention.

The need for prevention-oriented health reform is particularly well- illustrated by the recently released statistics indicating an explosive epidemic of diabetes.

In a recently published study in the journal Diabetic Care, research suggests that by 2034, the number of Americans with diabetes will increase to over 44 million, and the cost of treating this chronic illness will rise from $113 billion annually to $336 billion (a threefold increase). The burden of this illness alone has the potential of overwhelming the American health care system, and without major changes to educate and empower citizens to prevent diabetes, we will be ill-equipped to handle the problem.

Although the issue of disease prevention has been largely absent in the national debate, most Americans are well aware of the poor health habits contributing to the growing incidence of preventable illness. From a sedentary lifestyle to poor eating habits, a stressful life to little medical monitoring for identifying problems early, the average American is a candidate for poor health and poorly managed disease.

Despite major campaigns to encourage healthy habits, economic uncertainties, apathy and the ready availability of unhealthy, cheap fast food suggests that the chances are small to reverse this trend.

While the health care community must remain committed to public education, they must also be more attuned to the early indicators of potential illness; they need to act appropriately to prevent or curb further deterioration of health.

For example, the majority of Americans with Type II, or adult onset, diabetes have an elevated blood sugar long before the disease becomes clinically apparent. This condition is called pre-diabetes, which is relatively easy to diagnose by finding a fasting blood sugar above 100 or above 140 two hours after consuming a 50-gram glucose load.

From age 20 on, screening for pre-diabetes should be done every five years for those at high risk of developing diabetes. This includes those who are very sedentary, overweight, have a family history of diabetes or have proven cardiovascular disease.

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