HEALTH CARE: Prevention, Way Beyond an Apple a Day

I was about to recommend Minna Jung's thoughts on preventive care at the RWJF's Users Guide to the Health Reform Galaxy blog, when I realized she ended her post by recommending mine.... But the points we both made, about the need to understand that prevention is broader than giving people screening tests to detect disease, and that its economic benefits may not be easily measured in the short-term windows of federal budget policy, are illustrated in the real world at the Cleveland Clinic.

TIME took a look at the preventive health and wellness programs that the Cleveland Clinic is running for its own employees in its recent special edition on health. (Since this is a prevention post, we could explain that it took us nearly a month to read the article and photo essay because we swim more in the summer, and treadmill more in the winter, and we can't read magazines in the pool. But we digress.) The clinic, internationally renown for its technologically sophisticated medicine, is now putting at least some of its energy into things like hiring chefs to teach its workers how to fry food with less oil -- or better yet, to grill. No longer will helpful ER personnel offer to send out for food for a family waiting for test results -- and produce Kentucky Fried Chicken. 

The clinic wants to improve health. It also wants to prove that wellness pays:

The Cleveland Clinic's own experience suggests that [chief wellness officer Dr. Michael] Roizen's confidence in prevention's payoff is well founded. The hospital's chief human-resources officer anticipates that after growing between 4% and 8% each year over the past six years, employee premiums will not increase in 2010. That's in part due to savings from employees with chronic illnesses who are making lifestyle changes to keep themselves from getting sicker. This saves the clinic between $5,000 and $10,000 a year per patient on claims they would have otherwise filed for treatments such as dialysis, angioplasty or bypass.

The wellness teams at Cleveland are thinking well beyond short-term savings in premiums. They are thinking that wellness, properly done over the long-haul, can not only prevent disease, it can reverse it. And then we'd have a health care system that wasn't about sickness, but about health.