Introduction
Preventive medicine as a concept that started as a health movement that turned into a policy has faced a lot of opposition recently. The debates that have started about this issue provided some factors for and against prevention even though most ordinary people would mostly stand for prevention as a beneficial practice. To enlighten the situation that arose within this issue, this paper will analyze prevention as a practice and provide a brief view that stands for the position that it should be separated from market relations and consider health issues above all concerns.
Analysis
Preventive medicine is the section of medicine that is engaged in the process of preventing the development of diseases. This identification includes various practices, beginning from mass immunization of the population against various infectious diseases (for example, diphtheria or whooping cough), along with working out methods of destructing the carriers of these diseases (for example, mosquitoes which are carriers of malarial parasites) and the early prediction of heart diseases.
In providing a clear view of the issue of prevention in medicine, it should be cleared that the medicine itself is an aspect that always has been connected with the financial side.
The medical insurance system has gone through various changes and adjustments that tend to improve the interaction between the financial aspect which is the insurance and the medical aspect which is getting medical care assistance. The prevention of the diseases especially having huge medical and social values, is one of the priority problems not only for public health services but also for the society as a whole, as the real positive effect of the prevention and the strengthening of the health of the population depends on the coordinated actions of various sectors of the society and the health policy.
At first, it should be outlined that the preventive system should be working to be beneficial. Even though the preventive medicine in our public health services has the necessary attention, the priority place was always taken away, thus some developments in the system of health protection in this situation today demand decisions in the field of the organization and practical realization of preventive medicine.
The problems that could be mentioned are the consent about the existence of problems and available prevention methods that solves them, defining the priority problems of health of the population which especially demand decisions in the field of preventive medicine; identification of the role of various services in the system of public health services, working out regional programs and more active use of scientific and practical achievements.
It is necessary to notice, that active participation of the population in working out an effective policy of preventive medicine and its realization in various forms is necessary.
In turn, the forms of interaction with the population demand the use of modern methods of distributing the information about health and involving the population to acknowledge the healthy way of life, i.e. methods of social marketing health and preventive medicine programs.
In the prevention of all non-infectious diseases, a considerable role is played by the mentality and its influence where it is obvious, that all preventive influences are mediated through the mentality of an individual and population groups.
At the same time, the problem of psychosocial stress is of great importance in connection with the political, social, and economic stresses of our time.
The purposeful preventive actions that are pushed toward fighting major factors of risk and the promotion of a healthy way of life, should lead to a considerable decrease in the death rate(for example – cardiovascular diseases) at the population.
This result will be reached by associating the efforts of public health services and the public toward the prevention of the occurrence of new illnesses, instead of implementing new medical technologies and improving the quality of patients’ treatment.
The benefits of preventive medicine are obvious and in some way are logical if separated from financial considerations, whereas for example, the easiest and the most effective way to detect hypertension in time is to constantly measure pressure, especially it concerns those people who are in the risk group. The previously mentioned is the simplest example of the implementation of the preventive practice.
The arguments against preventive medicine are always cost concerned, whereas omitting statistics, preventing should substitute curing in the long term.
Another aspect that could be considered as a preventive practice that could be outlined for cost-effective skeptics is DOT (Directly observed therapy) – “a treatment approach whereby patients are observed by trained public-health workers in an outpatient setting.”
If speaking in numbers, based on the Journal of the American Medical Association “the cost of treating patients after errors in treatment occurred (errors that DOT would have prevented) was $4.8 million. This is the equivalent of 53 percent of the federal budget allocated for the elimination of TB.”
The use of DOT as a preventive therapy can save money in a way that demonstrates that treating a disease is more expensive than preventing it, were “preventive therapy in patients with a positive skin test but no other evidence of active disease–also has the potential to reduce costs associated with TB by ensuring people take the prescribed medication that will prevent their progression to full-blown active TB infection, which costs considerably more to treat.” In this case for those who provide evidence against prevention with numbers, the answer is “$100 of prevention is worth $250,000 of cure.” (Carroll)
However, the analysis of medicine is not always connected with saving, but rather with marketing as the field of medicine and insurance are always connected with expenses.
The functioning of medical and preventive establishments in the current system of market relations, especially in the field of medical insurance with its economic essence, forces the hospitals and clinics to pay direct attention to the marketing processes, while granting medical services that satisfy the demands of the patients
The variety of aspects and medical aid forms generates certain problems in the sense of market relations between the doctor and the patient. Such mutual relations, besides the classical pre-market definitions such as medical aid provision or asking for treatment, gain specific attributes of marketing.
Each of the directions of various medical activities, such as treatment, diagnostics, preventive inspection, obstetric aid and etc., at the industrial essence of public health services against insurance, get marketing essence, and therefore formalized and unequivocally defined.
In addition, when thoroughly investigated and researched, it appears that various kinds of medical activities in the light of market relations between all the participants such as the doctor as the manufacturer of medical services, the insurance as the intermediary, and the patient as the consumer of medical procedures, are extremely not equivalent, and at times inconsistent from the point of view of economic feasibility of the market.
Preventing diseases in the context of market relations, at first sight, is not compatible with the economic feasibility of manufacturing and selling medical services. As a matter of fact, the more there are healthy people, the less classical medical requirements (a requirement for treatment) are needed, and accordingly the lower the demand for medical procedures – which many consider as less preferable for this given market.
As a result in light of the implemented medical activity of a preventive orientation in marketing relations (that concerns preventive rather than curative medical services), it is unlawful to connect the terms manufacture and sale with the medical field.
If considering the market segmentation as a process of classifying the consumers by groups with various needs and requirements, characteristics, or behavior, the preventive orientation of medicine at marketing relations is realized within the limits of a certain segment of the chosen market of medical services.
If this market is formed and oversaturated by the medical services directed toward preventive medicine and the preservation of health and healthy life, then the characteristics and specific features of the given segment of the market are allocated and therefore should be fulfilled accordingly.
Indeed the preventive medicine should be worked out in collaboration with public awareness which should be driven by popularizing the concept of the healthy way of life; in this sense, the people should be more concerned about their health than the medical institutions that will possibly cover their medical care. Thus the preventive initiatives should contain educational programs that will encourage this awareness.
Following the previous outline there is a responsibility for doctors to participate in raising health awareness considering that “Despite assertions that managed care and health maintenance organizations (HMOs) are concerned about disease prevention and health promotion, they rarely give patients the advice they need to modify risky behaviors.” (“Is Your Doctor Giving” 1) This fact should give a possible direction for managing prevention effectively, as oral advice is an effective and “free” step to start prevention today.
However, according to a study by the University Prevention Research Center, while “Ninety-seven percent of physicians feel that it is their responsibility to give the advice to modify patient behavior to reduce risk factors”, “the provision of preventive services by doctors is relatively rare. Less than half the respondents reported any physician advice about prevention.” (“Is Your Doctor Giving” 1)
Conclusion
In general, the paper, while arguing for prevention, some aspects were not approached such as the cases where large costs of preventive practices proved ineffective afterward. The reason is that the bad examples are not indices for success or failure, and the essence of prevention will always be to help improve medical care and predict the disease earlier so the healing process can be more effective. Finally, as mentioned by the US Preventive Medicine – the main goal is “to change the health care system from a legacy of treatment to a culture of prevention.”
Works Cited
Carroll, Patricia. “A Penny of Prevention Saves a Dollar of Cure.” World and I. 1998: 303+.
“Insurer Pushes Health Incentives; CareFirst Wants Maryland to OK Preventive Care Program Bill.” The Washington Times. 2007: C09.
“Is Your Doctor Giving You Sufficient Advice?.” USA Today (Society for the Advancement of Education). 2000: 1.
Prevention Medicine Research Institute. The Dr. Dean Ornish Lifestyle Modification Program. 2008. Web.
US Preventive Medicine. Prevention Movement. 2008. Web.
Kesler, Bruce. NYTs Practice Of Medicine. 2008. Web.