Abstract
Preventable illnesses like type II diabetes, obesity, and hypertension affect a progressively larger proportion of the population. This paper explored the US healthcare system’s reactive approach to these diseases and suggested alternatives. Proactive and preventive healthcare was suggested as a feasible alternative to reactive healthcare. The discussed chronic diseases could be primarily attributed to modifiable lifestyle choices like smoking, drinking, not exercising, and overeating. Early detection, an appropriate and individualized preventive treatment plan, and appropriate behavioral changes were shown to reduce instanced of these illnesses. Moreover, preventive healthcare was a cheaper method in the long run. This study argued that a proactively oriented system should be created as appropriate and supported by research regarding both health and economic implications.
Introduction
I have recently experienced the saddening event of losing my mother, who passed due to many health problems, including kidney failure, diabetes, and high blood pressure. Hence, the problem under discussion concerns many chronic diseases that are preventable and yet worsened by a lack of appropriate healthcare and lifestyle guidance. A critical re-evaluation is especially significant since preventable illnesses like type II diabetes, obesity, and hypertension affect millions of Americans. Therefore, the following research question is posed: Should the US instigate reform of its healthcare system to be proactive and prevention-focused to reduce chronic disease rates and costs while improving accessibility? The following objectives were then set: to establish whether these diseases are preventable by proactive care; to demonstrate the benefits of preventive care; to discuss the structure and costs of the suggested reform.
Methodology
The relevant scholarly literature was obtained using school library databases and search engines like PubMed. Relevant and recent works were then selected and reviewed, with common themes identified for the literature review. The proposal initially included interviewing several healthcare providers plus receiving a statement from insurance company’s representatives and local spokesperson regarding their perspectives on the concept of proactive care. Unfortunately, this was not deemed feasible due to the time and capacity constraints. Hence, the results are presented based on literary research.
Literature Review
Preventing Chronic Illnesses with Proactive Care
For this research, healthcare can be divided into two major categories: reactive and proactive (also referred to as preventive or prophylactic). US healthcare is primarily reactive, meaning that healthcare providers respond to an injury or an illness after its occurrence or development (Wise et al., 2016). Meanwhile, proactive healthcare entails taking action before symptoms manifest, allowing to mitigate a disease before it becomes a significant health risk (Wise et al., 2016). The difference between these two approaches clearly manifests in handling chronic illnesses since the proactive approach allows potentially avoiding a lengthy treatment process. Chronic conditions like “cancer, diabetes, hypertension, stroke, heart disease, respiratory diseases, arthritis, obesity, and oral diseases” are the US’s leading cause of mortality and disability (Raghupathi & Raghupathi, 2018). It would be thus reasonable to include prevention of such severe illnesses in the healthcare routines.
Chronic disease management requires healthcare providers to approach the problem from many angles. Several critical risk factors were identified upon which the patients may be placed in appropriate risk groups. Wise et al. (2016) list “tobacco use, alcohol consumption, physical inactivity, [and] unhealthy eating” as contributing to over 90% of all chronic diseases altogether (para. 15). If the risk factors are known, the providers can develop personalized treatments easier since the underlying causes are already connected with the respective illnesses. Wise et al. (2016) further note that all four of these factors are “modifiable,” which means that providers may proactively intervene to help patients alter their behavior and mitigate the illnesses’ onset (para. 16). Thus, knowing the underlying behaviors and environmental factors enables physicians to guide patients toward making lifestyle changes to manage chronic diseases.
However, there are certain limitations to the preventive care administration. One of the significant factors is the effort-benefit balance: for instance, obesity reduction programs, despite being beneficial, are difficult to commit to and succeed (Taksler et al., 2019). Such an observation is understandable given that the excess number of tasks may quickly become overwhelming and thus demotivating. However, Taksler et al. (2019) find that patients are most likely to be motivated if they know they can receive individualized suggestions, ideally, those that are quicker, easier, and cheaper. These factors vary depending on individual priorities and abilities, so a personalized approach is vital.
Benefits of Preventive Care
Various benefits of preventive care have been established in the literature. While reactive healthcare incorporates lifestyle change discussions to an extent, they are often superficial and not comprehensive enough (Wise et al., 2016). Considering that reactive treatments are done post-factum, it is understandable – once a disease is developed, one may not see much benefit in changing the habits. However, Raghupathi and Raghupathi (2018) state that prevention can simultaneously reduce costs and improve outcomes. Having a patient know how to prevent or mitigate a chronic disease allows them to act before severe symptoms are present. In turn, improved understanding enables the patients to actively seek suitable and timely treatment, creating a more personalized care model (Raghupathi & Raghupathi, 2018). Further, incorporating a prevention-oriented model reduces readmissions and encourages providers to ensure the best outcomes for the patients.
Moreover, the proactive healthcare framework may attract more attention to propagating good health rather than merely avoiding illness. Wise et al. (2016) state that promoting healthy behaviors is crucial as it fosters long-term solutions. In other words, if proactive treatment is prioritized, the effects will be far more reaching and long-lasting. Furthermore, when people are free from chronic diseases, their productivity and life quality improve (Wise et al., 2016). Therefore, preventive care benefits the economy, health, and quality of life.
Structure and Costs of Healthcare Reform
To understand the need for healthcare reform, one must investigate the system’s present state. Chronic diseases in the US account for around 75% of healthcare expenses, or even more when public insurance is considered (Raghupathi & Raghupathi, 2018). This percentage allows one to comprehend just how serious – and expensive – the issue of chronic illness is in the US. Healthcare costs have skyrocketed, with a day of hospitalization costing $2,602 and between 17.8% and 35% of adult Americans having healthcare debt (Consumer Financial Protection Bureau, 2022). Moreover, the percentage of uninsured Americans is rising, currently at around 8.9%, which is alarming given that those without insurance are charged, on average, 2.5 times more for hospital care (Consumer Financial Protection Bureau, 2022). High costs, the lack of insurance, and confusing billing systems have led to widespread healthcare avoidance, notably among people with chronic diseases and disabilities and from underprivileged groups (Consumer Financial Protection Bureau, 2022). Thus, the financial situation with the treatment of chronic diseases is dire.
Furthermore, chronic illnesses have various impacts on all levels of finances, from individuals to the whole economy. Chronic illnesses frequently require continued care and may extend for as long as an individual’s lifespan (Wise et al., 2016). As previously discussed, continued care, readmissions, and other factors drive the expenses up, so preventing it is the best course of action. Therefore, catastrophic consequences for the US economy may occur if this issue is unresolved. Ananthapavan et al. (2021) further this argument by stating that effective preventive health policies need to be informed by cost-benefit analyses. The US could use the international experience from other developed countries to improve its healthcare system. To support preventive programs effectively, Nath (2018) calls for the growth of health insurance coverage. This suggestion is especially important when considering the growing number of people struggling with obtaining or keeping insurance. Overall, well-designed resource allocation and inclusion of preventive medicine in the insurance programs have the potential to improve the financial situation surrounding chronic disease management.
Conclusions
Based on the evidence obtained from the literature review, there is a clear need to foster a proactive healthcare system in the US. The spread of chronic diseases throughout the country increases, and the health impacts are devastating. However, most of these diseases can be attributed to a few habits that can be modified if administered an appropriate and individualized plan. Essentially, most chronic conditions that are the leading cause of hospitalization, morbidity, and mortality in the country can be prevented by timely detection of risk factors and appropriate behavioral modifications.
Moreover, preventive healthcare should be available to all citizens regardless of their socio-economic class and insurance since the costs for the uninsured are much higher, causing healthcare avoidance. The proactively oriented system can be funded through Medicare for that reason. The structure and costs were evaluated, highlighting that despite the potential increase in costs through Medicare, the proposed reform would result in tremendous long-term savings due to fewer readmissions, increased productivity, and decreased healthcare costs in other areas. Although potential healthcare reform expenses may seem high since it is a large-scale project, the current system does not present a viable long-term solution. Thus, it can be concluded that the US should instigate the healthcare system reform to shape it as a proactive and prevention-focused since it desperately needs to reduce chronic disease rates.
References
Ananthapavan, J., Moodie, M., Milat, A., Veerman, L., Whittaker, E., & Carter, R. (2021). A cost-benefit analysis framework for preventive health interventions to aid decision-making in Australian governments. Health Research Policy and Systems, 19(1), 1–23.
Consumer Financial Protection Bureau. (2022).Medical Debt Burden in the United States(pp. 1–53).
Nath, D. K. (2018). Insurance for outpatient and preventive care — future of health insurance. Bimaquest, 18(2), 17–38.
Raghupathi, W., & Raghupathi, V. (2018). An empirical study of chronic diseases in the United States: A visual analytics approach to public health.International Journal of Environmental Research and Public Health, 15(3), 1–24.
Taksler, G. B., Beth Mercer, M., Fagerlin, A., & Rothberg, M. B. (2019). Assessing patient interest in individualized preventive care recommendations.MDM Policy & Practice, 4(1), 1–14.
Wise, A., MacIntosh, E., Rajakulendran, N., & Khayat, Z. (2016). Transforming health: Shifting from reactive to proactive and predictive care (Transforming Health Market Insights). MaRS.