Mr. Parekh and Mr. Hoagland are leaders of a nonpartisan think tank.
The Senate has an opportunity to increase access to preventive health interventions by passing legislation that better measures the long-term budget savings they generate.
Senators should pass the bill without delay.
The Preventive Health Savings Act, passed by the House in March, would task the Director of the Congressional Budget Office (CBO) with determining whether proposed “preventive health care and services” measures would result in budget savings over a decade or more. It will give you authority. Future — and if so, CBO will require that the overall projection of the measure include an analysis of budget cuts.
CBO currently projects the bill's budget impact over a limited time period of 10 years. The bill would authorize the CBO Secretary to measure the budget impact of preventive health interventions for 20 years following the first 10 years.
Why should the Senate pass this bill? Because the potential savings from preventive health interventions often extend far beyond the first 10 years. The more lawmakers focus on the long term, the more likely they are to enact preventative health measures that not only save money but also improve the health of millions of Americans.
We believe that disease prevention must be one of our nation's health policy priorities.
Chronic diseases and mental health conditions account for an estimated 90% of the nation's approximately $4.5 trillion health care costs. And to a significant extent, health care spending drives overall federal spending. In fact, major federal health care programs are projected to account for nearly 40% of all federal spending toward the middle of this century (not including interest payments on the national debt). Medicare alone is projected to account for more than two-thirds of the increase in federal health spending over the next 30 years.
Indeed, in the short term, lawmakers need to enact structural reforms to how the government pays and reimburses health care providers. But implementing reforms to address chronic disease will require more than a decade of focus. Preventive measures often take time to reach their full effect.
Prevention works. Clinical prevention services, such as certain cancer screenings, immunizations, and substance use counseling, reduce disease and save lives. Community preventive services such as smoke-free policies, motor vehicle injury prevention, and diabetes prevention programs (such as physical activity and dietary changes) also improve health.
Prevention is also cost-effective. In fact, the CBO found that “a systematic review of the literature that analyzed hundreds of studies concluded that 20% of preventive health services improved health and reduced costs.” This is especially true for childhood immunizations, tobacco screening and counseling, secondary prevention with aspirin, and alcohol screening and counseling. This also applies to community preventive services such as community fluoridation and the use of motorcycle helmets. Many of the remaining 80% of preventive services are cost-effective and well worth the money.
Projected long-term savings from federal preventive health measures could motivate lawmakers to enact more such measures, which in turn could improve the health of Americans for decades to come. .
For example, Medicare coverage of anti-obesity drugs (combined with such coverage by private insurance companies) will reduce Medicare spending beyond the first 10 years as a result of reduced cases of obesity-related diseases such as diabetes and heart disease. likely to show significant reductions. , cancer, and other health complications.
Similarly, Medicaid requirements that states cover all FDA-approved smoking cessation treatments and behavioral counseling without imposing cost-sharing or other barriers on beneficiaries will also reduce federal and state spending in coming decades. There is a high possibility that it will be done. .
As CBO Director Philip Swagel told the House Budget Committee in late March, his organization is “well-positioned” to provide information to policymakers about the long-term budget implications of preventive care. It is in”. In fact, he said, CBO is already working on several analyzes related to anti-obesity drugs in Medicare, as well as proposals to fund screening and treatment for diseases such as chronic hepatitis C.
The House of Representatives passed the bill in question. Sens. Ben Cardin (D-Md.) and Mike Crapo (R-Idaho) have introduced similar companion legislation in the Senate. The time for that chamber to act is now.
Anand Parekh, MD, MPH, is chief medical advisor at the Bipartisan Policy Center. He is the author of Prevention First: Policymaking for a Healthier America. G. William Hoagland is senior vice president at the Bipartisan Policy Center and previously served as one of the first staff members of the Congressional Budget Office.
