In a 50 year review of Medicare in the NEJM, Blumenthal, Davis and Guterman propose several reforms to support the sustainability and effectiveness of Medicare. Their analysis is rather shallow, neglecting the value of lifelong prevention and health promotion as a means of reducing and delaying the impact of major causes and cost drivers of disease. Is it not time to take advantage of the benefits of effective workplace prevention and health promotion for Medicare costs?
One way to do this involves measuring and reporting the risk profile of people starting on Medicare and building a means of assessing at a population/employer level the degree to which prevention programs could have enhanced their profile. That assessment could then be translated into incentives to employers.
Starting with a retirement health status report could lead to a greater investment in prevention and health promotion before retirement. If successful, this may lead to a healthier and more independent retired population that is less costly to Medicare with additional benefits to national debt and required tax changes due to an aging population.
How do you think we can best prevent Medicare costs resulting from a lack of chronic disease prevention? Do you think employers or other stakeholders (government, academia, or a combination thereof) should lead this charge? Let us know in the comments below.
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