To: i-node who wrote (504701 ) 8/14/2009 11:50:30 AM From: Alighieri Read Replies (2) | Respond to of 1577025 Did you ever consider the human condition aspects of the subject? of course not...you are among the slice of repugnicans who don't give a shit about humans other than themselves. Read it carefully and consider the savings as well as the improvement of life conditions...just weight prevention alone around here would have a radical impact in years to come...obesity is rampant in the south. content.nejm.org Does Preventive Care Save Money? To the Editor: In the Perspective article by Cohen et al. (Feb. 14 issue),1 a narrow construction of what constitutes prevention leads to erroneous conclusions about its potential impact and costeffectiveness. The authors do not address preventive interventions that occur outside the doctor’s office. These include basic public health services and many other policies that bear directly on health (e.g., seat-belt laws and smoke-free policies). Health gains achieved through population-based approaches often exceed those that can be accomplished clinically, and these approaches are often cost-saving or highly cost-effective.2 Even if one considers only prevention in clinical settings, many high-value services are substantially underutilized. For example, less than 50% of the target population receives smoking-cessation services, counseling about aspirin use, colorectal- cancer screening, and influenza vaccines. Increasing use of these four services to 90% would save more than 100,000 lives annually.3 Policymakers should support investment in prevention for the right reasons — namely, to improve health at an acceptable cost, even if the services will not reduce overall spending. If reduced spending is the goal, then policymakers should discourage use of low-value services, both therapeutic and preventive. Jonathan E. Fielding, M.D., M.P.H. Los Angeles County Department of Public Health Los Angeles, CA 90012 Corinne G. Husten, M.D., M.P.H. Jordan H. Richland, M.P.H., M.P.A. Partnership for Prevention Washington, DC 20036 chusten@prevent.org Cohen JT, Neumann PJ, Weinstein MC. Al