October 01, 2009

Prevention Must be Cornerstone of Reform

Speech is Second in a Series on Health Care by Senate's Freshman Class

WASHINGTON – U.S. Senator Tom Udall, D-NM, today joined his fellow freshman senators on the floor of the U.S. Senate for the second in a series of speeches to highlight the need for health reform. In his remarks, Udall said that prevention must be a cornerstone of health reform in order for the United States to achieve success in "bending the cost curve" and reining in health care costs. Udall said that, in addition to clinical preventive services like mammograms, colonoscopies and cholesterol screenings, there also must be a focus on primary preventive measures, which help keep people from getting sick in the first place.

Senator Udall's remarks as prepared for delivery:

"I rise today to talk about an aspect of health care that America has systematically neglected for years – and one that is in danger of being neglected as part of this reform. I rise today to talk about prevention.

"Prevention can mean clinical services like mammograms and colonoscopies and cholesterol screenings. The good news is that most of the bills being considered would make these services much more accessible and affordable.

"But successful reform also means addressing another aspect of prevention. I'm talking about primary prevention – the kind that keeps people from getting sick in the first place.

"Evidence suggests that primary prevention should focus on three behaviors: physical activity, nutrition, and smoking. But the reality is – whether through personal choice or lack of options – too many Americans are struggling.

"Today, two-thirds of Americans are overweight or obese, and more than 20 percent smoke. Things are even worse for minorities, who often suffer the most from lack of preventive care. In my state and elsewhere, diabetes is epidemic among Native Americans.

"We're in this crisis today because we've neglected prevention for years. Of the more than $2 trillion we spend on health care each year, only 4 cents of every dollar is invested in prevention. It just doesn't make sense.

"Studies have shown that primary prevention not only will save lives, it will also save money. In New Mexico, a $10 -per-person investment in community-based prevention programs would save $88 million dollars annually. Nationally, that translates to more than $16 billion annually. That's a return of $5.60 for every $1 invested.

"We have solid evidence that we can spend less on health care while saving more lives. So, what should we do?

"Experts say effective prevention must address three levels: the individual, the institutional, and the environmental.

"Individual prevention is about Americans making the right choices for themselves. This means choosing nutritious foods, maintaining an active lifestyle, and avoiding smoking, drug abuse, and excessive drinking.

"Institutional and environmental prevention help individuals stay on the path to a healthy lifestyle. This could mean incentives for physical activity, disincentives for smoking, and nutritional labeling on menus. It could also mean safer streets, more school gardens, or increased mass transit.

"Legislation approved by the HELP Committee would establish a new fund to support these activities. This kind of dedicated, stable funding stream is critical to effectively addressing America's legacy of neglect regarding prevention.

"There's an often-quoted parable that tells of a nurse fishing downstream. As she fishes, she sees a person coming down the river struggling for life. The nurse pulls him out. Then, another comes and again must be rescued. This happens all afternoon and the nurse tires from constantly pulling people out of the river. Eventually, she realizes she has to get upstream, to see what's pushing them in the river in the first place.

"Madam President: It is time for America to look upstream, to see where the real problems lie. It is time to honestly address these preventable health problems."