The Politics of Prevention Part 2: Where the Candidates Stand

Dr. Cindy Haines Health Guide
  • As noted in one of my previous blogs, "The Politics of Prevention", chronic diseases are the leading causes of death and disability in the United States. The prevention of chronic disease must take center stage as one of the most realistic and effective ways to control the ever-expanding cost of health care. I wrote that I believe that the acceptance and adoption of a healthier lifestyle, at both an individual as well as a global level, is the missing link in our national healthcare crisis. I also detailed my belief that it is well within our power to do this for ourselves but I also believe that our government can do more to help, particularly for those who lack the resources to fully engage on their own.

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    I would now like to bring you some thoughts (...promises...?) from the 2008 presidential candidates themselves. I have not yet decided who will win my vote, but the following make the cut on this issue for me. Here is what they have to say (*quotes obtained from


    From the Republicans:


    John McCain

    "Childhood obesity, diabetes and high blood pressure are all on the rise. We must again teach our children about health, nutrition and exercise - vital life information. Public health initiatives must be undertaken with all our citizens to stem the growing epidemic of obesity and diabetes, and to deter smoking." (Campaign website, October 11, 2007)


    "Insurance companies should have incentives not only for them, but also for the people they insure for incentives to wellness and fitness, and they should be concrete, even in the form of cash payments for people, including payments even to health club fees..." (AARP Republican Candidate Forum, Sioux City, Iowa, October 25, 2007)


    Rudy Giuliani

    "Infuse Incentives in Insurance Markets That Promote Wellness and Better Outcomes for Chronic Diseases: Health insurance must be redefined to cover wellness as well as sickness. In conjunction with recommendations from doctors and nurses, Rudy will propose new initiatives to promote healthy lifestyles and wellness programs, and tie Medicaid payments to a state's success in promoting preventative care and tracking obesity for children." (Campaign website 9/05/07)


    Mike Huckabee

    "We do need to get serious about preventive health care instead of chasing more and more dollars to treat chronic disease, which currently gobbles up 80% of our health care costs, and yet is often avoidable. The result is that we'll be able to deliver better care where and when it's needed. I advocate policies that will encourage the private sector to seek innovative ways to bring down costs and improve the free market for health care services. We have to change a system that happily pays $30,000 for a diabetic to have his foot amputated, but won't pay for the shoes that would save his foot." (Campaign website, October 2, 2007)


    From the Democrats:


    Barack Obama

    "We all know the saying that an ounce of prevention is worth a pound of cure. But today we're nowhere close to that ounce... The problem is, there's currently no financial incentive for health care providers to offer services that will encourage patients to eat right or exercise or go for annual check-ups... The real profit today is made in treating diseases, not preventing them. That's wrong, which is why in our new national health care plan... we will require coverage of evidence-based, preventive care services, and make sure they are paid for. But in the end, prevention only works if we take responsibility for our own health and make the right decisions in our own lives." (Speech in Iowa City, IA, 5/29/07).


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    Hillary Clinton

    "My plan also has a prevention initiative, requiring the insurance industry and public programs like Medicare and Medicaid to promote wellness as well as treat illness and provide every American with comprehensive preventive care." (Universal Health Care Speech, September 17, 2007)


    "Senator Clinton would make it a condition of doing business with the Federal government that health plans would coordinate public spending on prevention across federal programs in the Department of Health and Human Services to maximize high-priority prevention. A public-private collaboration would ensure that prevention reaches beyond the health care system and into schools, workplace, supermarkets and communities through free provision of preventive benefits. It would enlist a new prevention workforce including pharmacists, church leaders and others..."


    Chris Dodd

    "Focus on Prevention. The Dodd plan will focus on chronic disease management and preventive measures. People who make personal choices to improve their health through smoking cessation, weight loss, and exercise will have access to plan rewards and incentives. Chronic illness will be prevented and treated through an integrated system of chronic disease management modeled after the system used by the Veterans Administration and outstanding private delivery systems." (Campaign website, October 9, 2007)


    "Under the Dodd Plan...all children will have access to preventive health screenings including vision, hearing, autism, and other neurological disorders." (Campaign website, October 9, 2007)


    [Editor's note: Chris Dodd has officially dropped out of the 2008 presidential race]


    John Edwards

    "Health Markets will offer primary and preventive services at little or no cost. Incentives like lower premiums will reward individuals who schedule free physicals and enroll in healthy living programs. Edwards will also support community efforts to improve health, such as safe streets, walking and biking trails, safe and well-equipped parks, and physical education programs for children...Health Markets will encourage plans to monitor patients' health to keep them out of the emergency room. For example, plans can pay for nutritional counseling for diabetic patients to help them make healthy choices and control their blood sugar levels...Edwards will boost public health funding, work with schools to remove unhealthy foods, invest in physical education, and promote wellness and fitness in communities and workplaces." (Campaign Website October 5, 2007)


Published On: January 13, 2008

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