The silver bullet of preventive care

With the formal launch of the health care debate by Sen. Max Baucus (right), who posted an 89-page PDF whitepaper on his Web site,  the time has come to ask the big question you, as an employer, probably ask every day.

Is preventive care a silver bullet against rising health care costs?

All reform efforts come down to this point. So do all the cost-benefit analyses aimed at selling health care IT.

The argument is that knowledge is power. If you know the health cost of that cigarette, or that donut, or that quiet afternoon in front of the football with the dog at your feet, you will do something about it.

Critics call this automating the nanny state. But, as yet-another study showed today, compliance is raised and health care improved when patients and doctors both get the right data at the right time.

Next month Emory University will host its fourth annual symposium on Predictive Health, which is the ultimate expression of this trend. Combine knowledge of genes and proteins to create a custom health plan for each person.

Will we follow it? And what will following it cost, as opposed to waiting for your stroke, having a good time, and then dieing suddenly in middle age?

The bottom line, in other words, is untested.

The response by reformers is that the stroke is not sudden. It is chronic conditions, like diabetes, that are driving up your health insurance rates. Better compliance reduces those costs.

What we know from the experience in every other industrial country is that cost pressures remain regardless of the system used, but when they're managed through a political rather than a private process costs go down.

Americans, on the whole, pay about 50% more for their health care than citizens in other industrial nations, and our outcomes are no better. We are fatter, less disciplined, more prone to chronic conditions, and we die younger.

What has changed in the last few years is that, for millions of small businessmen, the cost chickens have come home to roost. It was one thing when you couldn't afford to insure your employees. Now you may be without insurance yourself.

So it has been the move of business, from opposing reform to actively supporting it, that has brought us to this place.

The public debate will center on costs and mandates, but behind it will lie faith that Internet technology, if applied universally, can do what all those TV commercials telling you to watch your weight and stop smoking failed to do.

Restore discipline.