Gordon Blackburn, the program director of cardiac rehabilitation.
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The next step, says Roizen, will be to see if lifestyle changes can not only hold off disease but actually reverse it, transforming the strategy into a fully developed treatment option on a par with prescriptions and surgical procedures. Dr. Dean Ornish, a longtime prevention proponent who created the Preventive Medicine Research Institute in California, thinks this is possible. In 2008 he showed for the first time that even the course of a disease like prostate cancer can be altered by diet. Men at low risk of prostate cancer were asked to choose either Ornish's lifestyle program — which involves eating healthier, exercising and reducing stress — or continuing with their current habits. After three months, Ornish studied the activity of the men's genes and found that the healthier behaviors turned on cancer-suppressing genes and turned off cancer-promoting ones.
It's just this kind of data that prevention champions hope will be enough to finally change our reimbursement system as a whole to cover programs like Lifestyle 180. And those advocates now include a majority of consumers as well: in a recent survey by Trust for America's Health and the Robert Wood Johnson Foundation, 76% of Americans said they support an increase in funding for prevention programs.
But even with such widespread support, it won't be easy. It took Ornish 14 years to persuade Medicare to cover his lifestyle program for avoiding heart disease. Employers have been slow to invest up front for health savings that may never accrue to them if their employees leave for other jobs. Yet as the cost of claims rises, even that tide may finally be turning. In Minnesota's Twin Cities region, for instance, major companies such as Target, US Bank and Best Buy are coming together to discuss ways that investments in prevention and long-term cost savings can be shared by all the employers in the area, even if workers are moving between companies.
Will prevention work? And will our health system finally embrace the strategy over prescriptions and procedures? We don't have many other options. Prevention is a timeless idea, one our species has always practiced: pioneers preserved food to prevent starvation in the winter; modern workers invest in 401(k)s to prevent destitution when they're older. Applying the same ethos to medical care ought not be that hard — especially since the country's health, economic and otherwise, may depend on it.
Five Things U.S. Health Care Can Learn From the Cleveland Clinic
1. Make prevention programs free...
The clinic pays for employee memberships to Weight Watchers and Curves
2. ...really free
More people signed up once the clinic began paying club fees up front instead of reimbursing employees
3. Use cash to motivate
Employees in the health plan earn $100 for reaching their fitness goals
4. Share the wellness
The clinic provides free wellness programs at community centers
5. Pass it on
Savings from lower medical-claims payouts help keep employee health premiums from climbing