An ounce of prevention…
Displaying a healthy dose of common sense, Franklin argued that preventing a catastrophic fire was far better than rebuilding a city from scratch in its wake.
Because of his advocacy, Philadelphia acquired its first firefighting organisation, the Union Fire Company, rather more affectionately known as Ben Franklin’s Bucket Brigades.
The origin of the quote aside, Franklin’s preference for prevention over cure really needs to be given greater weight in the Australian health system.
For far too long the health system has focused on treating people after they become unwell, and this has resulted in vast social and economic costs associated with chronic disease.
The burden of disease in Australia, and the associated economic costs, is a progressively top-of-mind issue. Australia’s population is ageing and increasingly overweight, and is challenged by conditions such as coronary heart disease, diabetes and stroke. These diseases are largely preventable.
In 2013, over A$140bn (US$102bn)—or nearly 9.1% of Australia’s total gross domestic product—was spent on healthcare services. Yet Australia’s spending on preventive health is low by OECD standards and minuscule by what I call the “Benjamin Franklin standard”.
Unfortunately, policymakers have taken a big step backwards in the area of prevention. The 2014-15 budget saw the end to the Australian National Preventive Health Agency and the demise of the National Partnership Agreement on Preventive Health.
There is a real and immediate role for smarter preventive health. This is not limited to, but certainly includes, the use of complementary medicines for primary and secondary prevention of illness, and encouraging and empowering all Australians to take better care of their health.
A multi-faceted and inclusive approach is required to ensure the wellbeing and prosperity of Australians, especially given the diversity in gender, age, locality, socioeconomic and cultural backgrounds, and health behaviours.
New technologies will not only affect the behaviours of individuals, they will also affect the health spend. The development of smart wearable devices and new apps, and the ubiquity of the internet and social media, means that individuals are increasingly able to make informed decisions in relation to their own healthcare.
Person-centric healthcare, and the appropriate focus on prevention within the Australian health system, is a vital element of the vision of improved health. Preventive health is also an essential move towards improving cost-effectiveness.
A 2013 US study “Smart Prevention – Health Care Cost Savings Resulting from the Targeted Use of Dietary Supplements”, conducted by Frost & Sullivan, found the use of key dietary supplements, including omega-3s, vitamins B6 and B12m, and folic acid, could reduce hospitalisation costs by billions of dollars a year.
Moreover, a 2009 Access Economics report, “Cost effectiveness of complementary medicines”, commissioned by the National Institute of Complementary Medicine, found that the use of St John’s wort for mild to moderate depression could provide significant cost savings to the Australian health budget.
These reports begin to demonstrate the potential savings offered by complementary medicines as a means to combat unsustainable healthcare costs and as a means for high-risk individuals to reduce their chances of having to deal with potentially costly disease-related events.
However, the contribution needs to be included in health policy and practice. Government recognition of this potential contribution is vital, as is more research to further inform how complementary medicines can contribute to funding choices in the broader context of national health.
It’s been written that our health as a nation depends on our health as individuals, that our health does not exist separate to the rest of our society.
The potential need to rebuild a city for the sake of a bucket brigade is quite a good analogy, don’t you think? It’s really no surprise the Benjamin Franklin axiom is so often used to refer to health.