By Dr. Michael Pramenko, MD
Board Chair for Monument Health

If you’ve ever had a cup of coffee or a conversation with me, you know tackling upstream healthcare interventions are important to me. Most of our health care solutions are geared toward reactionary care and are not directed toward prevention. In other words, if we connect completely avoidable risk factors such as smoking, drinking, or obesity to poor health outcomes, we can begin shifting our attention and our resources to tackling these issues before they end up in the Emergency Room costing local taxpayers hundreds of thousands of unnecessary dollars each month and contributing to the high cost of health care overall.

Our healthcare system was created to take care of the sick, which is why our health care solutions are geared toward reactionary care. Unfortunately, this plays right into the high costs you experience when you open your medical bills.

Take for example an article published in October of 2020 by The Lancet Public Health, which found in the U.S. “the sheer cost of these preventable illnesses is staggeringly high, estimated at US $730.4 billion… in 2016. To put this figure into perspective, it is more than the 2019 GDP of 171 countries in the world, or all but the 19 richest countries.” The piece goes on to outline the cost of smoking: “Tobacco smoke had the fifth-highest attributable spending at $130 billion.” However, and of no surprise, the greatest spending in 2016 was attributed to Body Mass Index (BMI) or obesity amounting to $238.5 billion dollars.

These costs are all preventable if we modify our behavior. In the examples above, smoking cessation, healthy diets, and/or exercise would go a long way to cost savings while simultaneously lending to healthier lives and communities.

To drive this point home, literally, the City of Grand Junction’s Crime and Traffic Report reveals several categories of infractions related to alcohol, which are all preventable. In fact, Driving Under the Influence (DUI) and other alcohol related offenses are largely avoidable with improved education, prevention, and intervention. Moreover, the high rate of alcoholism and alcohol abuse in the United States leads to health care, police, and employer related expenses of just over $2 per drink” (CDC).

Shifting our focus to upstream preventions will require us to think in completely new ways. This is why Monument Health and its member hospitals and medical practices place such an emphasis on your relationship with a primary care provider and guarantee access to one for our members.

A 2019 report titled Investing in Primary Care found “consistent and growing evidence … that primary care-oriented systems achieve better health outcomes, more health equity, and lower costs [including] an association ….between increased primary care spending and fewer emergency department visits, total hospitalizations, and hospitalizations for ambulatory care-sensitive.” Primary care is just one way we are seeking to actively pursue interventions in care and shift our focus upstream resulting in lower costs and healthier people, but there is more work to be done.

Shifting medical practices and refocusing our community wide lens on prevention is not a simple task, but it is a worthy one, one Monument Health is commited to.