The Role of Prevention in Health Reform

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Abstract
In this issue of the Journal, Fries et al.1 offer an attractive alternative to health care cost-control proposals such as managed competition, global budgets, rationing, and the like. On behalf of the Health Project Consortium, they propose that wider use of preventive care, broadly defined, would control growth in medical expenditures and make Americans healthier at the same time. Fries et al. are not the first to suggest that prevention saves money -- the idea has enduring appeal. Cost-effectiveness studies, however, provide little evidence of savings. At the same time, the expectation that preventive care will save money may hold . . .