Prevention and Cost Control

The First Lady this week has announced a new push to fight childhood obesity. Michelle Obama’s cause is the kind of push needed to lower the health care cost curve long-term. We, as a nation, are getting fatter year by year and clearly our obesity related diabetes and heart disease will on its current path eventually bankrupt our health care system. Thirty years ago the teen age obesity rate was 5%, and now it is almost 18%. That is a huge change in one generation and portends a huge increase in future diabetes and heart disease cases. There is no doubt that health care marketers will be playing a key role in the shift from disease treatment to disease prevention.

DTC, as it is largely done today, is about treating the disease once it is diagnosed. Very few DTC ads are designed to encourage prevention. Once could argue that cholesterol drugs do promote prevention of heart attacks among people with high cholesterol. Or that diabetes pills promote control which prevents serious complications later in life.

The majority of ads, however, target existing disease sufferers for treatment. Under pressure from DTC critics drug companies have increased campaigns to encourage early diagnoses and testing. Clearly though, spending is about 90% in the brand awareness building among current sufferers.

The future of health care cost control will depend on keeping us from getting chronic illness. Some of this will be the result of early diagnosis. Much will be targeted to keep us from getting disease. The problem we face as advertisers is convincing America that they must slim down, exercise, and eat better. If it was easy to succeed through simple public service ads, we would not be getting fatter and more sedentary.

Michelle Obama is doing a good thing urging American parents and their kids to exercise and eat right. The issue is how to change behavior which clearly has been trending in the wrong direction. Drug, OTC, diet, exercise and food companies have an enormous opportunity to develop products and services to address prevention. They are fighting an enormous counter marketing machine for tasty, cheap products that create obesity. Marketing disease prevention will take all the creative talent we can muster.

I expect that marketing disease prevention is a huge future industry once we recognize that we do not have the budget to effectively treat a nation of obese diabetes and heart disease sufferers. Ten people in good shape might be able support the one costly sedentary sufferer of diabetes and heart disease. The reality is that we may have one in shape person for every obese person. That math will not support generous treatment. Sounds like our social security dilemma where the numbers just do not add up for affordability long term.

Once we get healthcare reform we can expect prevention to be a huge part of its metrics for success. We need to incentivize good behavior and penalize bad behavior. We can no longer allow people with bad health habits to get a full government subsidy to maintain bad habits. Medicare and Medicaid do just that. One day I suspect cost pressures will force government to shift co-pays to those who fail to maintain healthy habits. The fast-food, couch potato, smoker crowd may resent that but that is the way it has to be. Prevention will be encouraged and good habits rewarded with lower premiums and co-pays. Otherwise we will all go broke treating preventable disease.