Prevention's priceless
Boston Herald, Op-ed by Carole Allen, M.D., January 9, 2010

Although I am proud that Massachusetts leads the nation in expanding access to health care, I am alarmed that health costs consume 41 percent of the state’s budget.

I am a pediatrician, and most of my practice is designed to prevent problems years or decades in the future. I counsel my patients and their parents about healthy eating because childhood obesity can lead to heart disease and diabetes in adulthood. I screen toddlers for developmental problems to avert difficulties later in school. My goal is as much to promote health as to provide health care. Although I am proud that Massachusetts leads the nation in expanding access to health care, I am alarmed that health costs now consume 41 percent of the state budget.

This is the lens through which I watch Congress reconcile Senate and House health reform bills, paying particular attention to provisions that focus on preventive services for children, one of the highest priorities of the American Academy of Pediatrics. This is the lens through which I also watch federal efforts to create the Early Learning Challenge Fund and urge the Senate to act soon to pass legislation that the House approved in September.

The reason I link the two issues is simple: Attending a high-quality early education and care program not only significantly improves my young patients’ chances of succeeding in school but also boosts their long-term health and, in the process, helps contain medical costs. Indeed, the national advocacy group Docs for Tots calls investing in early education and care “a powerful public health initiative for America’s children.”

Adolescents and adults who attended high-quality early education programs are less likely to smoke or abuse alcohol and drugs or have children as teenagers, according to longitudinal studies of programs serving low-income young children. They are also more likely to wear seat belts, eat healthy foods and be physically active. They are less likely to suffer from depression. Because they are more likely to have the education needed to compete in our increasingly knowledge-based economy, they are more likely to find jobs with health insurance and thus more likely to seek medical care in a timely fashion. They are less likely to miss work for health-related reasons.

Consider, for instance, that research suggests that smokers, on average, engender 20 percent more in health care costs than non-smokers. Add to that the long-term economic benefits of reduced diabetes, depression and preventable injury, and it’s clear that high-quality early education has an important place in the national conversation about containing health care costs. The fact that more than 90 percent of young children in Massachusetts are cared for by someone other than a parent or guardian at least one day a week further buttresses the case for high-quality programs.

Congress should lead the way by establishing the Early Learning Challenge Fund, which would dedicate $1 billion a year for eight years to build a comprehensive, standards-based system of high-quality early education and care. The bill would encourage states to implement reforms designed to help transform early education, improve the training of the early education work force and ensure that children start school ready to succeed.

Beacon Hill policymakers should recognize that even in tough budgetary times investing in early education produces long-term benefits. Nobel Prize winning economist James Heckman, writing in The Journal of the American Enterprise Institute, calls investing in the education of young children “America’s best economic stimulus package.”

The most effective cure for our ailing health care system will maximize good health and minimize costs. That is why I and many of my fellow pediatricians prescribe investing in high-quality early education and care.