Most health care cost control efforts are reactive in nature: once illness occurs, they attempt to regulate the price of services. Proactive programs, on the other hand, begin their work before people become sick. They attempt to influence each individual to take more responsibility for his or her own health. The potential for savings, in both dollars and years of life, is vast. A prime example is heart bypass surgery, a procedure which has become routine in virtually all major hospitals. This invasive, expensive surgery is made necessary in most cases by a combination of lifestyle choices such as a highfat, high cholesterol diet, smoking and lack of exercise. Common sense tells us the cost of preventing disease is much less than the cost of treating it. A quick look at the table below confirms that logic.
Prevalence and Cost of Selected Preventable Conditions
| Magnitude | Condition | Cost Per Patient |
| Heart Disease | 7 million affected 500,00 death/year 284,000 bypass procedures/year |
$30,000 (bypass surgery) |
| Cancer | 1 million new cases/year
500,000 deaths/year |
$29,000 (lung cancer treatment) |
| Stroke | 600,000 cases/year | $22,000 |
| Injuries | 2.3 million hospitalized/year 142,000 deaths/year 177,000 spinal cord injuries/year Hip Fracture Head Injury |
$570,000 (quadriplegia) $40,000 $310,000 |
| HIV Infection | 1 to 1.5 million new cases/year | $75,000 |
| Alcoholism | 18.5 million persons abuse alcohol
105,000 alcohol related deaths/year |
$250,000 |
| Lowweight Birth | 260,000 born/year 23,000 deaths/year |
$10,000 |
CHART 3
Of the $178,916,728 of lifestyle/behavior related claims incurred by the Evansville Community for Indiana patients, 41% or $73,502,191 could potentially be reduced or avoided through health promotion efforts. The potential savings is calculated based on the concept of "relativerisk ratios." Relativerisk ratios used by the CHA are based, in part, upon data collected and published by the Carter Center of Emery University Health Risk Appraisal Program in August, 1991, the National Behavioral Risk Factor Surveillance Program, and the National Center for Health Statistics. They are mathematical formulas which compute the influence each risk factor has on the odds of getting each specific disease.
The Health Insurance Association of America has computed the cost of treatment for selected preventable conditions (reproduced on the previous page). The financial impact that these diseases can have on a community's health care costs is clear. While the CHA does not report specific diagnoses, it is highly likely that the health care claims experience of the Evansville Community includes one or more of these preventable conditions.