Preventive Medicine: A vital economic strategy

We have been told often enough that an ounce of prevention is worth more than a pound of cure. When it comes to the health of people, this is literally true. I remember my late father used to lament the lack of importance given by the local health establishment to Preventive Medicine, specially in relation to infectious diseases prevalent in our tropical environment.

For a while I thought he was just venting his frustration because this was his field of specialization and most of the attention was focused on what he calls diseases of the developed countries and the local elite. Thousands, if not millions of Filipinos are suffering more from infectious tropical diseases rather than heart disease or cancer and they are not being properly attended.

I remember when he was trying to explain to me some concepts for my statistics class, he talked about morbidity and mortality. He said that we should give more attention to the morbidity table, diseases that debilitate a person enough to make him economically unproductive, such as diarrhea and infectious respiratory diseases. These are the diseases that eventually affect total national productivity but are easily preventable if people are properly educated.

Unfortunately, even in the medical curriculum, Preventive Medicine, a subject that my late father taught at the UST College of Medicine, was not given the proper importance. Decades later, as I read articles in business journals on the subject of employee wellness, my conversations with my father on the subject of Preventive Medicine came to mind.

In fact, employee wellness, which is the corporate version of Preventive Medicine, is now an important management concern. Corporate bosses have come to realize that unless they invest time and resources in managing the health needs of their employees, the impact on the corporate competitiveness can be significant.

An article in Knowledge@Wharton observed "when workers take sick days, the financial impact on the company is not always related only to the specific job the sick employee performs. The impact can often ripple throughout the company, especially if the employee is part of a team whose output is time sensitive."

Until recently, however, it was hard for companies to measure the impact of employee absenteeism with any hard data. But it’s obvious the loss in productivity can be large. "The cost of a health-related absence often is more than just the wage paid to the worker who is out sick. When perfect replacement workers are not available to substitute for an ill colleague, there are broader implications for productivity. That’s specially true in organizations where employees work in teams, and where the team’s output is time sensitive."

What is true for a company in terms of the cost of health-related workforce absences can have a devastating cumulative effect on the entire economy. This is why Preventive Medicine is a vital economic strategy that must be given importance in the country’s economic development program.

From a macroeconomic view, a healthy population is a prerequisite to national development because people are our most important national resource. Or inversely, our inability to achieve economic takeoff is probably because our population is unhealthy and therefore unable to be as productive as the Singaporeans, the Malaysians and the Thais.

The first step towards reducing the burden of illness among our people is comprehensive health education on disease prevention . If Ate Glue does not get too distracted by the cha cha protests, she is scheduled to sign an Executive Order today that would include an effective public health awareness campaign in our educational system.

Called Health and Education Reform Order of 2006 (HERO of 2006), it is being spearheaded by the Philippine College of Physicians working through its Advocacy and Communications Committee headed by cardiologist Dr. Anthony Leachon.

According to Dr. Leachon, all they want is "a simple public health education and awareness to address the unresolved burden of preventable illnesses." They want a clear signal from the state that this is a top priority and healthcare professionals can be harnessed to help promote a healthier society in a cost-effective way.

In 2005, Dr. Leachon explains, total healthcare expenditure in the Philippines amounted to P165 billion, or about 3.5 percent of the GNP. Net of administrative costs, 10 percent was spent for public health while 80 percent was spent on personal health care services, mostly for the treatment of diseases and their complications.

Our healthcare spending, Dr. Leachon lamented, is focused on "sick care", paying for products and services to treat diseases in the advanced stages, rather than preventing these diseases from making people sick, to begin with. This, he said, is a highly inefficient way of using meager personal and government health resources, especially since it is well-established that much less resources are needed to prevent the onset of these diseases.

For example, diarrhea. It is easily preventable if people know proper hand washing techniques, hygiene in food preparation and cooking, intake of clean water, proper waste disposal. The same is true of communicable respiratory diseases. Their spread can be controlled through proper isolation of sick persons, hand washing, proper disposal of biological waste.

While infectious diseases have decreased in the developed countries, eight of the top 10 causes of morbidity in the Philippines are still infectious diseases that are easily preventable with proper education and measures such as vaccination and sanitation. But once infected, thousands of pesos can be spent on a single hospitalization… a waste of scarce economic resources.

Even in the case of heart diseases and cancer, proper health education can help reduce the economic impact of treating these diseases once you get them. Simple things like knowing what to eat, stopping bad habits and getting new good ones… can contribute greatly to preventing the onset of these diseases which are quite expensive to treat.

The economics of taking care of one’s health for the individual and for the company he works for can be great. As for the country, it is possible to estimate the total economic impact through an examination of a hospital bills or the cumulative charges per hospitalization for these diseases.

There are a lot more things that the Philippine College of Physicians want to do in relation to this education project. We will cover them in future columns. For now suffice it to say that at least, the local medical community is starting to do something about Preventive Medicine. It would have made my late father very happy. Hopefully they follow it through beyond an enthusiastic start.

In the meantime, for corporations interested in launching a wellness program for their employees, the Lopez Group wellness website ( www.lopezwellness.com) may give some ideas. Former DILG Secretary Raffy Alunan is on top of the Group’s wellness project and he will tell you it isn’t easy to convince people to take their health seriously until it is too late. But because Oscar Lopez is personally committed to walk the talk here, it is well on its way to being a model corporate program.

Ol’ Joe

A reader sent this old anecdote and it seems, the reference to a Joe is not necessarily coincidental.

John the farmer was in the fertilized egg business. He had several hundred young layers (hens), called "pullets", and 10 roosters, whose job it was to fertilize the eggs (for you city folks). The farmer kept records and any rooster that didn’t perform went into the soup pot.

That took an awful lot of his time, so he bought a set of tiny bells and attached them to his roosters. Each bell had a different tone so John could tell from a distance, which rooster was performing. Now he could sit on the porch and fill out an efficiency report simply by listening to the bells.

The farmer’s favorite rooster was old Joe, and a very fine specimen he was, too. But on this particular morning John noticed old Joe’s bell hadn’t rung at all! John went to investigate. The other roosters were chasing pullets, bells-a-ringing. The pullets, hearing the roosters coming, would run for cover.

But to Farmer John’s amazement, old Joe had his bell in his beak, so it couldn’t ring. He’d sneak up on a pullet, do his job and walk on to the next one. John was so proud of old Joe, he entered him in the Renfrew County Fair and he became an overnight sensation among the judges.

The result... The judges not only awarded old Joe the No Bell Piece Prize but they also awarded him the Pulletsurprise as well. Clearly, old Joe was a politician in the making: who else but a politician could figure out how to win two of the most highly coveted awards on our planet by being the best at sneaking up on the populace and screwing them when they weren’t paying attention.

Who else indeed?

Boo Chanco ‘s e-mail address is [email protected]