Betting on prevention as Medicare turns 50

Dr. Linda Fried

Dr. Linda Fried

Healthcare is an expense. But what if we looked at it as an investment – especially an investment in prevention of disease? The payback on that investment would be more years of healthy living and less cost treating chronic disease in old age . . . not to mention the human misery avoided.

Investment in healthy aging was one of the most interesting themes that surfaced last week at the Age Boom Academy, a two-day symposium for journalists I attended at Columbia University. Age Boom is s joint program of the Columbia Aging Center and the Columbia Journalism School.

This year’s meeting focused on a comparative look at aging around the world. One of the sessions looked at age-related increases in chronic disease, and the degree to which disease can be prevented.

Dr. Linda Fried, dean of the university’s Mailman School of Public Health, made the case that prevention could help people not just live longer, but enjoy more healthy years. “Health conditions associated with getting older are mainly preventable,” she told the group. “We used to think heart attack and stroke were inevitable consequences of aging 0 that was the view when I was training. We now know that’s not true, and that prevention works at every stage and age.”

Much of Fried’s research is focused on promotion of healthy aging, and the latest evidence shows that people who get to age 60 in relatively good health are likely to stay healthy. What to do about it? Here in the U.S., she argues, Medicare should have a much more robust focus on prevention. Fried lays out a prevention-oriented vision in an article in a new issue of the research journal of the American Society on Aging devoted to Medicare’s future.

In the article, she argues that Medicare should start covering preventive health care when Americans turn 50. “The investment would be worth it,” she says. “It won’t cost Medicare or the country more money, but having people living not just longer but healthier is essential to being able to experience the benefits of longer lives.”

Medicare celebrates its 50th anniversary this summer, and its impact on the health of seniors has been dramatic. Medicare has achieved a great deal. Since 1965, people over age 65 are living longer with far lower rates of death from chronic disease. The program has evolved and improved along the way, adding home health services, hospice care and prescription drug coverage, just to name a few innovations. The anniversary is a great time to ask what can be done better in the years ahead.

My Reuters column today features an interview with Dr. Fried about how Medicare should evolve to a more preventive focus.


  1. Eat whole grains, fruits and vegetables. Exercise daily. I’ll be 60 at the end of this year. Unless you plan to help remind me to do this or pay for my groceries, I don’t see what good extending coverage will do. Checkups tell us when something is not perfect and then take shortcuts (drugs, procedures) to “fix” them with side effects that are often worse than the original symptoms. A regular health coach (nutrition, exercise, discipline) is useful, not a medically trained doctor who is more out of shape then I was.

  2. Mark Miller says:

    Right, Bruce – never mind the science.

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