In the final hours of this year’s budget debate, Republicans and ultimately, Gov. M. Jodi Rell, targeted a line item titled “seniors’ fall prevention program” as wasteful spending.
I have to admit that when you hear the concept for the first time, without explanation, it sounds kind of comical and futile. Seniors fall. It’s a fact of life. Are we really going to spend money trying to prevent the unavoidable?
The line item would have cost $1 million over the next two years. In the scope of a nearly $38 billion budget — it’s spare change, but as a symbol of wasteful government spending, it works. The problem is mainly the title. If the program had been called the “Help for the Aged Fund,” or the “One Dollar Can Save a Life Fund,” it would have had a long healthy life as a permanent part of the state budget. Whoever put this idea forward had too much faith in common sense as a part of public policy.
The truth is that for every million dollars we spend in preventing falls we probably save millions more in health care costs for the elderly. If your elderly parent falls and breaks a bone, they end up in the emergency room — one of the highest cost delivery systems in health care. If they fall and break a hip, they might go from the emergency room, to surgery, to a rehabilitation center to a nursing home.
Hundreds of elderly Connecticut residents take tumbles every year and each one can result in anything from a small bruise to a health care bill — which we all pay — worth tens of thousands of dollars. So, the fiscally conservative approach to the fall prevention program is not to mock it and kill it, but to fund it.
The elimination of the fall prevention program is not going to balance the state budget and it is certainly not going to change the course of history. It does illuminate a larger point. The more we spend on prevention in health care, the healthier we all are and the more money we save down the road.
Regardless of what you think about a government- run health care system, there is no disputing the fact that a general policy shift toward prevention would save millions in Connecticut and billions nationwide. In fact, much of the savings contemplated in the president’s health care initiative comes from prevention-oriented care.
How do we get people to have regular annual physicals? How do we keep people from using the emergency room as a primary care center? How do we get them to stop smoking instead of relying on them to smoke so that we can tax them on their way to death? The same emphasis needs to be placed on mental health care as a way to prevent more serious illness and reduce health care expenditures. Progress in each of these areas — and many more — would result in real quantifiable savings. For fiscal conservatives out there, it’s called “a win-win.”
The bad news is Connecticut’s political leadership wasted most of this year in a budget stalemate that leaves us with nothing but bigger problems to face in the coming months. No one had the courage to make the argument — and vote for a plan — that said now is the time to fundamentally change how we are doing things. The good news is, in the face of a structural deficit that is potentially as high as $3 billion, there may now be no other choice than to look at the world from a new perspective. The logical place to begin is health care.
Dean Pagani is a former gubernatorial advisor. He is vice president of public affairs for Cashman and Katz Integrated Communications in Glastonbury.
