Bending the Cost Curve.

Also in JAMA [JAMA. 2009;302(11):1223-1224] is a useful article suggesting how to reduce cost while trying to expand access the health care. Disease prevention initiatives aimed at improving nutrition, physical activity, tobacco use, and related lifestyle behaviors are likely to have the greatest effect on slowing the annual increase in health care costs. Evidence suggests that investment in physical activity, nutrition, and smoking cessation yields a 5-fold greater return in cost savings² than that documented for most clinical preventive services, owing to the inability of identifying the specific high-risk populations likely to benefit from such interventions as opposed to across-the-board screening and testing.^{1, 3} Current health reform proposals that would allocate $10 billion for a Prevention and Wellness Fund targeted to promoting healthier lifestyles and communities represents a major step toward slowing the annual increase in health care spending over time, given the current evidence on return on investment.