Prevention vs. Treatment: What's the Right Balance?

Everyone knows the old adage, "an ounce of prevention is worth a pound of cure," but we seem not to live by it. In the Western world's health care it is commonly observed that prevention is underfunded while treatment attracts greater overall priority. This book explores this observation by examining the actual spending on prevention, the history of health policies and structural features that affect prevention's apparent relative lack of emphasis, the values that may justify priority for treatment or for prevention, and the religious and cultural traditions that have shaped the moral relationship between these two types of care.

Economists, scholars of public health and preventive medicine, philosophers, lawyers, and religious ethicists contribute specific sophisticated discussions. Their descriptions and claims lean in various directions and are often surprising. For example, the imbalance between prevention and treatment may not be as great as is often thought, and we may be spending excessively on many preventive measures just as we do on treatments compelled by the felt demands of rescue. A standard practice in health economics that disadvantages prevention, "discounting" the value of future lives, may rest on weak empirical and moral grounds. And it is an "apocalyptic" religious tradition (Seventh-day Adventism) whose members have put some of the strongest and most effective priority on long-term prevention.

Prevention vs. Treatment is distinctive in carefully clarifying the nature of the empirical and moral debates about the proper balance of prevention and treatment; the book pursues those debates from a wide range of perspectives, many not often heard from in health policy.

Halley S. Faust, MD, MPH, MA is a preventive medicine physician, philosopher, health care executive, and venture capitalist, and the President-Elect of the American College of Preventive Medicine. He is Clinical Associate Professor of Family and Community Medicine at the University of New Mexico.

Paul T. Menzel, PhD has taught philosophy at Pacific Lutheran University(Tacoma, WA) since 1971. He has authored two books on moral questions about health economics and numerous papers on rights to health care and the role of values in shaping choices of health system structure.