Prevention Attention! Turning a 'No' Vote Into a 'Now' Vote

By Marilynn Preston

March 28, 2017 6 min read

The people spoke. The vote was not taken. The Affordable Care Act lives on.

If we are smart and strategic, it will move closer to what it could and should be.

And here's one thing it must be: focused much more on the prevention of illness and chronic disease and ever so much less so on what's good for the insurance industry, the drug industry, the obesity industry.

As Sen. Susan Collins said: "With the demise of the House bill, there's a real window of opportunity for a bipartisan approach to health care."

A window of opportunity! Yes. This is the good news behind the recent shake-up in Congress over health care. From chaos comes opportunity — no shame, no blame, no name-calling necessary.

"Prevention is bipartisan," says Dr. Larry Cohen, executive director of the Prevention Institute. "No one likes to be sick."

And no one likes to be without affordable care. "The good news is that creating a 21st century health system that embraces wellness and addresses community conditions through prevention is more within reach," writes Cohen in his important new book, "Prevention Diaries: The Practice and Pursuit of Health for All."

Cohen is a world-class authority on what works and what doesn't when it comes to promoting health and wellness in communities all over the country. His book chronicles case after case of sweeping strategies that lower costs, save lives and enable people to thrive. The more that citizens thrive in their communities, the fewer demands they make on the health care system. It's that simple.

"People 'get' prevention," Cohen says, with conviction, after 30 years in the field. "It's a natural instinct to look out for the health and well-being of family and friends."

Cohen is hopeful. Not only do people all across the country get it, Cohen reports; there's a vibrant and growing movement of people who seek it out, a bottom-up banding together of innovators and advocates who work on prevention and education programs that have positive outcomes when it comes to reducing illness and injury before it happens.

Cohen and his colleagues are talking about community-centered health centers, and bike lanes, and safe play areas. We need to create more sources of fresh food and locations for fitness training. And more community-based programs that recognize that even violence can be prevented, if it's treated as the health issue it really is.

"Prevention Diaries" should be required reading for every legislator who will vote on what comes next in health care. Your well-being is at stake, so consider this:

—5 percent of the country's sickest people account for 50 percent of health care costs. Imagine what prevention programs could do to lower those costs.

—70 percent of illness and injuries are due to human behavior and one's environment. Helping people change their behavior — eating smarter, moving more — is what prevention looks like. Rejecting the added costs of providing clean air and clean water is what corporate greed looks like.

—Only 10 percent of illness and injury is due to lack of medical care. And yet 96 cents of every health care dollar goes to cover medical care for illness and injury after the fact. Only 4 cents goes to fund illness and injury prevention and education.

And the point is? In crisis, there is opportunity. The door on repealing Obamacare has closed at the same time the door to revisiting it in a bipartisan way has opened.

"By shifting to a prevention paradigm," Cohen explains, "our country can spend less, recapture savings, and reinvest those resources in advancing well-being."

Advancing well-being? Be still my heart.

"Once we accept that there are businesses whose core practices and product lines are fundamentally harmful to health and safety," writes Cohen, "we can take collective action to protect our communities from further harm."

It took consumer education and collective action to stop the tobacco lobby and get seat belt laws passed — two big victories for pro-prevention people — and that's what's called for once again.

It's time for you and me and all the bipartisan health care consumers who complained and protested and wrote letters and carried signs to step up and double down on building a system that cares more about human health than corporate profits.

"Prevention is possible," Cohen assures us. "As a country, we just have to stop getting in its way."


"It always seems impossible until it's done." — Nelson Mandela

Marilynn Preston — healthy lifestyle expert, well being coach and Emmy-winning producer — is the creator of Energy Express, the longest-running syndicated fitness column in the country. She has a website,, and welcomes reader questions, which can be sent to [email protected] She also produces EnExTV, a digital reincarnation of her award-winning TV series about sports, fitness and adventure, for kids of all ages, at and To find out more about Preston and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate website at

Like it? Share it!

  • 0

Energy Express
About Marilynn Preston
Read More | RSS | Subscribe