Health care demand management

Health care costs, rising prohibitively, are related in part to the magnitude of the illness burden (need) and to the services requested (demand), which in turn are related in part to preventable illness and to inconsistent and unproductive requests for utilization. A broadened model of health promotion is suggested by the author, with the twin goals of health improvement and of cost reduction. The model includes health risk reduction goals and selected screening tests, but also includes cost-focused features. Eight such programs have recently been proven to reduce medical costs by 20%, potentially representing savings of $200 billion annually, but such programs are not yet widely disseminated.