Payment for cancer prevention. Community and government perspectives

The development of a stronger interest in cancer prevention and early detection programs has led to the opportunity for mechanisms to provide adequate financial support at the individual, practitioner, and community levels. This discussion draws on the experiences of public health systems and emerging models for personal care to describe a framework for consideration of prevention and early detection funding, and to discuss the prospects of funding.

Some prevention and early detection services are financed appropriately through individual payment mechanisms and can be covered in indemnity and capitated insurance plans. Population-based approaches to prevention do not fit this model, however, and need to be financed at the community level, through taxes or other shared financing schemes.

Lack of public understanding of the differences between individual- and population-based prevention makes resource development difficult. Practitioners interested in such approaches need to join with others in the community to gain support. Long-term support of community efforts currently remains unclear. Although the actions identified are essential, they are not sufficient to support a comprehensive cancer prevention and detection program fully. The concerned clinician should become a part of the community-wide effort. This may be done individually, through participation on a local board of health or a hospital-based health promotion coalition. This also may be achieved through associations such as the local medical society or the local American Cancer Society.