Read the original op-ed in the San Jose Mercury News.
Pension and health care reform is not a one-stop service. Real reform and a robust retirement for millions of Californians demands foresight, flexibility and smart investments. Californians are justifiably worried as they watch vital programs and services slashed to meet the state's other obligations.
But cuts are not the only solution. The fiscally responsible approach is to support and promote policies that keep people healthier now, in order to reduce the demand for medical care throughout their lives. That approach is called prevention.
When the city of San Jose and the Boys &Girls Clubs of Silicon Valley signed a joint use agreement that allowed them to share a sports field and gym, they weren't just creating more opportunities for residents to exercise. They were also decreasing their likelihood for chronic illnesses like diabetes, heart disease and osteoporosis, and increasing their potential for healthy lives as they age. Those are dollars well spent.
Runaway health costs are the leading long-term threat to state and federal budgets and to personal and family financial security. The state faces a $51.8 billion bill over the next 30 years to pay for future retiree health benefits, more than half of the state's current budget. By the year 2030, our aging adult population will swell from 6 million today to 11 million, adding 25 percent to overall health care spending costs. And the costs to California of heart disease, cancer and diabetes resulting from unhealthy eating and physical inactivity have doubled in the past six years to $41 billion. Those costs are projected to rise to $52.7 billion by 2011. We simply cannot afford them.
Prevention isn't just about improving the physical health of individuals. It also is about improving the fiscal health of communities and the state. A recent study by the Prevention Institute and the Trust for America's Health found that an investment of just $10 per person per year in proven community-based programs to increase physical activity, improve nutrition and prevent smoking could save California more than $1.7 billion in annual health care costs within five years. That is $5 for every $1 invested in prevention strategies.
Of the $1.7 billion in annual savings, the state and federal government could each save more than $84 million in Medi-Cal costs; private payers in California could save more than $1 billion, and federal Medicare savings would be more than $468 million. Given that CalPERS is by far the largest private payer in the state, much of those savings will help address the long-term costs the Public Employees' Retirement System and the state face for retiree health benefits.
When you see a great investment opportunity, you move on it. That is why we both supported including community prevention in the federal stimulus package and health reform bills. We now urge that some of those resources be dedicated to making sure that all Californians live healthier lives and save more money along the way.
Every successful public health movement, from sanitation to air pollution, from drunken driving to tobacco use, has shown that people will only be healthy if public policies are in place to support them. When grocery stores are replaced by fast-food outlets, or parks and other open spaces are closed off or developed, people are less likely to eat healthy foods and be physically active.
Prevention may cost more in the short term. But it's an investment not just in the physical health of Californians, but also our long-term fiscal health. That is real reform.
JOHN CHIANG is California state controller and LARRY COHEN is executive director of the Prevention Institute. They wrote this article for this newspaper.