Robert E. Herron, Ph.D.
During the past two decades, the United States has become increasingly concerned with reducing medical care expenditures while continuing to improve the health of Americans. However, medical costs have continued to rise rapidly, despite efforts to contain them. Unlike the treatment-based strategies for health care that are currently in wide use, prevention-oriented approaches offer great unrealized potential to directly improve the health of U.S. citizens and thereby to reduce medical utilization and its attendant costs. At present, however, there is little research to validate the cost effectiveness of such prevention programs. This paper reviews the cost effectiveness of the current U.S. health care system as compared with those of other nations, especially Canada, and examines the potential of effective prevention programs for alleviating the health care cost crisis. A strategy is suggested to lower medical care utilization and expenditures by directing effective health-promotion and disease-preventive interventions toward the highest-cost patients-that fraction of the population that consistently incurs the majority of all medical expenses. The scientifically validated Transcendental Meditation program is proposed as an effective preventive intervention to accomplish this strategy, and pertinent health-related research on the Transcendental Meditation program is reviewed. Future research possibilities are also suggested in order to enhance and expand national preventive care and thereby to further reduce high medical expenditures in the U.S.
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