PAYMENT FOR CANCER PREVENTION - COMMUNITY AND GOVERNMENT PERSPECTIVES

PURPOSE: The development of a stronger interest in cancer prevention a nd 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 pub lic 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. OVERVIEW: Some prevention a nd early detection services are financed appropriately through individ ual payment mechanisms and can be covered in indemnity and capitated i nsurance plans. Population-based approaches to prevention do not fit t his model, however, and need to be financed at the community level, th rough tares or other shared financing schemes. CLINICAL IMPLICATIONS: Lack of public understanding of the differences between individual-and population-based prevention makes resource development difficult. Pra ctitioners interested in such approaches need to loin with others in t he community to gain support. Long-term support of community efforts c urrently remains unclear. Although the actions identified are essentia l, they are not sufficient to support a comprehensive cancer preventio n and detection program fully. The concerned clinician should become a part of the communi:ty-nide effort. This may be done individually, thr ough participation on a local board of health or a hospital-based heal th promotion coalition. This also maybe achieved through associations such as the local medical society or the local American Cancer Society .