The oft used metaphor of an ambulance at the foot of the cliff rather than a fence at the top to contrast the wisdom of investing in preventive rather than reactive expenditure in health is actually over 100 years old! So why is it still so hard to justify the lower expenditure on prevention compared to a much greater expenditure with a typically worse outcome for the patient when the inevitable happens?
Simon Chapman, Professor of Public Health at University of Sydney, Australia, explains, noting that "The paradox of prevention is that it succeeds when nothing happens"
He identifies the major problem thus:
"The beneficiaries of prevention are statistical non-victims, not self-identifying individuals whose pain, neglect or imminent death can call attention to their plight.
Everyone in need of health care has a name, and nearly always a family and friends who care deeply about their welfare. But I cannot name a single individual who I know for sure will be a direct beneficiary of a preventive policy that will reap its benefits into the future."
Depressing, isn't it...