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discussion response with one outside source Nardi et.al report “while medical expenses before death can be large, on average they constitute only a small fraction of total spending, both in the aggregate and over the life cycle. Hence, medical expenses before death do not appear to be an important driver of the high and increasing medical spending found in the US” (2016). In 2011, the baby boomers, comprised of 75 million people, began to turn 65 with 20% of the population being older than 65 by 2030. The cancer risk for people over 60 years old increases by 20-30% (Cope, 2006). Future projections indicate a 12% increase in cancer incidence for those 75 and older and for those 85 and older, a fourfold increase by 2050 (Edwards et.al, 2002). When you combine those statistics as well as the fact that the older population tend to have more comorbidities, it is no surprise that medical costs more than double between the ages of 70 and 90, and we would be wise to expect that medical spending will increase as a result as well. Medicare Part B covers many preventative services including; screenings for cancer, cardiovascular disease, diabetes, glaucoma, HIV, STI, and bone mass measurements; flu, pneumonia, and hepatitis shots as well as the COVID-19 vaccine; annual wellness visits, Welcome to Medicare preventative visit, self-management training for diabetes, medical nutrition therapy, alcohol counseling, smoking cessation, cardiovascular disease risk reduction visits, and obesity behavioral therapy-most of which are available at no cost (Medicare.gov, 2025). As such, I’d argue that a preventative approach has and is being approached, so that begs the question on factors of utilization. Despite Medicare’s preventative services coverage and the fact that nearly 90% of beneficiaries visited their PCP at least once annually (and most on average 6 visits per year), with the exception of blood pressure and cholesterol screening, approximately 70% of beneficiaries did not receive these services. Much literature suggests that expansion of coverage can lead to increased utilization; however, this alone would be a suboptimal solution (Ozminkowski et.al, 2006). A significant portion of Medicare beneficiaries are unaware of the preventative health benefits available to them (PAN, 2024). Socioeconomic factors such as income, education, and race/ethnicity, as well as health plan type, and access to care are additional factors related to lack of utilization. To answer the question: would a prevention approach benefit to decrease the rising cost? We’re asking the wrong question—We need to solve for the factors that lead to under-utilization of the existing prevention approaches.

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