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of adding clinical preventive services in small practices, as opposed to large groups, was new to me.

The Partnership for Prevention has recently come up with three or four priority clinical preventive services that were suggested as areas of emphasis, smoking cessation, obesity/nutrition, for example. So, in the spirit of summary, I flagged a couple of things that stuck in my mind as interesting ideas. It was suggested that Medicare might be extended to provide clinical preventive services for the age group 50 to 64. This national or federalized clinical preventive services program would allow private insurers to offload these, and give the Medicare program, that would benefit most from healthier beneficiaries at entry, the responsibility of providing those services that would make for a healthier population.

Another interesting thought was raised on a sticking point between individual choice in behaviors and policy options. This is seen by many as being either/or, the big hand of government telling us what to eat or what to smoke, versus individual freedom, individual choice. So as we think about policy changes as a way to advance prevention, we need to be aware that there is a view of policy as heavy handed, in contradiction to individual liberty and individual choice.

Dr. Len Lichtenfeld: In closing we’d like to thank Sue Curry, Tim Byers, and the IOM for sponsoring the report and for the use of their facilities, the invited speakers and all the participants for their wonderful contributions, and to thank the NCI and the ACS for their support of this symposium.



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