The lifetime health-monitoring program. A practical approach to preventive medicine.

Current patterns of health care and its financing need to be improved by the incorporation of cost-effective and health-effective preventive measures. As a stimulus for further development, we propose a Lifetime Health-Monitoring Program that uses clinical and epidemiologic criteria to identify specific health goals and professional services appropriate for 10 different age groups. During infancy, for example, we recommend seven immunizations, tests to detect anemia, hemorrhagic diseases, phenylketonuria and developmental deficiencies, and routine prophylaxis of gonorrheal ophthalmia. In the age group 40 to 59, tests for hypertension, cervical, mammary, and gastrointestinal cancer, and control of obesity and smoking are in order. The cost of such preventive measures. which should not be prohibitive, must be covered by health-insurance programs, whether based on fee-for-service or capitation. The program suggested, by incorporating prevention into day-to-day care, should strengthen the patient-physician relation.