We're missing the mark on preventative care | Viewpoint

We talk a lot about prevention in healthcare — catching illness early, bending the cost curve, keeping people out of the ER.

Still, chronic diseases are the leading causes of illness, disability, and death in the U.S., and every year, we’re spending trillions managing diseases that often began decades earlier. Early diagnosis and intervention is more effective and cost-efficient than treating advanced illness later in life, but the healthcare ecosystem has continued to overlook the earliest stage of preventative care: pediatrics.

Children in the U.S. today are far more likely to have a chronic condition than they were even a decade ago. Yet in the face of increasing need, our pediatric system remains fragmented. While primary care broadly faces underfunding, burnout, and poor coordination, pediatrics has been especially overlooked – often left out of healthcare innovation and reform, both clinically and in reimbursement models.

I have witnessed how this fragmentation can strain families and clinicians alike. I saw it firsthand when my daughter was diagnosed with an autoimmune disorder. Despite over a decade of building care delivery companies in healthcare, it was a challenge to navigate the siloed pediatric care system on behalf of my daughter and family.

As a parent, the issue is personal. As a healthcare leader, it is unacceptable. If we’re serious about improving patient outcomes and lowering long-term costs, we have to stop treating pediatrics as an afterthought and more like the foundation of preventative healthcare that it should be.

Why pediatrics is a smart investment

Many adult chronic conditions have early roots in childhood. It is during these formative years that there is the greatest opportunity to identify risks, intervene early, and lay the groundwork for a healthier life. Chronic conditions like obesity, asthma, diabetes, and mental health disorders can all begin in childhood, leading to more serious complications later in life when left unaddressed.

Research shows when children receive consistent, coordinated care that addresses physical, behavioral, and developmental needs together, their overall health outcomes are better. And the impact goes beyond childhood: healthy children are more likely to become healthy adults who raise healthier families, creating a ripple effect across generations that would dramatically reduce long-term strain on the broader healthcare system.

Yet despite clear evidence showing the multigenerational benefits of early, comprehensive pediatric care, we continue to underinvest. The U.S. is spending the bulk of its healthcare dollars managing chronic conditions in adulthood that could have been prevented with proactive pediatric care.

The U.S. spends roughly $5 trillion on healthcare annually ($14,570 per person), and around 90% goes towards the treatment of chronic and mental health conditions. Meanwhile, children make up almost a quarter of the U.S. population, but account for just 10% of personal healthcare spending.

If we invested more in foundational pediatric multispecialty care — things like preventive services, screenings, behavioral health support, and proactive care coordination — we could build healthier trajectories from the outset, rather than paying the price for preventable complications down the line.

For instance, the costs from treating cardiovascular disease alone are projected to reach $2 trillion by 2050 and diabetes costs over $400 billion annually. As many of these chronic conditions can often develop in childhood, proactive, coordinated pediatric care is one of our greatest opportunities to mitigate costs upstream.

Reimagining pediatric care delivery

Investing in pediatrics benefits the health of our children today and lays the foundation for healthier generations to come, with the potential to lower long-term costs and strengthen the healthcare system as a whole. But to unlock the full promise of pediatric care, we must break down the structural barriers holding the system back.

Public policy: A strong pediatric system depends on stable, long-term public investment. Programs like Medicaid and CHIP play an essential role in providing access to care for millions of children. Yet, they remain vulnerable to funding uncertainty at a moment where the need couldn’t be greater. Policymakers must prioritize sustained support for these programs, alongside dedicated funding for integrated behavioral health services and multispecialty collaboration within pediatric settings. Real progress requires policymakers to treat pediatric care as a key foundation for prevention and long-term cost control.

Clinician compensation: Pediatricians earn less than specialists in almost every other medical field in the U.S., discouraging many from pursuing pediatrics. The industry must reexamine funding and reimbursement models to account for the full breadth of pediatric work and increasing complexity. Working toward scalable value-based models of care must continue to be a priority across the private and public sectors. Without meaningful change, we are risking further weakening the pipeline of future pediatricians.

Coordinated care models: According to clinicians, breakdowns in communication and coordination are one of their most common barriers to providing comprehensive, collaborative care. To address this, we need to reimagine care delivery — building scalable models that prioritize continuity and collaboration, with consistent touchpoints across specialties and care settings.

Modernizing workflows: Many pediatricians are stuck navigating outdated systems that add friction to already demanding jobs. Administrative tasks like EHR documentation, billing, and insurance paperwork eat into their time with patients and often extend into evenings and weekends, exacerbating burnout. Thoughtful use of AI and other emerging tools can reclaim valuable time, helping clinicians summarize complex patient histories, surfacing relevant clinical research, and facilitating more informed, efficient appointments.

Strengthening pediatric systems through funding early interventions, equipping clinicians with better tools, and designing care models that prioritize long-term impact over short-term fixes is one of the most future-focused investments we can make – for both public health and healthcare's bottom line.

The path forward can no longer be about incremental fixes. It requires a national commitment to pediatric health as the starting point for long-term population well-being, economic sustainability, and generational health equity. Investing in pediatrics is not just about healthcare — it’s about building a healthier, stronger nation from the ground up.

Danish Qureshi is the founder and CEO of Zarminali Pediatrics.