Thursday, August 13, 2009

Preventive care, but no savings

John Stossel explains:
...last week, CBO Director Doug Elmndorf wrote a letter to Congressmen explaining what cost savings they can expect from preventive medical services:

The evidence suggests that, for most preventive services, expanded utilization leads to higher, not lower, medical spending overall.

It makes sense if you think about what are called the "false positives". 

As I've written before, I take Lipitor. The drug may extend my life. But this doesn't lower my health-care costs. Years of pill-taking increases costs. If the pill works, I may live long enough to get an even more expensive disease. And maybe I, like millions of others, take Lipitor unnecessarily because we would never have had heart attacks. We then spend more, not less, on health care.

Elmendorf went on to write:

That result may seem counterintuitive. For example, many observers point to cases in which a simple medical test, if given early enough, can reveal a condition that is treatable at a fraction of the cost of treating that same illness after it has progressed...But when analyzing the effects of preventive care on total spending for health care, it is important to recognize that doctors do not know beforehand which patients are going to develop costly illnesses. To avert one case of acute illness, it is usually necessary to provide preventive care to many patients, most of whom would not have suffered that illness anyway. ... Researchers who have examined the effects of preventive care generally find that the added costs of widespread use of preventive services tend to exceed the savings from averted illness. Preventive care may improve public health, but it doesn't save money.

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