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Prevention May Prove Costly
The latest messages from Congressional Budget Office (CBO) Director Douglas Elmendorf are not ones that congressional Democrats pushing for healthcare reform are likely happy to hear.
In a letter and later in his recent blog, Elmendorf said that expanded use of preventive health measures lead to higher healthcare spending.
"That result may seem counterintuitive," he said in his blog. For example, he noted that preventive medical care—such as use of cancer screening or cholesterol monitoring—if given early enough can reveal conditions that are treatable at a percentage of the cost of treating those same conditions that have progressed.
However, physicians usually do not know beforehand which patients will develop costly illnesses; therefore, to detect cases of acute illness, preventive care is provided to most patients—many of whom will not incur that illness anyway, he said. Plus, a great deal of preventive medicine already is being performed, and many insurance plans already "cover certain preventive services at little or no cost to enrollees."
Consequently, a "new government policy to encourage prevention could end up paying for preventive services that many individuals are—already receiving|which would add to federal costs but not reduce total future spending on healthcare," he said in his blog.
Elmendorf cited several studies, including one from the New England Journal of Medicine, that found that fewer than 20% of preventive services that were examined save money, "while the rest add to costs."
In a letter to Rep. Nathan Deal (R-GA), the ranking minority member of the House Energy and Commerce Health Subcommittee, Elmendorf said that just because a preventive service adds to total spending does not mean that it is a bad investment though.
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vkh (12/7/2009 at 5:55 PM)
I fully agree with anonymous but want to say it a bit differently. When will we change the mindset that preventive care is finding disease early? It should be about helping people AVOID disease in the first place. The most common conditions these days can almost all be ameliorated by lifestyle choices, so if prevention could be about helping people exercise, eat well, and take care of themselves costs would be lower--no "treatment" is involved with this approach.
Anon (8/13/2009 at 2:23 PM)
Director Elmendorf states that many insurance plans already "cover certain preventive services at little or no cost to enrollees." None of these services are "covered" for the millions of uninsured. That cost is showing up in the ERs of the country, and we are all paying for those. Insurance companies are in business to control costs, and they seem to think that preventative care works.
anonymous (8/13/2009 at 2:12 PM)
Why is preventive care deemed to be either employer-sponsored "wellness" programs (generally unwarranted expenditures which provide no benefit)or expensive, and usually unecessary "medical" tests? We need a paradigm shift away from high tech to low tech; i.e. more sleep, organic food, organic vitamins, and less techology all the way around. All the tests in the world don't cure anyone of anything. Modern medicine doesn't cure, it maintains "chronic" illnesses.