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.
"Experts have concluded that a large fraction of preventive care adds to spending but should be deemed 'cost effective,' which means that it provides clinical benefits that justify those added costs," he said. In cases where the provision of preventive medical care saves money, "potential savings from expanded federal support might be limited," he said.
As for wellness, designing government policies that are "effective at inducing people to be healthier is challenging," he wrote. However, even successful efforts "might take many years to bear fruit" and could involve significant costs, he added.
As with preventive medicine, he said the "net budgetary effect" of government support for wellness services depends on the balance of two factors: The reduction in government health spending for people who reduce their future use of medical care and the costs to the government of providing or subsidizing wellness services.
Although some case studies suggest that certain employer wellness programs reduce subsequent medical care, "little systematic evidence exists," he said. The findings from case studies may not be applicable to programs that would be implemented more broadly.
The White House has started a new Web site to fight charges that President Obama's proposed overhaul of the nation's healthcare system would inevitably lead to socialized medicine, rationed care and even forced euthanasia for the elderly. Speaking at a summit of North American leaders in Mexico, Obama predicted that "the American people are going to be glad that we acted to change an unsustainable system so that more people have coverage."
President Barack Obama is trying to convince Americans with health insurance that legislation in Congress would benefit them by holding three town-hall meetings. Obama will emphasize how the legislation would fix three specific problems, according to a White House official. The Democratic National Committee said it is mobilizing supporters to attend local meetings that have been dominated by health-overhaul opponents.
Arlington-based Texas Health Resources, North Texas' largest hospital system, has laid off 33 workers to gear up for cutbacks in response to a decline in patients who pay their bills. Although it is just a fraction of its 19,000 workforce, the move could be the beginning of widespread cost-cutting. The layoffs were spread across the company, from administration to clinical staff, according to a spokesman.
To cover the needs of an estimated 6.8 million uninsured illegal immigrants, some advocates have proposed broadening the healthcare overhaul legislation now before Congress. It is immoral, immigration activists say, for hospitals and doctors to deny healthcare to the seriously ill, no matter their legal status. But proponents of tougher immigration enforcement and others fighting to contain runaway costs fear that providing such services would encourage more illegal border crossings.
Louisville, KY-based Jewish Hospital has opened an outpatient facility as part of a strategy by the healthcare company to move more services to faster growing parts of the Louisville area. The facility has a 24-hour emergency room and provides diagnostic medical imaging services. It also offers oncology services such as infusion and radiation, holistic medicine, and cardiac services. A rehab center will open in November.
The University of South Florida has partnered with Intuitive Surgical Inc. to establish the USF Health daVinci Center for Computer Assisted Surgery. The $4 million center at the USF College of Medicine in Tampa is one of two centers nationwide using the daVinci Surgical Systems SI model to teach physicians in training and community physicians how to do robotic-assisted surgery, USF Health said in a release.
August will be a make-or-break month for the drive to revamp the healthcare system, as members of Congress use the recess to either sell the need for an overhaul to voters or continue attacks on the insurance industry, the chief of the insurers' main lobbying arm said. Karen Ignagni, president of America's Health Insurance Plans, said that recent broadsides against the industry by President Barack Obama and other leading Democrats are designed as a distraction as the healthcare debate becomes more contentious.
Dozens of adults are enrolled in a flurry of fast-track flu vaccine trials that will grow to include 11,131 adults and 5,740 children, with more trials planned. The vaccine is designed to blunt the effect of a virus that, starting this fall, could infect 100 million people in the United States and cause 30,000 to 90,000 deaths based on scenarios drawn from past pandemics, says Arnold Monto of the University of Michigan, an adviser to the Centers for Disease Control and Prevention and the World Health Organization.
Scores of surgeries were delayed or rescheduled at Northwestern Memorial Hospital after a fan malfunctioned in the operating room suites. Emergency and "essential" surgeries continued to be performed, but an unspecified number of elective or non-urgent procedures scheduled have had to be moved. The kinds of procedures that can wait would include hip or knee replacements or plastic surgery, hospital officials said.
