Is preventative medical care really worth it? I can see how eating a sensible diet, exercising, and such could lead to health care savings overall, but these are all things that don’t really need to involve medical care.[1] How about those preventative measures that do involve the medical industry? The CBO says, “Hang on a minute there…”
Preventive medical care includes services such as cancer screening, cholesterol management, and vaccines. In making its estimates of the budgetary effects of expanded governmental support for such care, CBO takes into account any estimated savings to the government that would result from greater use of preventive care as well as the estimated costs of that additional care. Although different types of preventive care have different effects on spending, the evidence suggests that for most preventive services, expanded utilization leads to higher, not lower, medical spending overall.
Well…yeah. Consider Joe who goes in for cancer screening. He’s clear. So how much did we save? Nothing. In fact, we are in the hole since we spent money screening a person with no cancer. Bob goes in next and it turns out he has cancer. How much did we save? Hard to say. We spend money on the screening and treating his cancer. Now, maybe we’d save some money for Bob than if he got no screening and his cancer progresses, but it is also possible that the cancer progresses to the point that whatever treatment is undertaken is not that great because Bob’s cancer is so far advanced he dies shortly after treatment starts.
Then there is just the number of people involved. Here is how the CBO puts it,
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. Judging the overall effect on medical spending requires analysts to calculate not just the savings from the relatively few individuals who would avoid more expensive treatment later, but also the costs of the many who would make greater use of preventive care.
In other words, if the preventive care saves us $1 million (treating diseases earlier), but costs $1 million (increased number of screenings) there is no savings.
However, in chasing cost savings this is one area where we might want to proceed with caution. After all, preventive screening can save lives.
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[1] I say could because if it leads to increased life spans and that most health care expenditures come from those over 65, then having more people live past 65 could have the overall effect of increasing health care expenditures. If a person were to suddenly drop over dead at 49 of a heart attack, chances are he’s saving us far, far more money than the guy who runs 5 miles every day, eats right, and goes to his annual check up.
