The ‘Preventive Care’ Myth - Prevention is a wondrous good, but in the aggregate it costs society money

By Charles Krauthammer at the National Review Online

In the 48 hours of June 15–16, President Obama lost the health-care debate. First, a letter from the Congressional Budget Office to Sen. Edward Kennedy reported that his health committee’s reform bill would add $1 trillion in debt over the next decade. Then the CBO reported that the other Senate bill, being written by the Finance Committee, would add $1.6 trillion. The central contradiction of Obamacare was fatally exposed: From his first address to Congress, Obama had insisted on the dire need for restructuring the health-care system because out-of-control costs were bankrupting the Treasury and wrecking the U.S. economy — yet the Democrats’ plans would make the problem worse.

Accordingly, Democrats have trotted out various tax proposals to close the gap. Obama’s idea of limits on charitable and mortgage-interest deductions went nowhere. As did the House’s income-tax surcharge on millionaires. And Obama dare not tax employer-provided health insurance because of his campaign pledge of no middle-class tax hikes.

Desperation time. What do you do? Sprinkle fairy dust on every health-care plan, and present your deus ex machina: prevention.

Reform proponents repeat this like a mantra. Because it seems so intuitive, it has become conventional wisdom. But like most conventional wisdom, it is wrong. Overall, preventive care increases medical costs.

This inconvenient truth comes, once again, from the CBO. In an August 7 letter to Rep. Nathan Deal, CBO director Doug Elmendorf writes: “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.”

What’s the real-life actuality in the United States today? A study in the journal Circulation found that for cardiovascular diseases and diabetes, “if all the recommended prevention activities were applied with 100 percent success,” the prevention would cost almost ten times as much as the savings, increasing the country’s total medical bill by 162 percent. Elmendorf additionally cites a definitive assessment in the New England Journal of Medicine that reviewed hundreds of studies on preventive care and found that more than 80 percent of preventive measures added to medical costs.

Prevention is a wondrous good, but in the aggregate it costs society money. Nothing wrong with that. That’s the whole premise of medicine: Treating a heart attack or setting a broken leg also costs society. But we do it because it alleviates human suffering. Preventing a heart attack with statins or breast cancer with mammograms is costly. But we do it because it reduces human suffering.

However, prevention is not, as so widely advertised, healing on the cheap. It is not the magic bullet for health-care costs.

You will hear some variation of that claim a hundred times in the coming health-care debate. Whenever you do, remember: It’s nonsense — empirically demonstrable and CBO-certified.

Read it all here.....