Comments on: Does Prevention Reduce Costs?

By: Reducing National Health Care Spending « Donald Marron

Reducing National Health Care Spending « Donald Marron — Sat, 28 Nov 2009 00:58:02 +0000

[...] population, and there is little evidence of substantial cost offsets.” (A few months ago, I made a similar point about prevention efforts. In both cases, it is important to keep in mind that spending reductions should not be the only [...]

By: Donald Marron

Donald Marron — Wed, 19 Aug 2009 18:38:59 +0000

Thanks Guy-Andre. In its letter, CBO gets at one of the distinctions you are drawing, which is between what it calls prevention programs (which I discussed in my post) and wellness programs, which are more lifestyle oriented. The basic budget issues raised are similar for the two kinds of undertakings, but as you note some aspects differ.

I agree that self-initiated wellness efforts can be free for the health care system, but there is growing interest in programs that are actually sponsored (and paid for) by private insurers and government programs. That’s where the potential direct budget impact comes in.

And yes, lots of tests can be wasteful or even harmful (a relative of mine recently got a severe infection from a colonoscopy).

By: Guy-André Pelouze

Guy-André Pelouze — Tue, 18 Aug 2009 09:57:54 +0000

Sorry about prevention you made a conventionnal error. As illness insurance is not healthcare prevention is not more tets!
Prevention is either lifestyle modifications (avoiding addictions, eating a diet compatible with our genomics, exercising) to diminish the incidence of diseases or a series of intervention of doctors to track a clinically silent disease or a recurrent known affection (secondary prevention).
The lifestyle modifications are free for the healthcare system and I would write carry positive externalities. Studies on runners but also on other people exercising regularly showed that their expenses in the healthcare system are lower.
On the other hand prevention by the healthcare system means more tests, imaging and fees. But contrary to an intuitive thinking it is not always beneficial to the patients.I will do it very short: if you have on a mammogram a tumour it does not mean that you will die of it and you could die of a preventative treatment initiated after this diagnosis. Same reasonning for prostate or lung cancer. In an other field: type 2 diabetes. It is hard to find a definitive proof of the efficiency of drugs when the type 2 diabetes is treated before any clinical signs. On the contrary lifestyle modifications are highly efficient. The first prevention is costless, the second costly…

By: Assorted Links (8/10/2009) – The Jim Garven Weblog

Assorted Links (8/10/2009) – The Jim Garven Weblog — Tue, 11 Aug 2009 22:42:03 +0000

[...] Does Prevention Reduce Costs? [...]

By: Donald Marron

Donald Marron — Tue, 11 Aug 2009 04:14:42 +0000

I agree, targeting is key. Also, as noted in subsequent post, we should think about cost effectiveness, not just money saving.

By: Do the Benefits of Preventative Care Justify the Higher Spending?

Do the Benefits of Preventative Care Justify the Higher Spending? — Tue, 11 Aug 2009 04:13:33 +0000

[...] Policymakers are desperate for painless ways to pay for expanded health care coverage. Many of them have therefore become enamored of the idea that increased spending on preventative care could reduce overall health spending. As I noted yesterday, however, there’s a problem with that idea: it generally isn’t true. [...]

By: Charlie

Charlie — Mon, 10 Aug 2009 17:22:00 +0000

While preventive CTscans may not be cost-effective, it is hard to believe that tests for early detection of high cholesterol, hyper-tension, blood sugar/diabetes..are not worth it – given the high prevalence of related/resulting problems

The approach has to be targeted – that is the key.

By: Assorted Links – The Jim Garven Weblog

Assorted Links – The Jim Garven Weblog — Mon, 10 Aug 2009 17:15:51 +0000

[...] Does Prevention Reduce Costs? [...]

By: Marcus

Marcus — Mon, 10 Aug 2009 13:12:06 +0000

Seems the experience of other countries could help here. I know the British government relied on savings from preventive health care in ‘selling’ the national health service in 1947/8. Within a few years they realized the savings weren’t happening and the system required a large infusion of cash. Seems to support your hypothesis.

By: An Ounce of Prevention - Economics -

An Ounce of Prevention - Economics - — Mon, 10 Aug 2009 10:19:44 +0000

[...] August 2009 (141)July 2009 (553)June 2009 (503)May 2009 (468)April 2009 (522)March 2009 (178)February 2009 (1)January 2009 (2)December 2008 (1)November 2008 (3)October 2008 (1)September 2008 (3) …is expensive, says CBO:the evidence suggests that for most preventive services, expanded utilization leads to higher, not lower, medical spending overall.Coverage of the issue here and here. [...]