Preventive Care Rarely Pays
This is from Michael Tanner's Cato paper on the Obama and McCain health plans:
Studies….show that preventive care usually ends up costing money in the long run….For every disease that we prevent or catch early, we end up testing and treating many people who will never get sick. For example, Jay Bhattacharya, a doctor and economist at Stanford's School of Medicine, estimates that to prevent one new case of diabetes, an anti-obesity program must treat five people. Similarly, a study of retirees in California by Jonathan Gruber found that when retirees had fewer doctor visits and filled fewer prescriptions, overall medical spending declined. People became ill more frequently, but treating their illnesses was still less costly than paying for preventive care for everyone. Thus, increased preventive and primary care may well be beneficial for the individual in terms of health, but may not provide a societal benefit in terms of reduced costs.
Tanner also has a very good treatment of the two plans, including this tidbit: the McCain plan would reduce the number of people who lack health insurance by more than half – from 27 to 23 million.
Parente’s earlier study found that buying across state lines would reult in an additional 12 million people acquiring insurance. So the McCain tax credit by itself must produce an equally large impact.
Interesting, in light of all the criticism about the credit one hears from the Obama camp.
We have a very strange definition of prevention. What most people call “prevention” is really secondary prevention– screening to catch a disease early.
We have invested next to nothing in primary prevention of chronic and lifestyle diseases, which most evidence would show is linked to diet, exercise, and stress reduction. Compared head to head with many chronic medications, engagement in diet and exercise proves similar results to engagement in medical therapy. Overall, engagement in diet and exercise seems to holistically reduce incidence of many chronic diseases simultaneously.
So when we talk about prevention, its a shame we don’t include the discussion on how to engage people in diet and exercise in addition to all the screening stuff that isn’t really “prevention” as much as “slow progression of something you already developed”.
I think you meant a reduction “from 47 to 23 million”, which would be about 50%. Of course, we might get it down to the 27 million number today, simply by using the term “uninsured” accurately.
This is a great job! Well done. Thank you sharing your ideas and knowledge.