Does preventive care save money?
30 06 09 - 12:04
Is Preventive Care a Cost Saver?
Preventive care saves money, right? Uh, not exactly.
Senate Democrats drafting the big health care overhaul were hoping not only to improve Americans’ health by promoting preventive care but also to squeeze out savings for the government to help provide insurance coverage to people who lack it.
If health care providers can prevent or delay conditions like heart disease and diabetes, the logic goes, the nation won’t have to pay for so many expensive hospital procedures.
The problem, as lawmakers are discovering to their frustration, is that the logic is wrong. Preventive care — at least the sort delivered by doctors — doesn’t save money, experts say. It costs money.
That’s old news to the analysts at the Congressional Budget Office, who have told senators on the Health, Education, Labor and Pensions Committee that it cannot score most preventive-care proposals as saving money.
“I think there’s a great desire to believe that everything that’s good saves money,” says Paul N. Van De Water, a senior fellow at the Center on Budget and Policy Priorities. “Unfortunately, there are a lot of things that are good that cost money.”
The reason preventive care doesn’t save money is simple. To prevent a single stroke, for example, doctors must treat thousands of people who have high blood pressure and therefore are at risk of stroke. The same goes for use of cholesterol-lowering statin drugs, which can prevent heart attacks.
All of those prescription drugs and office visits add up to big money. But many of the patients never would suffer a stroke or heart attack even without treatment. And some will suffer such attacks despite it.
In the end, the expense of the preventive care for thousands of people outweighs the expense of treating the few that would have suffered strokes or heart attacks without treatment.
But while preventive care isn’t cost-effective, Rutgers health economist Louise B. Russell says that doesn’t mean it isn’t worthwhile.
“It’s a good thing to prevent people from getting heart bypass surgery,” she said. “They’re healthier, and that’s what we want the health system to do. But we can’t, unfortunately, say that not only are we going to make people healthier, we’re going to save money.”