Prevention Matters

Encouraging use of medical services – and discouraging use of services without evidence of effectiveness – will be critical to improving the performance of our health system and to controlling healthcare costs. A New York Times editorial rightly gives Medicare credit for proposing not to cover virtual colonoscopies since they are believed to be less effective at discovering small polyps than standard optical colonoscopies.

The quasi-governmental U.S. Preventive Services Task Force and Task Force on Community Preventive Services – the groups charged with evaluating the effectiveness of clinical and community-based preventive services – have been leaders in the movement toward evidence-based medicine. They have carefully identified those preventive services that are proven to be effective. Where there is evidence that preventive services are ineffective, or where there is simply insufficient evidence to even render a judgment, the task forces say so.

Decision-makers across the health system should follow the lead of the Medicare program and provide coverage of proven services while discouraging use of services of uncertain benefit. This is an important first step in moving toward a health system that provides high quality and ensures that our health dollars are spent wisely.