Wednesday, August 19, 2009

The Problem with Savings

The question of why prevention doesn't save money continues to dominate media coverage of health reform issues as they relate to disease prevention and health promotion. The most recent example was Michelle Andrews, who wrote a piece entitled "The Problem with Prevention" for The New York Times' online "Prescriptions" page. The "problem" is, of course, is that experts say prevention won't save as money, contrary to claims made by President Obama and others.

Partnership President Rob Gould was interviewed for the piece, and he cautioned that value, not savings, is the proper question for consideration.

"The key is to invest in measures that provide the most bang for the prevention buck — high clinical value at a reasonable cost," Andrews writes. 'The right question to ask is whether it’s a cost-effective use of health dollars,' said Rob Gould, president of the Partnership for Prevention, a nonprofit that promotes preventive health.

"Judged this way, certain preventive services, but not all, may be considered worthwhile, in that while they may not save money, their cost is considered reasonable for the years of sickness and the deaths that they help people avoid," Andrews says. "By those criteria, effective prevention includes colorectal cancer screening for adults ages 50 and older, adult flu shots and screening for high blood pressure in appropriate patients."

But Andrews also notes that even those services may run afoul of the Congressional Budget Office scoring that holds that "the lower mortality rates that result … could increase federal spending for Social Security and Medicare.”

This prompted the following response from one reader: "I’m waiting with bated breath for the stunning argument... that the cheapest way of all is to have NO health care system."


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