Prevention Matters

After The Washington Post buried the news from his recent study under a pile of all-too-typical blather about whether prevention measures will save enough to pay for the health reform bill, Michael O'Grady wrote a column for Roll Call outlining his proposal to change rules for scoring federal health care spending in a way that addresses prevention more realistically.

"Fighting chronic disease is costly and hard," writes O'Grady, a senior fellow at the University of Chicago's National Opinion Research Center. "However, we do not have to make it look more costly than it really is."

O'Grady cites findings from the National Institutes of Health that an intensive diabetes management program only begins to yield lower spending on diabetes treatment and complications after about eight years, with the bulk of the reductions occurring between years 10 and 20. The result, he says, is that the Congressional Budget Office's current scoring system, which only “scores,” the cost reductions achieved in the first 10 years of a program, "underestimates the longer term economic benefits associated with aggressive diabetes management programs."

"It is time the CBO uses the best available epidemiologic models as well as actuarial and economic models when predicting costs associated with disease interventions," he says. "...Overlooking the cost reductions associated with fewer kidney transplants, dialysis, heart attacks, strokes, blindness and amputations resulting from interventions pioneered by the NIH and CDC because they occur outside a 10-year budget window is harmful to the health of our economy and our people."