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There are some things that make you ask, "Why are we even debating this?" The debate over preventive health care is one of those things for me. Today Stephen A. Brunton, M.D., FAAFP wrote on the Huffington Post:

Beyond the political and budgetary challenges in Washington and the debate around the relative merits of various aspects of the ACA, these reductions to the Fund are representative of a broader alarming shift in our health care system: a growing desire to cast prevention as expendable and as synonymous with wasteful spending.
He goes on to point out, what seems fairly obvious, that this myopic point of view doesn't consider the long-term cost savings and the long-term health benefits for patients that come from preventive health screenings and tests.

The criticisms that this kind of approach does more harm than good is mind-boggling. How can doing nothing be better than doing something? Seriously, I need help understanding the logic from those that don't support preventive health - is it simply a well-funded and influential insurance lobby?

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Comment Preferences

  •  Don't Forget, Facilities Are Increasingly For-Prof (1+ / 0-)
    Recommended by:
    tardis10

    it too. Profit is not just for insurance. Most aspects of health market that are for-profit have incentives to reduce prevention and increase high priced remediation.

    We are called to speak for the weak, for the voiceless, for victims of our nation and for those it calls enemy.... --ML King "Beyond Vietnam"

    by Gooserock on Thu May 23, 2013 at 08:59:42 AM PDT

  •  Insurance Companies make money with preventive (1+ / 0-)
    Recommended by:
    Nattiq

    health.

    Under the PPACA law increased healthcare spending means the insurance companies have higher profits as they make a fixed margin on healthcare spending.  Reducing healthcare spending hurts their profitability.

    The most important way to protect the environment is not to have more than one child.

    by nextstep on Thu May 23, 2013 at 09:07:12 AM PDT

  •  Preventative care often doesn't save money (5+ / 0-)

    overall.  That's not to say it isn't a good thing to do, because it clearly is, but it's not a money saver, generally.   It saves money in those individual instances where it prevented a more costly diagnosis, but not always as an overall matter.  

    Here's, hypothetically, how that works.  Let's say you have a diagnosis that costs about $100,000 to treat.  There's a preventative test, that costs $5000, that can prevent that cost.  Simplistically, you say, $5000 to prevent $100,000 -- that's a money saver.  But that only works IF it is certain that you would otherwise have the $100,000 condition.  Let's say only one in 100 would, without the $5000 test, get that condition.  That means that, if you look at things overall (like from an insurer's perspective) you have spent $500,000 to prevent one person from having a $100,000 condition.  From a pure dollars basis, that's a money loser for the insurance company.  It's a very very good thing, of course, for that one person who was saved from the $100,000 problem, and that's a legitimate basis or arguing that preventative care is a very good thing to do, but it's often not true to argue that preventative care is a money-saver.  Depending on the numbers, it may well not be.  

    Really, when people talk about "health insurance" including preventative care, they aren't really talking about insurance in the normal sense of the word -- insurance is paying a premium now in case there's an unexpected event later.  What we now call "catastrophic" health insurance" (coverage if you get hit by a bus, or if you develop cancer, but not for ordinary doctor's visits) is insurance.  What we generally call "health insurance" now is really "health cost pre-payment," where you sort of "pay one price" (insurance premiums) and then get whatever health care you want, with some co-pays down the line.

    •  Also need to include "false positives" (1+ / 0-)
      Recommended by:
      Nattiq

      those who test positive for a condition, when they don't actually have the condition and then receive all or part of the treatment.

      The most important way to protect the environment is not to have more than one child.

      by nextstep on Thu May 23, 2013 at 10:37:08 AM PDT

      [ Parent ]

  •  You can't make the general statement that (2+ / 0-)
    Recommended by:
    nextstep, Nattiq

    preventive care always results in long term savings. It is very specific based on the cost of the diagnostic tests, the frequency of the diseases, and the cost of the therapies.

    "let's talk about that"

    by VClib on Thu May 23, 2013 at 09:52:47 AM PDT

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