The Cost of Preventive Health Care
[Guest post by DRJ]
The Obama Administration has pushed the cost-saving benefits of preventive health care but the CBO says preventive care won’t save money:
“Although different types of preventive care have different effects on spending, the evidence suggests that for most preventive services, expanded utilization leads to higher, not lower, medical spending overall,” [CBO Director Douglas] Elmendorf wrote.
***
“Researchers who have examined the effects of preventive care generally find that the added costs of widespread use of preventive services tend to exceed the savings from averted illness.”
Mike K has pointed this out on several occasions. Perhaps the Obama Administration has been listening because Linda Douglass, the infamous White House communications director for Health Reform, responded that preventive care will save money because it will be targeted.
I wonder how they will decide who gets this targeted preventive care? It could be our personal physicians but I’m betting on the government death panel.
— DRJ
“Targeted” is the new Obama buzzword. Its vacuous nonsense. There is a lot of research on “preventative care” over the last couple of decades. With the exception of vaccination and smoking cessation, its almost all nonsense.
SPQR X (26be8b) — 8/9/2009 @ 3:58 pmCould everyone just keep a open mind. Stop yelling and listen. People are so afraid of change. That is so stupid! We need change in this country. Let the president help us. I am convinced that he will. Please stop all the bitching about every thing and just listen. Open your minds for everyones sake! Please!
Darlene Smith (dd719f) — 8/9/2009 @ 5:02 pmWhy do folks always ask us to “open our minds” when they mean “agree with me”?
If someone WANTS to change minds, they can try with facts- instead of threats, violence and insults.
Foxfier (db0f51) — 8/9/2009 @ 5:06 pmObama’s problem, Darleen, is that we have been listening.
Paul (creator of "Staunch Brayer") (623916) — 8/9/2009 @ 5:09 pm…or emoticons!
AD - RtR/OS! (0bd1ec) — 8/9/2009 @ 5:09 pmBut then, without feelings the Left is absolutely empty.
… And it is definately odd hearing all this “stop all your yelling” spin coming from the allcaps crowd.
Sean P (3928ec) — 8/9/2009 @ 5:09 pmI neither need nor want President Obama’s “help”. I need him to get his hands off my money and my life, and let me do it for myself.
His proposed HC is a tax, rationing of care, and reduction in quality.
Try reading the bill he wants us to shut up and accept, and then come talk to us.
Scott Jacobs (d027b8) — 8/9/2009 @ 5:18 pmYou know Darleen, “change” is not always good.
Suppose you’re a little froggy swimming around in a big kettle with the water at 78 degrees. Feels pretty good. Then along comes Mr. Obama and he “changes” the temperature of the water to 180 degrees and keeps it there for an hour.
You go from being a froggy to poached frog legs–so much for the benefit of “change” if you’re the frog.
Mike Myers (674050) — 8/9/2009 @ 5:31 pmI’ll be a dip shit and say I had mentioned this over and over also. So no surprise here.
I keep saying the best way to lower health care cost is to encourage smoking, unprotected sex and lots McDonald’s.
The sooner you die, the less health care you consumer. Just that simple.
HeavenSent (01a566) — 8/9/2009 @ 5:39 pmconsumer = consume
HeavenSent (01a566) — 8/9/2009 @ 5:40 pmDarlene,
Are you open minded enough to say President Bush won the Iraq War and has created a climate of change in the Middle East?
Change for plurality, secularism, democracy, women’sright, etc…..
Just asking.
HeavenSent (01a566) — 8/9/2009 @ 5:42 pm“Targeted”? Sounds like in-your-face “preventive care.” So, we go from the “nanny state” to the “nagging harpy state.”
Kevin Murphy (0b2493) — 8/9/2009 @ 6:08 pm…as in the cigarette scene in “The Fifth Element”
Kevin Murphy (0b2493) — 8/9/2009 @ 6:09 pmNotice that Darlene’s idea of opening one’s mind is to just shut up and not argue.
Not happening.
She’s “convinced” that the President will help us. Based on what? We’ll never know because she can’t articulate any real reason.
Cult behavior. Don’t question the Chosen of God.
SPQR X (26be8b) — 8/9/2009 @ 6:17 pmDarlene sounds like an ObamaTard.
HeavenSent (01a566) — 8/9/2009 @ 6:20 pmPreventative care can only help if the “care” is forced, like if you have to go to doctors twice a year for full checkups and you pay the total for it….then your insurance can cover the costs for care “IF” you get an illness….
A regular check-up that I get once a year, including knee and back X-rays, costs about $300 here in New Orleans if I have to pay for all of it (I did once when it snuck up on me).
Problem comes when people do this, and their insurance covers all but the $25 co-pay.
I can’t get my insurance company to lower the rate I pay monthly if I would cover those costs myself. I’m in a “state” plan for teachers.
We’ve got to get health insurance to a similar level as car insurance….you pay for basic costs, the insurer pays for the extra-ordinary costs following accidents (extreme illnesses)……
reff (ee9f7a) — 8/9/2009 @ 6:37 pmreff is right.
HeavenSent (01a566) — 8/9/2009 @ 6:52 pmIn the ’70’s, Democrats pushed HMO’s as the solution to our supposed health care woes specifically because they were supposed to be incentivized by capitation to focus on preventative care.
But the HMO’s discovered that preventative care was largely not cost effective. Vaccination is the best case. Smoking cessation programs the next best case but after that, almost no preventative care programs actually reduce health care costs in excess of the preventative care costs themselves.
Today, HMO’s are the bad guys – even for Democrats who themselves pushed so hard for legislation creating them like Ted Kennedy.
SPQR X (26be8b) — 8/9/2009 @ 6:58 pmThe only preventative health care that is really going to be cost effective is membership in some kind of exercise facility, transportation to and from and a trailer hitch implanted in your ass to haul you there and back five times a week.
And a nicotine patch.
rls (e58293) — 8/9/2009 @ 8:32 pmAre you kidding me “SPQR X”?? Democrats did NOT push HMOs!!! Ever heard of NIXON? The Truth is that you should try hearing those wonderful tapes that surfaced after his death… that’s right, you hear him discussing ways to make health care “profitable” and in doing so, brings up the idea of …you got it…HMOs.
AnInconvenientTruth (efd6a1) — 8/9/2009 @ 8:51 pm‘We need change’
That means there’s a crisis? Because before Obama got into the Senate (when the dems took over in 2006), the nation was humming like a well oiled machine. Everything was much better than it is now.
Health care needs less regulation. It’s got problems, and less regulation would help. Even with its problems, it’s great. What would have cost a fortune 20 years ago is affordable today. Expensive treatments are available today that, through scale and better tech, become cheap tomorrow. Advanced science costs a lot of resources, and nothing will ever change that, but we’ve got a great health care system today. Better than the world has ever seen before.
And full of freedom.
Juan (bd4b30) — 8/9/2009 @ 8:56 pm“health care “profitable””
UM, that’s a good thing. You make it sound like some kind of abomination for people to have an incentive to create great advances in health care.
Trust me, it’s the profitability that drives the cures for what hurts today. HMOs are not bad things.
Juan (bd4b30) — 8/9/2009 @ 8:58 pmHMOs were supposed to deal with costs and were pushed by Paul Ellwood. Inconvenient should learn some history. The theory was that preventive care would save money; it doesn’t. Early diagnosis of breast cancer saves lives but not much money. The only things that save money are such public health measures as stopping smoking, losing weight and exercise. I expect that, if against all odds Obama’s plan passes, we will see punitive measures, including taxes, on obesity, smoking and lack of exercise. Remember how Michelle said we would never be allowed to go back to our lives ?
Does anyone remember the Hitler Youth ?
Mike K (2cf494) — 8/9/2009 @ 9:00 pmyou think of “death panel” before “targetted smoking programs”?
yeah, I don’t care what health insurance plan you have— there’s no cure for what you have.
psycho.
bb (71698b) — 8/9/2009 @ 9:01 pmAs I informed another commenter who appeared to be rather new here, DRJ is the most civil, respectful, and forgiving person on this blog or any other.
It would serve you well to keep a civil tongue when you speak to her.
Be. Polite.
Or be. Gone.
Scott Jacobs (d027b8) — 8/9/2009 @ 9:14 pmbb,
Let’s take your example of smoking. Don’t you wonder who decides which people are smokers and should be targeted? It could be physicians that target patients who report they are smokers, but not everyone will honestly report their habits. How long do you think it will take before there is a government program that encourages or requires people to report smokers?
DRJ (8d138b) — 8/9/2009 @ 9:22 pmThat ignores the fact that such reporting would violate Patient Confidentiality laws.
If we aren’t allowed to check mental health records (because of that very same law) when someone buys a handgun, why would THIS be allowed?
Scott Jacobs (d027b8) — 8/9/2009 @ 9:24 pmDarlene, Inconvenient, and bb would have you believe what you know to be untrue.
JD (f8b50e) — 8/9/2009 @ 9:28 pmScott,
There are many “public health” exceptions to such reporting. It’s not a huge stretch to imagine a justification similar to that for STD’s or other communicable diseases.
Stashiu3 (ed6467) — 8/9/2009 @ 9:30 pmI reported Darlene to flag@whitehouse.gov so they would know she is a believer, Inconvenient for being aggressive in its pursuit of disinformation, and bb for being a twatwaffle.
Oh, and the rest of you being racist Nazis.
JD (f8b50e) — 8/9/2009 @ 9:36 pmMan that flag@whitehouse thing creeps me the hell out. I hate to violate Godwin’s law and all but even Chimpy McHitler never proposed anything as creepy as that. Wonder if the names on the database will ever come up when the person in question needs a new kidney under Obamacare?
Sean P (3928ec) — 8/9/2009 @ 9:50 pmThe theory was that preventive care would save money; it doesn’t.
That’s not too surprising.
I do recall reading an article some time ago (I believe it was in the LA Times) about one health insurance provider (Blue Shield of Calif?) that claimed its preventative program was a good value, a net return on its dollar. However, I was skeptical about its overall impact, mainly because human nature being what it is, many people will resist mommy-type lecturing and nagging unless there’s something wonderful in it at the end of the line—-that being, say, a prize of money, and not just better health for the sake of better health.
People love their indulgences — eg, tasty but junky food in particular — and weening them off them will require a huge, huge carrot tied to the end of a stick.
Obamacare’s preventative health provisions likely would end up being no more than a continuation of 1960s-type, kum-bah-yah, do-gooder programs that represent lots and lots of dollars being poured down a big black hole.
Mark (411533) — 8/9/2009 @ 10:14 pmObama care makes me wonder. What do you think will happen to all the charities that depend on donations to do research? Do you think people will think the government will take care of them and since I’m paying extra tax I no longer have to donate? And for all of you that think the government needs to take care of this for us, why don’t we just let Obama decide our entire life for us? You know like smoking, drinking, what job we do, when it’s ok to take a vacation, should we be aloud to visit our friends. I think it would be great if the government controlled every aspect of our life. Of course that wouldn’t be America. America is supposed to be a place of freedom, not total government control.
Huey H (23e39d) — 8/10/2009 @ 12:10 amGiven the Federal Government’s less than exemplary record on cost control and efficiency in the other social welfare programs in maintains, I have no confidence whatsoever the any healthcare system under its control will achieve any appreciable advantage over how healthcare is currently run in the US. Furthermore, I have lived for the past 7 years in two countries which have state-subsidized healthcare (Australia, Singapore) – while adequate for routine treatment and basic preventative care needs I would by no means say it is “better” in quality, and not necessarily cheaper in local currency terms.
Mark Turner (bd50f1) — 8/10/2009 @ 4:17 am[…] Reform, responded that preventive care will save money because it will be targeted. Targeted??? How does one target preventive care? By it’s definitive, preventive care is just that … PREVENTIVE for all. Unless Obama is […]
CBO Says Obamacare Will Raise Costs, Not Cut Them … Quick Notify Obama’s Nark Squad at flag@whitehouse.gov | Scared Monkeys (1b1833) — 8/10/2009 @ 4:55 amI think what Darlene meant was that you should stop opening your mouths and shouting out the opinions you’ve come to without reading or researching anything. You are all guilty of that on here, which is why I find it rather entertaining to read this slop from a distance.
Nobody you personally know (e7c459) — 8/10/2009 @ 5:24 amYup, we should just shut the f*ck up and listen to those self-proclaimed moral betters because they feel superior. None of you can read or research, so you should just get the hell out of the way and let the dirty little socialists do their dirty little socialisms because they know better what you want and need than you do.
JD (0be158) — 8/10/2009 @ 6:25 amWhat a sanctimonious self-important pr*ck that one is.
JD (45da85) — 8/10/2009 @ 6:56 amYou are all guilty of that on here, which is why I find it rather entertaining to read this slop from a distance.
Of course you do , sweetheart. And yet here you are. But we have this annoying feature here of posting sources to back up our opinions. So let’s assume that you can do the same. Any evidence to back up your claims? It should be fairly easy to do – just look at the archives over the past few months, give us some examples and let’s debate the relative merits of your rant. Sound good?
Dmac (e6d1c2) — 8/10/2009 @ 8:47 ampr*ck that one is
You’re laboring under a false assumption, methinks. I think it’s more of a neutered eunic, or at least has the gonads of a mouse.
Dmac (e6d1c2) — 8/10/2009 @ 8:48 amMSNBC’s Lawrence O’Donnell gives the worst most slanted interview ever, discussing health care with Peter Schiff. Schiff is running against Senator Dodd.
Wesson (03286d) — 8/10/2009 @ 8:49 amhttp://www.youtube.com/watch?v=gJxkFVoYp5o
That ignores the fact that such reporting would violate Patient Confidentiality laws.
The history of confidentiality laws implies that “the government” will be an exception — they’re there to protect you, after all.
Instead of being denied coverage (or charged extra) for your health, you will be denied coverage (or charged extra) to the degree your behavior falls outside government-approved norms (protected classes exempted). The other difference is that there won’t be an alternative insurer.
Kevin Murphy (0b2493) — 8/10/2009 @ 8:58 amI didn’t say that you don’t know how to research, just that you don’t actually do it. So go ahead and get all riled up over something I did not say.
Nobody you personally know (e7c459) — 8/10/2009 @ 9:43 amI submit every one of Karl’s posts as evidence of your douchebaggery. But it is easier to argue against caricatures and voices in your head, isn’t it?
JD (2eff36) — 8/10/2009 @ 10:14 amAll bow to your moral and intellectual better.
JD (2eff36) — 8/10/2009 @ 10:21 amThe best preventive care is that of the self-imposed variety. I would like to live for a long time and be able to enjoy knowing grandkids, shoot for the 75 year anniversary mark with my spouse, and have most of my faculties intact till the end.
voiceofreason2 (10af7e) — 8/10/2009 @ 10:38 amIn order to do that I exercise, refrain from smoking, get flu shots, vaccinations, recommended screenings at certain age milestones and eat lots of veggies and fish.
In the words of Bob Dylan “don’t need a weatherman to know which way the wind blows..”
Thanks but no to government intervention on my lifestyle.
that you should stop opening your mouths and shouting out the opinions you’ve come to without reading or researching anything
I didn’t say that you don’t know how to research, just that you don’t actually do it.
Obvously said by one who neither bothers to read the actual posts nor attempts to engage his feeble cranial capacity in order to try to comprehend them. You’re just spouting talking points without understanding the actual site you’re attempting to discredit. Reading = comprehension. Every single post on this site by our hosts is sourced and linked. Epic fail on your part, princess – and your rampant sockpuppetry only furthers your complete beclowning. But thanks for demonstrating once again why the far left cannot debate this issue effectively without resorting to misdirection and outright lying on their parts.
Dmac (e6d1c2) — 8/10/2009 @ 10:49 amI agree with douchebag you personally don’t care about!
Douchebag you personally don't know (e6d1c2) — 8/10/2009 @ 10:53 amI have reported nobody you personally know to flag@whitehouse.gov for being not very good at its marching orders.
JD (593b0c) — 8/10/2009 @ 10:56 am#46 Amen to that.
If I choose to spend more on healthcare to live longer, that’s my choice. If I choose to save it for my off-spring, and neglect some healthcare options – that, too, should be my choice.
Any panel; government, insurance company, or otherwise, shouldn’t be able to tell me how I can spend the money I earned.
Corwin (ea9428) — 8/10/2009 @ 10:58 amwhich is why I find it rather entertaining to read this slop from a distance.
Could we ask you to please increase the distance ? By a lot ?
AS for effectiveness of preventive care, I would suggest becoming a Morman would be the best method. Utah has a life expectancy well above the rest of the country, especially the blue states.
What most politicians describe as preventive care is routine behavior that should not need a doctor.
Mike K (2cf494) — 8/10/2009 @ 11:23 amPreventative care will soon include the government telling me what I can eat, taxing foods and drinks I enjoy, etc.
If I had warned about a potential tax on coke ten years ago, most liberals would say I was hysterical. Of course, they are also wrong today to say we’re inventing problems. This bill is a foot in a door. And we all know what is coming through that door in a generation. Our nation is going to have a very hard time paying for anything, very very soon. What are they going to do when they have the ability to run our lives and need to come up with tons of money?
Juan (bd4b30) — 8/10/2009 @ 12:02 pmJuan – That income people earn is really just passing through on its way to the government.
JD (b9ca6b) — 8/10/2009 @ 12:10 pmDarlene,
Analysis contrary to yours is not always the result of a personal fault. Perhaps you are under the delusion that liberal politics is the natural progression from being a good person. This shame based politics is effective for primitive pre technological societies, yet I hope we have evolved beyond that.
I for one will not be shamed by the noble lie. It is a lie. A falsehood. An affront to reality and to intelligence. I will bitch until I rest in the earth.
anon (403eb6) — 8/10/2009 @ 1:27 pmDarlene,
Analysis contrary to yours is not always the result of a personal fault. Perhaps you are under the delusion that liberal politics is the natural progression from being a good person. This shame based politics is effective for primitive pre technological societies, yet I hope we have evolved beyond that.
I for one will not be shamed by the noble lie. It is a lie. A falsehood. An affront to reality and to intelligence. I will bitch until I rest in the earth.
anon (403eb6) — 8/10/2009 @ 1:27 pmYou can say that again!
Juan (bd4b30) — 8/10/2009 @ 1:33 pmComment on health care…If the total estimated annual cost for smoking related problems is 96.7 billion and the total estimated annual cost for problems due to obesity equals 99 billion, why don’t we encourage smoking and thereby help folks with weight problems lose those excess pounds ? The money saved could be used to build regional crematoriums.
Seniorjj (1b5cbc) — 8/17/2009 @ 10:21 pmSenior JJ
“The only things that save money are such public health measures as stopping smoking, losing weight and exercise.”
Wrong.
Smoking costs, peer reviewed medical article on overall costs:
http://content.nejm.org/cgi/content/abstract/337/15/1052
Not peer reviewed, but sourced:
http://www.usatoday.com/news/health/2009-04-08-fda-tobacco-costs_N.htm
“Vanderbilt University economist Kip Viscusi studied the net costs of smoking-related spending and savings and found that for every pack of cigarettes smoked, the country reaps a net cost savings of 32 cents.”
Obesity costs, again peer reviewed medical article on overall costs:
http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0050029
You live longer, you cost more overall. The problem that the “smoking costs 90 billion per year” misses… everyone dies eventually.
Dying 5-10 years sooner, at 75 instead of 85? Saves a ton of cash, those are the more costly years you’ve missed out on.
But hey, I’m probably wrong. I’ve just linked peer reviewed articles in medical journals… I’m sure your feelings count more than that.
Gekkobear (4f1f4b) — 8/18/2009 @ 11:15 amGekkobear, some of Kip Viscusi’s costs are non-medical in nature such as social security benefits paid out.
Nonetheless, the basic point remains that there are few real “preventative medicine” proposals that actually reduce medical costs.
SPQR (5811e9) — 8/18/2009 @ 11:26 am