I have been carrying an article with me around the country over the last year or so. It was written in February 2008 in the New England Journal of Medicine. The "Perspective" asks the question, "Does preventative care save money?" The writers conclude that most of the political rhetoric about the possible dollars that could be saved by prevention is "overreaching."
The authors make it clear that vaccinations, smoking cessation, low cost screening for a disease (when a cost effective treatment for the disease exists), and avoiding misuse of alcohol DO save money. However, they also point out that expensive high-tech treatments for some diseases might be a more cost effective use of medical care. I think that the most interesting statement in the article is the following:
- "Although some preventive measures do save money, the vast majority reviewed in the health economics literature do not. Careful analysis of the costs and benefits of specific interventions, rather than broad generalizations, is critical." (emphasis added)
- "Is an ounce of prevention REALLY worth a pound of cure?"
Whether we like it or not, our future medical care providers (whether private doctors, HMOs, or the federal government) will be looking at some of the issues raised in this short article. In fact, the "quality-adjusted life-years (QALYs)" discussed in the article are essentially the means by which all socialized medical systems ration care. I really don't like to think that my health care decisions will be made by someone looking up the QALYs of a particular treatment before deciding to allocate the funds for it. I like the ability to make that decision myself. In any case, how much freedom do you think we will have when our heart, lungs, knees, and backs become line items in the federal budget?
Quite frankly, I think a lot of sickness could be prevented if we just stopped talking about a takeover of our health care system by the government. I know that my blood pressure would be lower if we did.