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Congressional Budget Expert Says Preventive Care Will Raise -- Not Cut -- Costs

RightinNYC

RightinNYC

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Congressional Budget Expert Says Preventive Care Will Raise -- Not Cut -- Costs - Political Punch

This is a bit depressing - I had always assumed that this was one area where both sides could come together in acknowledging that we could save money by expanding a particular type of care. It looks like we were all wrong.

In yet more disappointing news for Democrats pushing for health care reform, Douglas W. Elmendorf, director of the Congressional Budget Office, offered a skeptical view Friday of the cost savings that could result from preventive care -- an area that President Obama and congressional Democrats repeatedly had emphasized as a way health care reform would be less expensive in the long term.

Obviously successful preventive care can make Americans healthier and save lives. But, Elmendorf wrote, it may not save money as Democrats had been arguing.

"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," Elmendorf wrote. "That result may seem counterintuitive.

"For example, many observers point to cases in which a simple medical test, if given early enough, can reveal a condition that is treatable at a fraction of the cost of treating that same illness after it has progressed. In such cases, an ounce of prevention improves health and reduces spending — for that individual," Elmendorf wrote. "But when analyzing the effects of preventive care on total spending for health care, it is important to recognize that doctors do not know beforehand which patients are going to develop costly illnesses. To avert one case of acute illness, it is usually necessary to provide preventive care to many patients, most of whom would not have suffered that illness anyway. ... 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."
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Congressional Budget Expert Says Preventive Care Will Raise -- Not Cut -- Costs
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That's exactly right, because you're gonna have cats going to the doctor for everything from a mashed thumb to a sunburn. People are going to see one thing when the OC bill passes, "free", and that's it. There's gonna be a whole new generation of hypochondriacs invented by this legislation. When all those clowns go to the emergency room, it's going to cause a person with an actual problem to have to wait for hours on end for treatment.

But, hey, if this is what the Libbos want, fine. You know who to blame when it turns into a complete cluster ****.
 
apdst said:
That's exactly right, because you're gonna have cats going to the doctor for everything from a mashed thumb to a sunburn. People are going to see one thing when the OC bill passes, "free", and that's it. There's gonna be a whole new generation of hypochondriacs invented by this legislation. When all those clowns go to the emergency room, it's going to cause a person with an actual problem to have to wait for hours on end for treatment.

But, hey, if this is what the Libbos want, fine. You know who to blame when it turns into a complete cluster ****.
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And guess who will have to clean up this unholy mess once the Dems are kicked on their collective asses??

yep the GOP!!!
 
RightinNYC said:
Congressional Budget Expert Says Preventive Care Will Raise -- Not Cut -- Costs - Political Punch

This is a bit depressing - I had always assumed that this was one area where both sides could come together in acknowledging that we could save money by expanding a particular type of care. It looks like we were all wrong.
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What Elmendorf is saying sounds counter-intuitive at first, but makes perfect sense when you think about it: the way to cut down on health care costs is to not see the doctor.

Which actually cuts to the heart of why the amalgamation of health insurance regulations being touted in the House as "reform" are, in fact, no such thing, merely more of the same. You can't drastically cut costs by swapping one set of procedures for another set of procedures.

So how can "prevention" reduce health care costs? Lifestyle adjustments. People need to focus on getting 8 hours of sleep each night, eating their veggies for dinner and their Wheaties for breakfast (thank GOD coffee lowers cancer risks! :D). People need to take the stairs more often than the elevator. People need to live so as to need fewer trips the doctor, rather than more. When they do that, health care costs overall will come down.

Real "prevention" is more akin to changing the oil in your car every 3 months or so. Spend $50 every three months on an oil change, and you reduce wear and tear on the engine, and push out significantly the day when that the engine throws a rod or blows a head gasket. Do a radiator flush every year and you avoid clogging the cooling system that will burn up the engine.

Real "prevention" is changing the filter on your A/C vent to reduce airborne contaminants, and steam cleaning the ductwork every couple years. Real "prevention" is letting babies get properly dirty so they can program their immune systems properly (there's a small but growing body of research data that suggests that allowing children a slightly more relaxed level of hygiene can help lower incidence of allergies to environmental contaminants like dust, pollen, pet dander, and evidence that some intestinal parasites can even reduce and eliminate food allergies). Real "prevention" is getting enough sun to manufacture enough vitamin D, but not baking by the pool like a slab of meat. Real "prevention" is allowing enough fats and Omega-3 in the diet to boost cardiac and neurological health, but not so much that the arteries clog up like the George Washington Bridge at rush hour.

That's "prevention"--living so as to ward off disease. Three brazillion new blood tests and imaging scans to detect that one pre-cancerous prostate cell which may become a tumor six months before you get flattened by the beer truck are not "prevention", merely expanded remediation.
 
Well, we all know what I think of the CBO. Not sure why people trust his numbers, but whatever.
 
formerroadie said:
Well, we all know what I think of the CBO. Not sure why people trust his numbers, but whatever.
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Why on earth would anyone believe you over the CBO?

Elmendorf is a brilliant economist who left Obama's campaign at the request of the Democratic Congress to head a massive organization tasked with doing exactly what he's doing. You're some guy on the internet.
 
formerroadie said:
Well, we all know what I think of the CBO. Not sure why people trust his numbers, but whatever.
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My opinion originates from common sense, not CBO numbers.
 
RightinNYC said:
Why on earth would anyone believe you over the CBO?

Elmendorf is a brilliant economist who left Obama's campaign at the request of the Democratic Congress to head a massive organization tasked with doing exactly what he's doing. You're some guy on the internet.
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I have shown proof that the way the numbers are run are false. Not my observation, someone else's. I will find it again for you if you wish.
 
formerroadie said:
I have shown proof that the way the numbers are run are false. Not my observation, someone else's. I will find it again for you if you wish.
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I sincerely doubt it, and am amused at the cries of bias and falsity being launched at the CBO now that your side is the one trying to push things through Congress.

I don't recall many dems screaming about how the CBO was unfairly overestimating the cost of the war in Iraq or of Bush's tax cuts.
 
RightinNYC,

I believe what CBO is assessing with respect to preventive care is mainly the relative costs/benefits associated with the extra diagnostic tests associated with such care. I agree with CBO that there probably would be no savings.

If, on the other hand, people, in general, smoked less, exercised more, etc., savings might develop. But those changes would have nothing to do with the health care legislation and are beyond the scope of what CBO is analyzing.

Finally, barring a major restructuring of the health care industry, namely knocking down anti-competitive industry and regulatory barriers and practices, introduction of such diagnostic tests on a larger scale, increasing the use of technology, etc., would probably result in minimal savings, at best.
 
donsutherland1 said:
RightinNYC,

I believe what CBO is assessing with respect to preventive care is mainly the relative costs/benefits associated with the extra diagnostic tests associated with such care. I agree with CBO that there probably would be no savings.

If, on the other hand, people, in general, smoked less, exercised more, etc., savings might develop. But those changes would have nothing to do with the health care legislation and are beyond the scope of what CBO is analyzing.

Finally, barring a major restructuring of the health care industry, namely knocking down anti-competitive industry and regulatory barriers and practices, introduction of such diagnostic tests on a larger scale, increasing the use of technology, etc., would probably result in minimal savings, at best.
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Ok, so the health care legislation is not changing folks health insurance (well, not right away), it's not changing how health care is consumed, it's not changing how health care is billed/paid for (it's still fee-for-service), and it's not reducing people's trips to the doctor.

Ummm......where's the "reform"? This bill looks like 1,000 pages of more regulating to sustain the status quo.
 
formerroadie said:
I have shown proof that the way the numbers are run are false. Not my observation, someone else's. I will find it again for you if you wish.
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You're correct to doubt it Right. His "proof" is a former Clinton white house member who disagree's with the CBO based on pure speculation based on seemingly nothing more than the fact that he thinks the computarized system...something many doctors have already stated they think is a bad idea...is somehow going to cut costs of medical research by 50%.

A partisan, former clinton white house advisor, who is a supporter of the health care plan or a non-partisan government office whose came out negative on both republican and democrat bills numerous times before and has no real stock either way on the politics of this.

Yes, the first is DEFINITELY the more reliable source.
 
donsutherland1 said:
RightinNYC,

I believe what CBO is assessing with respect to preventive care is mainly the relative costs/benefits associated with the extra diagnostic tests associated with such care. I agree with CBO that there probably would be no savings.
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This was where I had been hoping for savings - I guess that I assumed that if everyone was getting tested for cancer/diabetes/etc. early, things would be caught much quicker and we would incur less costs over time.

If, on the other hand, people, in general, smoked less, exercised more, etc., savings might develop. But those changes would have nothing to do with the health care legislation and are beyond the scope of what CBO is analyzing.
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I agree, I don't really see how more frequent preventative care would induce people to work out more or smoke less. That seems to be where the most savings are, but I don't think that Congress is really serious about dealing with it. The way forward is right in front of them:

New York City reached its lowest rate of smoking on record -- 15.8 percent, with 350,000 fewer smokers than in 2002, city health officials said.

...

The city's adult smoking rate has fallen since 2002, from 21.5 percent in 2002 to 15.8 percent in 2008, a decline that could prevent more than 115,000 premature deaths in future years, Frieden said. Among smokers, the proportion of heavy daily smokers -- 11 or more cigarettes per day -- has fallen from 36.4 percent to 28.7 percent since 2002.
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Increase cigarette taxes and decrease the places where they can be smoked, and you'll see a massive shift in the number of smokers and the accompanying health care costs.

Finally, barring a major restructuring of the health care industry, namely knocking down anti-competitive industry and regulatory barriers and practices, introduction of such diagnostic tests on a larger scale, increasing the use of technology, etc., would probably result in minimal savings, at best.
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I'd settle for them teaching my old doctor's goddamn receptionist how to use a fax machine. :lol:

Seriously though, some offices that have implemented technological advances are so much more efficient that it's absurd. Where I used to have to go back to the office to get blood test results or copies of things, I'm now cc'd on emails from the testing company to my doctor. Where I used to have to bring my insurance card and my wallet each time, co-pays are now autodeducted from my checking account. Where I used to have to sit there and have someone take my temp, BP, HR, etc. one by one, they now bust out this machine that does all 3 in 30 seconds.

It's good stuff.
 
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