Prevention may not be cure for reform ills

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Will an ounce of prevention cure a pound of health care costs?

 

Cost control is a central argument President Obama and Democrats have made to urge passage of their overhaul of the health care system. In other words, spend money on preventive care on debilitative diseases now and save on staggering care costs later.

Makes sense, except a new study says it won’t actually work that way.

The study on the Web site of Health Affairs, a leading journal of health policy research, points out that the costs of an aggressive but simple program for federally insured Type 2 diabetes patients, for example, would just about break even in a mere 25 years through lower spending on dialysis, kidney transplants, amputations and other treatment. In fact, the study says, except for the youngest diabetics, the treatment, pegged at $1,024 a year per patient, actually would add to overall spending, not decrease it. The study uses data from long-standing clinical trials and makes its projections from diagnosis to death.

Democratic leaders have chastised the Congressional Budget Office for not including an estimate of savings from preventative measures in their evaluations of reform bills. In fact, the CBO has reported “expanded governmental support for preventive medical care probably would improve people’s health but would not generally reduce total spending on health care.”

Critics say the CBO’s 10-year estimates don’t go out far enough and may seek to use the study’s finding to bolster their argument. But if this study indicates it’s likely to be a wash in 25 years, it’s unlikely the CBO would come up with a different projection.

That doesn’t mean we shouldn’t overhaul health care and the health insurance system. But if we do, it should be based on real numbers.

There is now additional proof that prevention won’t produce a pot of savings at the end of the reform rainbow. With deficits at an astronomical all-time high, a global recession that is not retreating fast enough and imperatives for climate change initiatives gaining in immediacy, congressional leaders need to put aside straw arguments and start dealing in the realities of what can be done to heal health care — starting this week when Congress gets back to work.

Otherwise health care reform may be DOA.

Editor’s Note: This article was originally published in The Albuquerque Journal on Sunday, Sept. 6.