Why Preventive-Medicine Services Aren't Lowering Health-Care Costs

By Perry, Susan | MinnPost.com, January 30, 2013 | Go to article overview

Why Preventive-Medicine Services Aren't Lowering Health-Care Costs


Perry, Susan, MinnPost.com


In an article published Tuesday by Reuters, health and science reporter Sharon Begley does a great job of debunking the widely held belief that providing more preventive medicine will significantly cut health-care costs.

In fact, notes Begley, a 2010 study [PDF] in the journal Health Affairs "calculated that if 90 percent of the U.S. population used proven preventive services, more than do now, it would save only 0.2 percent of healthcare spending."

That's not to say that some preventive services don't reap savings. Childhood immunizations are one great example. But, as Begley points out, the disease-prevention programs that actually save money are the exceptions. Most don't. Begley explains why:

One big reason why preventive care does not save money, say health economists, is that some of the best-known forms don't actually improve someone's health.

These low- or no-benefit measures include annual physicals for healthy adults. A 2012 analysis of 14 large studies found they do not lower the risk of serious illness or premature death. But about one-third of U.S. adults get them, said Dr. Ateev Mehrota, a primary- care physician and healthcare analyst at RAND, for a cost of about $8 billion a year.

Similarly, some cancer screenings -- including for ovarian cancer and testicular cancer, and for prostate cancer via PSA tests -- produce essentially no health benefits, causing the U.S. Preventive Services Task Force to recommend against their routine use. The task force bases its recommendations on medical benefits alone, not costs.

The second reason preventive care brings so few cost savings is the large number of people who need to receive a particular preventive service in order to avert a single expensive illness.

"It seems counterintuitive: If you provide care to prevent all these expensive diseases, it should save money," said Peter Neumann, an expert on health policy and professor of medicine at Tufts University School of Medicine. "But prevention itself costs money, and some preventive measures can be very expensive, especially if you give them to a lot of people who won't benefit. …

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