THE ISSUE: Can preventive health measures not only improve the well-being of Americans, but also reduce the cost of health care?
THE POLITICS: President Barack Obama wants insurance companies to cover routine checkups and screening tests such as mammograms and colonoscopies. “That makes sense, it saves lives, and it will also save money over the long run,” he often says. Democrats are eager to identify savings that will reduce the cost of health care to the government and address a major obstacle in getting legislation through Congress. But the savings associated with prevention are not so clear. Even Obama’s chief economic adviser, Lawrence Summers, conceded recently that any savings that result from technology, wellness and illness prevention programs envisioned by Obama are difficult to measure. “We know enough to know that it’s important to do, but we don’t know enough for an auditor to account for it,” he said.
WHAT IT MEANS: Wellness efforts could be fruitful. Nearly 40 percent of U.S. deaths are attributed to smoking, poor diet and inactivity, or alcohol misuse — conditions that can be reversed with lifestyle changes. Obesity alone costs the health care system $147 billion a year, according to a study published in journal Health Affairs. But a widely cited New England Journal of Medicine article last year noted that broadly administered screening tests for certain diseases could cost more than treating the fraction of the population that would otherwise fall sick. The independent Congressional Budget Office likewise concluded that “for most preventive services, expanded utilization leads to higher, not lower, medical spending overall.” A recent report, published in Health Affairs, concluded that costs savings — and health benefits — could become more evident over the long term, beyond the 10-year budget windows used by the government.
_ Jim Kuhnhenn
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