Friday, August 14, 2009
Barry / Politics Why Health Care Reform is Really Hard
Posted by Bruce Barry on Fri, Aug 14, 2009 at 11:35 AM
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One reason it's difficult is that the effects of change on cost are not always intuitive. Take preventive medicine, for example. In his Washington Post column today, Charles Krauthammer (with whom I agree about as often as I time travel) justifiably debunks the conventional wisdom that more preventive care "will save money," as Nancy Pelosi and Steny Hoyer put it in a USA TODAY op-ed earlier this week.
Krauthammer's argument is grounded in a Congressional Budget Office analysis that arrived at what the CBO labels a "counterintuitive" conclusion. A few excerpts:
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....The CBO does concede that preventive services may add costs but still be worth doing: "Experts have concluded that a large fraction of preventive care adds to spending but should be deemed 'cost-effective,' meaning that it provides clinical benefits that justify those added costs." And then there's the pesky fact that preventive care could make you live longer, adding to the burden you place on the federal budget:
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....Slightly fewer than 20 percent of the services that were examined save money, while the rest add to costs.
Social Security outlays rise when people live longer, and Medicare outlays may rise because, even if a preventive service lowers a beneficiary's risk of one illness, a longer lifespan allows for more time to incur other health care expenses associated with age.The clear message for all you deficit hawks out there: stop worrying about your blood pressure and by all means skip that cholesterol test -- it's the patriotic way to help balance the federal budget.
Comments (2)
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The 2010 federal budget is $3.55 trillion. The CBO estimated the cost of health care reform will be $1 trillion over 10 years. That's 3 percent, not much when compared to the DOD costs. And we would be building healthy American citizens, instead of unhealthy foreign nations.
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Posted by
Sabo Pike
on August 14, 2009 at 10:13 PM
