Surprise! Preventive care will raise, not lower health care costs

Rick Moran
It's actually been known for quite a while that the panacea of so-called "preventive care" might save lives but not much money. That's because any savings in health care dollars from catching some diseases early is more than offset by the fact that the treatment is given to a huge percentage of people who will never get the disease.

If doctors had a crystal ball and were able to give the tests only to those who would eventually get sick, it would obviously save a bundle. But medicine is science, not magic, and the numbers tell a different story.

Director Douglas Elmendorf of the CBO quoted by Jack Tapper of ABC News:

"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."

Even Republicans have been caught up in this idea that preventive care could be one way to pay for health care reform. Unfortunately, it appears to be a dry hole. This is not to say that on an individual basis, preventive care can't be very beneficial and contribute to a longer, healthier life.

But as a means to bring down health care costs, it is a mirage.



It's actually been known for quite a while that the panacea of so-called "preventive care" might save lives but not much money. That's because any savings in health care dollars from catching some diseases early is more than offset by the fact that the treatment is given to a huge percentage of people who will never get the disease.

If doctors had a crystal ball and were able to give the tests only to those who would eventually get sick, it would obviously save a bundle. But medicine is science, not magic, and the numbers tell a different story.

Director Douglas Elmendorf of the CBO quoted by Jack Tapper of ABC News:

"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."

Even Republicans have been caught up in this idea that preventive care could be one way to pay for health care reform. Unfortunately, it appears to be a dry hole. This is not to say that on an individual basis, preventive care can't be very beneficial and contribute to a longer, healthier life.

But as a means to bring down health care costs, it is a mirage.