No Savings from Preventive Care

A new study published in the journal Health Affairs calls into question claims by congressional Democrats and President Obama that mandatory coverage of preventive care services in public and private health insurance programs will lead to substantial cost savings.  The study looks specifically at diabetes care, an expensive to treat chronic condition, the worst side-effects of which can often be mitigated by early intervention and more coordinated care. It is often assumed that more and better preventive care could substantially lower costs associated with treating diabetes and its complications.  Not so, say the authors. Although better preventive care can lower the costs associated with treating the complications of diabetes, that preventive care isn’t free.  Adding in the cost of the preventive services raises the overall cost of care.

For people with diabetes, the cost of that extra care is arguably worthwhile.  Spending money to reduce the prevalence of debilitating and potentially life-threatening complications probably seems like good value for money.  But that’s decidedly not what the President and congressional Democrats have been claiming.  Instead, they argue that this extra preventive care will lower overall costs and help pay for health care reform.  But, as the results of this study suggest, that’s just not true.  And it’s not only untrue for diabetes, it’s also untrue for most other preventive care services.

More comprehensive studies, such as a literature survey published last year in the New England Journal of Medicine, suggest that, on balance, preventive care services add to health care costs, not reduce them:  “[S]creening costs will exceed the savings from avoided treatment in cases in which only a very small fraction of the population would have become ill in the absence of preventive measures.” Ironically, as Dartmouth University Professor of Medicine Gilbert Welch wrote in The New York Times, “Screening for heart disease, problems in major blood vessels and a variety of cancers has led to millions of diagnoses of these diseases in people who would never have become sick.”