"The evidence suggests that for most preventive services, expanded utilization leads to higher, not lower, medical spending overall," CBO director Douglas Elmendorf wrote in an Aug. 7, 2009, letter to Rep. Nathan Deal, the top Republican on a congressional subcommittee involved in the debate.Reading further we find this comment which has been totally ignored by the White House and HHS.
Elmendorf explained that while the cost of a simple test might be cheap for each individual, the cumulative cost of many tests adds up:
"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. ... Preventive care can have the largest benefits relative to costs when it is targeted at people who are most likely to suffer from a particular medical problem; however, such targeting can be difficult because preventive services are generally provided to patients who have the potential to contract a given disease but have not yet shown symptoms of having it."
In fact, a government policy to encourage prevention could end up paying for services that people are already receiving, including breast and colon cancer screenings and vaccines, Elmendorf said.So why the push for free preventive care?
Other studies backed up the CBO's analysis, including a Feb. 14, 2008, article in the New England Journal of Medicine that was written in response to campaign promises for more preventive care.
"Sweeping statements about the cost-saving potential of prevention ... are overreaching," according to the paper. "Studies have concluded that preventing illness can in some cases save money but in other cases can add to health care costs." They write that "the vast majority" of preventive health measures that were "reviewed in the health economics literature do not" save money.
And if they really BELIEVE requiring health insurance carriers to offer preventive care without patient copay's or deductibles is such a good idea, then why do they want to PENALIZE SENIORS ON MEDICARE with a tax on "first dollar" Medigap policies?