AIP column: Many Ounces of Prevention

posted at 10:12 am on August 10, 2009 by Ed Morrissey

One of the underlying assumptions about ObamaCare and health-care reform in general is that the private sector allowed costs to get out of control by not emphasizing preventive care, especially with the uninsured and underinsured.  Barack Obama himself regularly touts the cost savings that would be realized if we just provided an effective battery of preventive tests and services that would delay or avoid expensive illnesses later in American lives.  Unfortunately, the CBO analyzed this proposition, and in a letter to the ranking Republican on the House health subcommittee of the Energy and Commerce Committee, explodes that argument.  My AIP column (delayed from last week) looks at the Obama canard and what it means for ObamaCare:

Responding to inquiries from Rep. Nathan Deal, the ranking Republican on the health-care subcommittee of the House Energy and Commerce Committee, Elmendorf said that increasing prevention programs would necessarily increase the costs of delivering health care, not decrease them as Obama and his allies have argued:

“In making its estimates of the budgetary effects of expanded governmental support for preventive care, CBO takes into account any estimated savings that would result from greater use of such care as well as the estimated costs of that additional care. 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.”

Why? President Obama’s underlying assumption for health-care reform is based on the proverb that “an ounce of prevention is worth a pound of cure.” That’s true – for those who eventually need the cure. However, as Elmendorf points out in his letter to Deal, not everyone develops preventable costly illnesses. …

That doesn’t make prevention less valuable, but it makes sense to target prevention rather than assume everyone will get the disease without it. When we have to assume that everyone may get every disease and run tests for everyone constantly for early detection, then the utilization of the system will rapidly increase – and so will the costs.

No one will argue with the value of preventive care.  However, it only is a cost savings to those patients who don’t eventually develop a disease or who catch one early enough to use less costly treatments to cure it.  Common sense tells us that a rapid increase in utilization will create cost increases, not decreases, and that the savings will only come in the long term — and as the CBO discovered, will not cover the cost increases.

Arguing that this effort will save money is dishonest.  Unfortunately for Obama, that’s the only argument he has for fiscal responsibility and cost savings in Obamacare, or at least the only one that doesn’t involve heavy rationing of services.

Be sure to read the whole column, and visit Yid With Lid to get his thoughts on the Elmendorf letter.  While you’re at AIP, catch up with AIP’s great stable of bloggersJohn Hanlon looks at the environmental impact of Cash for Clunkers, Jimmy Bise notes that the ACLU has suddenly become very trustful of executive power, and Despina Karras says we don’t have death panels in ObamaCare yet, but it’s almost as bad.


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I demand you stop your blatant racism and let us pass this bill!
/sarc

Browncoatone on August 10, 2009 at 10:18 AM

The rout is on.

Have members of SEIU found Elmendorf’s home address, or are they planning on confronting him at the office?

Has Elmendorf found any horses heads in his bed?

BuckeyeSam on August 10, 2009 at 10:22 AM

i have no doubt the cbo is starting to really piss off oboobi, look for a replacement in the form of a czar real soon.

SHARPTOOTH on August 10, 2009 at 10:22 AM

Arguing that this effort will save money is dishonest. Unfortunately for Obama, that’s the only argument he has for fiscal responsibility and cost savings in Obamacare, or at least the only one that doesn’t involve heavy rationing of services.

Since when has this administration cared about fiscal responsibility. Fact of the matter is that the filthy liar in the White House could probably have gotten away with this scheme to nationalize healthcare had he not already spent trillions on other things.

The whole bill is built on dishonest claims which tinkers with the way Americans would recieve healthcare. Nevertheless, the systemic issues like funding, tort reform, and level of care are ignored in order to push through this plan.

highhopes on August 10, 2009 at 10:23 AM

Has anyone considered how expensive car insurance would be if ‘preventive care’ things like oil changes and tire rotations were covered?

I just found out that my wife’s health insurance didn’t cover a routine annual check up, and that we would have to pay for it out of pocket. I was actually kind of happy.

BadgerHawk on August 10, 2009 at 10:23 AM

You are clearly unAmerican

faraway on August 10, 2009 at 10:23 AM

Preventative care: stop inciting Union thugs to rough people up and thereby cause runs on ERs and doctors. How’s that for ya Bambi? The most arrogant, nasty, divisive President ever. President Campaign to the rescue!!!

NJ Red on August 10, 2009 at 10:23 AM

Private insurance companies have been trying to lower the cost of health care through preventive care measures for decades. If they can’t do it with profit motive, the government won’t be able to do it through legislation.

if they were really concerned about child obesity, they’d bring back gym and PE and actually force them to exercise for 45 minutes a day. Some physical activity every day would go a long way to avoiding obesity. No provisions for new exercise in school (they have the kids for 8 hours a day).

They want to spend more money on healthy food, but they won’t provide exercise classes in public schools that would lower health costs, make healthier kids, and not really cost anything extra.

ThackerAgency on August 10, 2009 at 10:23 AM

Are people who do not file an income tax return going to pay a fine for not purchasing coverage?

d1carter on August 10, 2009 at 10:23 AM

If an ounce of prevention is worth a pound of cure, if you preventively test more than 16 people and only one gets a disease, the prevention costs more than the cure–the accumulated “ounces” weigh more than a pound.

One of the major problems with the current health-care system is that many doctors are so afraid of malpractice lawsuits that they order CAT scans and other costly tests “just in case” they might miss a diagnosis. The vast majority of these tests don’t find anything, but insurance pays for them, which drives up the price of insurance. If the medical malpractice tort system could be reformed, with caps on damage awards, doctors would order fewer “just-in-case” tests, and only order expensive tests when they believe that the patient may have a serious condition which needs to be diagnosed.

Steve Z on August 10, 2009 at 10:24 AM

You make a strong point, Ed. The fabulously successful statin drugs, if given to people with high cholesterol but no previous coronary disease, will on average prevent one heart attack or stroke for every 3,600 monthly prescriptions filled.

mikeyboss on August 10, 2009 at 10:24 AM

I heard via a friend that the best way to prevent prostate cancer is to use “it” often. Anything in the bill to help prevent prostate cancer?

WashJeff on August 10, 2009 at 10:24 AM

One of the major problems with the current health-care system is that many doctors are so afraid of malpractice lawsuits that they order CAT scans and other costly tests “just in case” they might miss a diagnosis

+1,000,000

NJ Red on August 10, 2009 at 10:26 AM

I heard via a friend that the best way to prevent prostate cancer is to use “it” often. Anything in the bill to help prevent prostate cancer?

WashJeff on August 10, 2009 at 10:24 AM

no, but there was that other ‘crisis’ bill which provided condoms to horses if that counts.

gatorboy on August 10, 2009 at 10:28 AM

Considering Obama has NO education in economics (they don’t study that in Harvard’s School of Community Organizing) and has never had to work crafting ANY legislation (state or Federal) beyond putting his name on something others had done, this is not surprising. The only thing this empty suit has ever done is talk, yet he’s costing the nation trillions while doing it.

bradley11 on August 10, 2009 at 10:28 AM

/liberal mode on

You dumb teabagging inbreed redneck low grade morons just don’t get it. Civil debate is required you mother humping moronic corporate paid toadies!!!

liberal mode off/

Any real american care to respond to that?? My response is go to hell.

sonofdy on August 10, 2009 at 10:30 AM

The rout is on.

Have members of SEIU found Elmendorf’s home address, or are they planning on confronting him at the office?

Has Elmendorf found any horses heads in his bed?

BuckeyeSam on August 10, 2009 at 10:22 AM

Look at this info from Open Secrets….

These dems have raked in the most cash from union contributions.

Hoyer tops the list with $3,596,358
Edward Kennedy is 2nd with $2,741,591
Pelosi is 3rd with $2,737,550

Unions Lobby to Thwart Health Care Deal Breaker

http://www.opensecrets.org/news/2009/07/unions-lobby-to-thwart-health.html

Download a list of contributions from labor PACs to all current members of Congress (including to their candidate committees and leadership PACs) since 1989 here:

http://www.opensecrets.org/news/LaborPAC_Contribs.xls

If you use this info give credit:
http://www.opensecrets.org/MyOS/credit.php

Just counter Pelosi and Hoyer un-American accusations with these facts. National Health Care is a Union Trojan Horse…..
The unions will use they tax free insurance status as a recruiting tool if National Health Care is set in place.

izoneguy on August 10, 2009 at 10:31 AM

voodoo economics?

weewilly on August 10, 2009 at 10:32 AM

One of the little “questions” in this bill, is what is Preventive Medicine…

The only preventive medicine which is cheap, and works, has to do with LIFESTYLE choices. What you eat! How much you excercise.

All of the programs in companies which incentivized this did lower their health care costs, BUT, this will give the Government even MORE intrusion into how we live our lives.

And when we have an overweight Surgoon General… I find that amusing…

Romeo13 on August 10, 2009 at 10:32 AM

Ogabe will order a fresh round of human-wave assaults because of this.

You people are going to get your dreamy nationalized healthcare even if Ogabe has to kill you to do it.

Bishop on August 10, 2009 at 10:32 AM

Considering Obama has NO education in economics (they don’t study that in Harvard’s School of Community Organizing) and has never had to work crafting ANY legislation (state or Federal) beyond putting his name on something others had done, this is not surprising. The only thing this empty suit has ever done is talk, yet he’s costing the nation trillions while doing it.

bradley11 on August 10, 2009 at 10:28 AM

The only eduction Obummer got was a full course in Marxism from Frank Marshall Davis – his real daddy….it’s in Obummer DNA…

izoneguy on August 10, 2009 at 10:32 AM

i have no doubt the cbo is starting to really piss off oboobi, look for a replacement in the form of a czar real soon.

SHARPTOOTH on August 10, 2009 at 10:22 AM

“In order to eliminate redundancy, and reduce government costs, at a time when the disinformation produced by Congressional Budget Office has hindered the passage of urgently-needed health care reform, the Congressional Budget Office is hereby abolished by this Emergency Executive Order.”

Barack Hussein Obama II

Steve Z on August 10, 2009 at 10:32 AM

If an ounce of prevention is worth a pound of cure, if you preventively test more than 16 people and only one gets a disease, the prevention costs more than the cure–the accumulated “ounces” weigh more than a pound.

More importantly, you can’t quantify preventive costs. It’s like the Obama jobs creation/savings claim. How do you declare “lives saved” or “costs reduced” when there is no certainty that there was an underlying health issue in the first place.

highhopes on August 10, 2009 at 10:35 AM

More importantly, you can’t quantify preventive costs. It’s like the Obama jobs creation/savings claim. How do you declare “lives saved” or “costs reduced” when there is no certainty that there was an underlying health issue in the first place.

highhopes on August 10, 2009 at 10:35 AM

That’s a feature of the plan, not a bug. It allows them to claim success no matter what.

BadgerHawk on August 10, 2009 at 10:37 AM

What would be the cost/benefit ratio of applying early professional testing of congressional candidates and potential presidents for being pathological liars; i.e. getting that determined and treated BEFORE we let the run the entire freakin country?

MikeA on August 10, 2009 at 10:38 AM

The bad news and the bad news, which do you want first?

Slow Job Growth and Inflation, but…

Those numbers will probably be good enough to enable President Obama to get re-elected, but his second term will be plagued by rising inflation, high interest rates, and unsustainable deficits, along with stubbornly high unemployment.

Mr. Joe on August 10, 2009 at 10:39 AM

i have no doubt the cbo is starting to really piss off oboobi, look for a replacement in the form of a czar real soon.

SHARPTOOTH on August 10, 2009 at 10:22 AM

I understand Obama is dropping the facade and from now on they’ll be commissars.

rplat on August 10, 2009 at 10:44 AM

That’s a feature of the plan, not a bug. It allows them to claim success no matter what.

BadgerHawk on August 10, 2009 at 10:37 AM

That and provides the funding mechanism where they claim that middle class taxpayers won’t have to pay a single penny more. The whole trillion dollar package is supposedly going to be paid for out of these preventive treatment “savings.”

highhopes on August 10, 2009 at 10:46 AM

“Preventative care” is a joke and is a huge burden in terms of cost for medical care.

Eat right (when you can), exercise moderately on a regular basis, don’t smoke or drink, or if you do, do so in moderation, see your doctor and dentist at least annually so you don’t have problems just for a check-up.

Or don’t.

There is all you really need to know for “preventative care”

catmman on August 10, 2009 at 10:48 AM

Bottom line: if ‘an ounce of prevention is worth a pound of cure’, then a particular prevention is only cost effective if more than one in sixteen people will need the cure for what it prevents.

Count to 10 on August 10, 2009 at 10:54 AM

It makes no sense to spend billions to save millions 50 years from now. But that’s what Obama is trying to sell.

cadams on August 10, 2009 at 10:55 AM

Vaccinations qualify. Cleaning teeth (+flouride) may qualify.
or, if I were feeling nasty,
abortions and end-of-life options.

No wait, are the nasty ones maybe included?

tomg51 on August 10, 2009 at 10:55 AM

Real Healthcare Reform = IF(OR(AND(INDIVIDUAL BMI > 18, INDIVIDUAL BMI 18, COMPANY AVG BMI < 25))), CURRENT TAX RATE * .5, FULL TAX RATE)

CMonster on August 10, 2009 at 10:56 AM

I’m sure BO’s simple solution to that problem is to create a massive DNA database of everyone in the US. The government promises to only use that database to screen for those individuals who are genetically predisposed to certain types of illnesses. That way, the preventative treatments can be tailored to each individual.

Do you believe that?

suburbanite on August 10, 2009 at 10:57 AM

No one will argue with the value of preventive care.

My idea of prevention is early screening and treatment. Their idea of prevention is printing these dopey pamphlets with their dorky advise, eg, eat more vegetables.

Blake on August 10, 2009 at 10:58 AM

I am curious as to what type of conversation will be had if any with the Gay community. I mean since ‘Preventive Care” is so important, will there be any requirements or higher premiums for Risky behavior? Not to be crude but since seniors will be having a visit or what ever they want to call it. Just curious…

Ladywolfnl on August 10, 2009 at 11:02 AM

I wish people would see the Obama’s grandma’s hip surgery for what it is: It was done for palliative reasons, e.g., to make her comfortable and stop the pain.

Contrary to Dr. Obama, you can’t just take a pill and the pain magically goes away.

Blake on August 10, 2009 at 11:03 AM

The rout is on.

Have members of SEIU found Elmendorf’s home address, or are they planning on confronting him at the office?

Has Elmendorf found any horses heads in his bed?

BuckeyeSam on August 10, 2009 at 10:22 AM

This reminds me of the times when Richard Nixon fired special prosecutor Archibald Cox from heading up the Watergate investigation. The bumper sticker of choice back then said:

“Nixon is a Cox-sacker”

Any bumber-sticker suggestions for when OlbysMessiah fires CBO head Elemndorf?

how about:

“Have you hugged your CBO chief lately?”

or

Obama 56, America 1

Sweet_Thang on August 10, 2009 at 11:04 AM

Savings through prevention is the modern Fountain of Youth. Numerous studies have shown that prevention measures increase costs. Take, for example, cancer screenings. For every person who saves money by catching cancer early, there are THOUSANDS of people who never get cancer, but keep getting screenings.

Other preventative measures prolong the lives of sick people, thereby increasing costs even more. Example: say you have a 60-year old man who quits smoking because he’s developed lung problems. He’s likely added years to his life – years that will cost more in medical bills than if they were a non-smoker.

More here:
http://seekingalpha.com/article/154994-healthcare-does-prevention-reduce-costs

Does this mean prevention is bad? Certainly not, for the individual. It’s telling that medical experts are already arguing that prostate cancer screenings may not be cost-effective. But if you’re the person who survives prostate cancer because of early detection, it’s VERY effective.

hawksruleva on August 10, 2009 at 11:07 AM

Remember that article from the UK saying women should have less access to screening for breast cancer because it was costing more because they were finding tumors they had to biopsy?

Blake on August 10, 2009 at 11:07 AM

What would be the cost/benefit ratio of applying early professional testing of congressional candidates and potential presidents for being pathological liars; i.e. getting that determined and treated BEFORE we let the run ruin the entire freakin country?

MikeA on August 10, 2009 at 10:38 AM

there, FIFY!!!

Sweet_Thang on August 10, 2009 at 11:07 AM

President Obama’s underlying assumption for health-care reform is based on the proverb that “an ounce of prevention is worth a pound of cure.”

Well, here comes the food czar, with a list of approved food and restaurants.

Johan Klaus on August 10, 2009 at 11:08 AM

Real Healthcare Reform = IF(OR(AND(INDIVIDUAL BMI > 18, INDIVIDUAL BMI 18, COMPANY AVG BMI < 25))), CURRENT TAX RATE * .5, FULL TAX RATE)

CMonster on August 10, 2009 at 10:56 AM

That almost looks like something that makes sense, but not quite, and I’m not seeing an obvious way of correcting it.

Count to 10 on August 10, 2009 at 11:08 AM

For every person who saves money by catching cancer early, there are THOUSANDS of people who never get cancer, but keep getting screenings.

It’s peace of mind. Few people get screen for no reason. Many get screened because it’s in their family.

Blake on August 10, 2009 at 11:10 AM

Well, here comes the food czar, with a list of approved food and restaurants.

Johan Klaus on August 10, 2009 at 11:08 AM

You scared me. I thought you meant jonknee is back to post another thousand comments with mis-information.

Blake on August 10, 2009 at 11:12 AM

I predict that the CBO will soon have, shall we say, an unfortunate accident.

KS Rex on August 10, 2009 at 11:15 AM

hawksruleva on August 10, 2009 at 11:07 AM

This will be a delima for Obama. Stop smokimg to extend life, hence more cost or keep smoking and die younger. And, eventually a “Logan’s Run”, ” Soylent Green ” scenario.

Johan Klaus on August 10, 2009 at 11:16 AM

This preventive care reasoning REEKS. You can do all the diabetese, cardiovascular, lipid screening and counseling in the world on a 350 pound woman, but unless she decides to lose weight and excercise it will be worthless. It will still cost a whole lotta money to treat her for the complications of obesity irregardless of your “prevention”.

bloggless on August 10, 2009 at 11:27 AM

Look for WH Fish Special Action Units to clear the CBO of all such fishiness ASAP.

curved space on August 10, 2009 at 11:31 AM

Obama care is like a liberal’s approach to war. We had to destroy the village in order to save it.

Mojave Mark on August 10, 2009 at 11:33 AM

Johan Klaus on August 10, 2009 at 11:08 AM

That sure would end his jobs problem. They would need millions of menu checkers to go house to house to insure compliance. Then they would need to keep hiring more to replace those that mysteriously disappear each week.

chemman on August 10, 2009 at 11:48 AM

Ed:
Barry uses WONDER ECONOMICS, that’s why he can get more for less. I think it’s covered in Socialist Economics 101 – under the subsection about magic unicorns.

GarandFan on August 10, 2009 at 12:20 PM

Look for the Dems to start cutting the budget of the CBO and turning it into a patronage palace.

njcommuter on August 10, 2009 at 12:44 PM

Obama said “you just get into some very difficult moral issues” when considering whether “to give my grandmother, or everybody else’s aging grandparents or parents, a hip replacement when they’re terminally ill.

“That’s where I think you just get into some very difficult moral issues,” he said in the April 14 interview. “The chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health- care bill out here.”

Perhaps those aging people PAID IN TO MEDICAL & SS as opposed to worthless leeches on welfare and worthless leeches that are illegals.

Jeff from WI on August 10, 2009 at 1:50 PM

Arguing that this effort will save money is dishonest. Unfortunately for Obama, that’s the only argument he has for fiscal responsibility and cost savings in Obamacare, or at least the only one that doesn’t involve heavy rationing of services.

When I first heard Obama say we had to pass health care to save the economy, I thought he was joking! If our public schools had not dumbed down the American populace, everyone would have laughed when he said it.

Christian Conservative on August 10, 2009 at 2:20 PM

Another thing that people aren’t discussing (probably because it seems quite heartless) is that if your ounce of prevention keeps someone from dying of a heart attack at 55 and extends their life into their 80s, that’s an additional 25 years worth of medical coverage that they’re going to need. Furthermore, many of the most costly diseases have increased likilihoods as people get older. So, by extending someone’s life, you are not only increasing the number of years that they need health care, but it’s still quite likely they’ll need some sort of long-term expensive medical care for cancer, dementia, etc. The only savings then would be in deciding not to cover many treatments for the elderly. Of course, that gets into rationing to lower costs and we’ve all been assured that this program will magically reduce costs without rationing while increasing use.

More of something better for cheaper…..when it sounds too good to be true, it is.

JadeNYU on August 10, 2009 at 2:46 PM