One of the arguments made for forcing everyone into comprehensive health insurance plans relied on the cost savings that would occur once all Americans began getting routine wellness checks and diagnostic tests. Democrats, including Barack Obama, insisted that the long-term declines in necessary treatments would offset the short-term increase in costs associated with easier access to providers, as various diseases and conditions got addressed sooner and more expertly. Rather than allowing people to choose whether to buy catastrophic insurance and deal with the routine care out of pocket, Obama and the Democrats mandated more expensive comprehensive care to force people to get the routine checks that would eventually save everyone lots of money … sometime.
Now that the mandates are in place, however, it seems that “many doctors” are now advising that the routine checkups are not valuable at all. In fact, the mammograms that got specifically cited at the time waste “billions of dollars” from false positives, NBC News reported:
False-positive mammograms, which suggest a woman has breast cancer when she actually doesn’t, cost the nation $4 billion a year, new research shows.
And a second study, also released Monday, shows that new treatments for women who really do have breast cancer may cost more, but they are helping them survive longer than older treatments.
The two studies, published in the journal Health Affairs, don’t say whether the costs either way are worthwhile, but they add some data to the debate about whether wider screening is worthwhile and to the discussion about health care costs in general.
How odd that this debate is taking place now, eh? I mean, wouldn’t it have been helpful to have this debate in 2009, when many of us pointed out that forcing everyone to take lots of diagnostic tests would increase costs in both the short term and the long term? At least the counter argument to that was that the extra costs might be worth it because the tests save lives. And it’s very curious that the debate over mammogram screening is now taking place when the federal government is facing lots of questions about the coverage that tax subsidies give insurers for all the added costs of free screenings mandated in ObamaCare.
Well, maybe there might be some legitimate debate about the efficacy of regular mammogram screening. How about the annual physical? Isn’t that at least worth the money paid for comprehensive-plan premiums? Apparently not — and might be harmful in some cases, as NPR reported yesterday:
Vega, a strapping man with a thick black beard, is feeling good, but he came to see the doctor today because his wife thought he should. She even made the appointment. It is free to him under his insurance policy with no copay, as most preventive care is under the Affordable Care Act.
Vega is one of more than 44 million Americans who is taking part in a medical ritual — visiting the doctor for an annual physical exam. But there’s little evidence that these visits actually do any good for healthy adults. …
“I would argue that we should move forward with the elimination of the annual physical,” says Dr. Ateev Mehrotra, a primary care physician and professor of health policy at Harvard Medical School.
Patients should really only go to the doctor if something is wrong, Mehotra says, or if it’s time to have an important preventive test like a colonoscopy.
In fact, Mehotra says that studies going back to the 1980s prove that the annual physical is a waste of time and money. Especially money:
The Society for General Internal Medicine even put annual physicals on a list of things doctors should avoid completely for healthy adults. One problem, Mehrotra says, is the cost. Each visit usually costs insurers just $150, but with so many people getting them, that adds up fast.
“We estimate that it’s about $10 billion a year, which is more than we spend as a society on breast cancer care,” Mehrotra says. “It’s a lot of money.”
Yes, it is. So are the premiums demanded for comprehensive insurance under the mandate, designed specifically to get people to take these tests more often. Now that the government is indirectly footing the bill for diagnostics through ObamaCare subsidies, expect a lot more experts to “discover” that these tests are now bad for you.
If we had used a free-market approach to health-coverage reform that didn’t bar catastrophic coverage and used retail clinics in a competitive, price-signaled market, we wouldn’t have this issue. People would have plenty of their own income to make decisions for themselves on whether to seek routine examinations by judging their value for themselves. Instead, we will end up paying for them and eventually see them get denied while trapped in a quasi-single-payer system, where only the wealthy will still have enough cash to seek out preventive care on their own.