Health Care Reform Idea...

[toomuchtime_]

Thanks. I'll read that in a bit when I have some time to study it.

What I have found so far regarding preventative care seems to take into account universal screening rather than screening of those at risk. If that's the case, of course cost is going to be higher and the relative benefits lower.

I'd like to know if there are any studies regarding cost savings for early detection and routine maintenance care opposed to the cost of treating conditions that are advanced and/or have complications that could have been prevented, delayed or lessened if that care had been available early on.

That's exactly what the CBO document I posted a link to addresses. When you find the time to read the CBO letter, you will see:



http://www.cbo.gov/ftpdocs/104xx/doc10492/08-07-Prevention.pdf

Well, no, that's not quite what I was asking.

"widespread use of preventive services tend to exceed the savings from averted illness"

That's what I was referring to when I mentioned universal screening and I agree that would be costly.

I can't find anything addressing the cost benefits for early detection and maintenance care, though. I will read the link, thanks.

The researchers found that those steps would substantially reduce the projected number of heart attacks and strokes that occurred but would also increase total spending on medical care because the ultimate savings would offset only about 10 percent of the costs of the preventive services, on average.

I also wonder what the costs are they claim will increase even as incidence of strokes and heart disease are 'substantially reduced'? It says spending on medical care. Is that just for those conditions specifically? Does it include the cost of treating their complications as well? What about the indirect costs of those conditions and complications, for example lost wages and productivity, disability, etc.

In fact, the example of treating high blood pressure and high cholesterol to prevent heart attacks and strokes is an example of early detection and maintenance. These measures are in widespread use only among the high risk population, not among the general population. If you wait any longer to begin treatment, you are treating the disease, itself, not trying to prevent it.

Obviously, the earlier the detection of risk factors the larger the at risk population will be because many of these will not go on to show other signs or symptoms of impending disease and the more expensive it will be to monitor these people and to try to control risk factors.

Ever since Hillary made such a big point during her campaign of claiming she would save health care dollars with preventative health measures, there have been loads of studies that have shown that, while preventative health measures are good medicine and produce good health outcomes, nearly all preventative health measures cost more than they save. Why should it be a surprise that it costs more to produce good health outcomes than to produce poor ones?

 

[Diuretic]

I suppose there's a sound economic argument in there somewhere, about the efficacy of spending x dollars to prevent premature deaths so that individuals can continue to be productive. Anyway that's an interesting point about prevention costing more than cure. I don't know why it's a surprise to realise that but I have to say I'm surprised.

 

[Emma]

That's exactly what the CBO document I posted a link to addresses. When you find the time to read the CBO letter, you will see:



http://www.cbo.gov/ftpdocs/104xx/doc10492/08-07-Prevention.pdf

Well, no, that's not quite what I was asking.

"widespread use of preventive services tend to exceed the savings from averted illness"

That's what I was referring to when I mentioned universal screening and I agree that would be costly.

I can't find anything addressing the cost benefits for early detection and maintenance care, though. I will read the link, thanks.

The researchers found that those steps would substantially reduce the projected number of heart attacks and strokes that occurred but would also increase total spending on medical care because the ultimate savings would offset only about 10 percent of the costs of the preventive services, on average.

I also wonder what the costs are they claim will increase even as incidence of strokes and heart disease are 'substantially reduced'? It says spending on medical care. Is that just for those conditions specifically? Does it include the cost of treating their complications as well? What about the indirect costs of those conditions and complications, for example lost wages and productivity, disability, etc.

In fact, the example of treating high blood pressure and high cholesterol to prevent heart attacks and strokes is an example of early detection and maintenance. These measures are in widespread use only among the high risk population, not among the general population. If you wait any longer to begin treatment, you are treating the disease, itself, not trying to prevent it.

Again, I'd like to see the actual study. I think you are misunderstanding that it's saying; it's talking about the cost of widespread screening, rather than screening those at risk. It seems to be arguing against that specifically, which is pretty much the recommended norm anyway.

Obviously, the earlier the detection of risk factors the larger the at risk population will be because many of these will not go on to show other signs or symptoms of impending disease and the more expensive it will be to monitor these people and to try to control risk factors.

That is expensive and why guidelines exist as to who to screen for what and at what age.

 

[PeterS]

Although I am not conversant with your hospital, the following is generally true:
Medicaid pays hospitals $.86 for $1 healthcare provided
Medicare pays hospitals $.97-.98 for each $1 healthcare provided
Private Plans pay hospitals about $1.32 for each $1 of healthcare provided.

So any ObamaCare plan that results in fewer private healthcare plans will result not in savings but in dimunition of healthcare, and increase in costs.

This is a bit of a misnomer. Medicare and Medicaid require that as many procedures as possible be combined in as few visits as possible. This doesn't mean that the doctor or hospital is operating at a loss only not allowed to pad the bill. It is also better for the patient because it gets treatment over quicker. Here is an example of what I am talking about. This past winter I had surgery for three skin cancers. Total office visits were 8 and total cost just under 20K. My father-in-law who is retired and on medicare had surgery for 2 skin cancers plus a preventive face peal all done in just 3 visits. Total cost just over 5K In both cases the doctor and health care facility eared a profit.

This isn't a reduction in quality but just the opposite since the ordeal is over quicker and recovery faster.

Who ever fed you your talking points did a nice job but accepting both medicare and medicaid patients is done by free choice of the doctor and health care facility. Do you really think they would do so if it were costing them money?

 

[veritas]

Your post simply indicates that those proposing the healthcare plan are unable to predict costs.

Unable, incompetent, have an agenda,...who knows.

But always, always inderestimate the costs by many, many fold.

Predicting costs is a very, very difficult thing to do. Amazingly, there are very few people on the planet that have the necessary expertise to estimate things of this magnitude. One of the main elements in any estimation is the contingency component. In a project such as this, there are elements you haven't even thought of. Contingencies for stationary projects such as building a nuclear power plant could approach 25% and still be within an acceptable margin of error. Things like the stock market losing 10% of it's value in a short time would have to be added into the mix. Unemployment rates and the availability of pertinent skilled labor go into it as well. Education costs and the price of food and war, disease, natural disasters, fraud etc., etc.........an estimation is only good for any proposed snapshot in time with the things actually considered and accounted for, therefore the contingency would have to be quite large. This isn't costing out a sun room.

It isn't about inability or incompetence.

 

[toomuchtime_]

Well, no, that's not quite what I was asking.

"widespread use of preventive services tend to exceed the savings from averted illness"

That's what I was referring to when I mentioned universal screening and I agree that would be costly.

I can't find anything addressing the cost benefits for early detection and maintenance care, though. I will read the link, thanks.



I also wonder what the costs are they claim will increase even as incidence of strokes and heart disease are 'substantially reduced'? It says spending on medical care. Is that just for those conditions specifically? Does it include the cost of treating their complications as well? What about the indirect costs of those conditions and complications, for example lost wages and productivity, disability, etc.

In fact, the example of treating high blood pressure and high cholesterol to prevent heart attacks and strokes is an example of early detection and maintenance. These measures are in widespread use only among the high risk population, not among the general population. If you wait any longer to begin treatment, you are treating the disease, itself, not trying to prevent it.

Again, I'd like to see the actual study. I think you are misunderstanding that it's saying; it's talking about the cost of widespread screening, rather than screening those at risk. It seems to be arguing against that specifically, which is pretty much the recommended norm anyway.

Obviously, the earlier the detection of risk factors the larger the at risk population will be because many of these will not go on to show other signs or symptoms of impending disease and the more expensive it will be to monitor these people and to try to control risk factors.

That is expensive and why guidelines exist as to who to screen for what and at what age.

The example given about monitoring blood pressure and cholesterol levels among diabetics and other with high risk of heart disease and of treating them to prevent heart attacks and strokes, is an example of preventive medicine being used in a high risk group, not of widespread screening. It studied the effect of widespread use of monitoring and preventive medication within this high risk group, not among a broader population, and it concluded that the cost of preventing heart attacks and strokes that were prevented by this monitoring and treatment among this high risk group was about ten times the cost of treating them if they had occurred. If you are interested in the effect of applying preventative medicine among high risk groups, this is an example of what that effect will be. The reason this is so is that the cost of treating the number of heart attacks and strokes that will be prevented among this high risk group of people is much less than the cost of monitoring and treating everyone in this high risk group.

Preventive medicine is good medicine and produces good health outcomes, but the myth that it also reduces health care costs has been thoroughly debunked and politicians who continue to make this claim are either ignorant of the facts or lying.

 

[Emma]

In fact, the example of treating high blood pressure and high cholesterol to prevent heart attacks and strokes is an example of early detection and maintenance. These measures are in widespread use only among the high risk population, not among the general population. If you wait any longer to begin treatment, you are treating the disease, itself, not trying to prevent it.

Again, I'd like to see the actual study. I think you are misunderstanding that it's saying; it's talking about the cost of widespread screening, rather than screening those at risk. It seems to be arguing against that specifically, which is pretty much the recommended norm anyway.

Obviously, the earlier the detection of risk factors the larger the at risk population will be because many of these will not go on to show other signs or symptoms of impending disease and the more expensive it will be to monitor these people and to try to control risk factors.

That is expensive and why guidelines exist as to who to screen for what and at what age.

The example given about monitoring blood pressure and cholesterol levels among diabetics and other with high risk of heart disease and of treating them to prevent heart attacks and strokes, is an example of preventive medicine being used in a high risk group, not of widespread screening. It studied the effect of widespread use of monitoring and preventive medication within this high risk group, not among a broader population, and it concluded that the cost of preventing heart attacks and strokes that were prevented by this monitoring and treatment among this high risk group was about ten times the cost of treating them if they had occurred. If you are interested in the effect of applying preventative medicine among high risk groups, this is an example of what that effect will be. The reason this is so is that the cost of treating the number of heart attacks and strokes that will be prevented among this high risk group of people is much less than the cost of monitoring and treating everyone in this high risk group.

Preventive medicine is good medicine and produces good health outcomes, but the myth that it also reduces health care costs has been thoroughly debunked and politicians who continue to make this claim are either ignorant of the facts or lying.

I still believe it's talking about universal (therefore widespread) screening. I'll know for sure when I see the study it's referring to.

I am still not convinced it's a myth. That letter seems to contradict itself at times:

In particular, Medicare already covers preventive services that have been shown to reduce net costs. Moreover, legislation enacted last summer authorizes Medicare to add coverage of preventive services that improve health, including those that also reduce costs.

Also, a link provided in the letter:

Approximately 100 million elderly will enter Medicare over the next 25 years. We consider the potential benefits of interventions that would reduce or eliminate the most important risk factors for disease and spending. Effective control of hypertension could reduce health care spending $890 billion for these cohorts while adding 75 million disability-adjusted life years (DALYs). Eliminating diabetes would add 90 million life-year equivalents at a cost of $2,761 per DALY. Reducing obesity back to levels seen in the 1980’s would have little effect on mortality, but yields great improvements in morbidity (especially heart disease and diabetes) with a cost savings of over $1 trillion. Smoking cessation will have the smallest impact, adding 32 million DALYs at a cost of $9.045 per DALY. While smoking cessation reduces lung disease and lung cancer, but these are relatively low prevalence compared to the other diseases. Its impact on heart disease is negligible. The effects on overall social welfare are unknown, since we do not estimate the costs of these interventions, the costs of any behavioral modification, or the welfare loss due to providers from lower medical spending.

 

[Emma]

And btw,

Reducing obesity back to levels seen in the 1980’s would have little effect on mortality, but yields great improvements in morbidity (especially heart disease and diabetes) with a cost savings of over $1 trillion.

That is just sad.

 

[toomuchtime_]

Again, I'd like to see the actual study. I think you are misunderstanding that it's saying; it's talking about the cost of widespread screening, rather than screening those at risk. It seems to be arguing against that specifically, which is pretty much the recommended norm anyway.


That is expensive and why guidelines exist as to who to screen for what and at what age.

The example given about monitoring blood pressure and cholesterol levels among diabetics and other with high risk of heart disease and of treating them to prevent heart attacks and strokes, is an example of preventive medicine being used in a high risk group, not of widespread screening. It studied the effect of widespread use of monitoring and preventive medication within this high risk group, not among a broader population, and it concluded that the cost of preventing heart attacks and strokes that were prevented by this monitoring and treatment among this high risk group was about ten times the cost of treating them if they had occurred. If you are interested in the effect of applying preventative medicine among high risk groups, this is an example of what that effect will be. The reason this is so is that the cost of treating the number of heart attacks and strokes that will be prevented among this high risk group of people is much less than the cost of monitoring and treating everyone in this high risk group.

Preventive medicine is good medicine and produces good health outcomes, but the myth that it also reduces health care costs has been thoroughly debunked and politicians who continue to make this claim are either ignorant of the facts or lying.

I still believe it's talking about universal (therefore widespread) screening. I'll know for sure when I see the study it's referring to.

I am still not convinced it's a myth. That letter seems to contradict itself at times:

In particular, Medicare already covers preventive services that have been shown to reduce net costs. Moreover, legislation enacted last summer authorizes Medicare to add coverage of preventive services that improve health, including those that also reduce costs.

Also, a link provided in the letter:

Approximately 100 million elderly will enter Medicare over the next 25 years. We consider the potential benefits of interventions that would reduce or eliminate the most important risk factors for disease and spending. Effective control of hypertension could reduce health care spending $890 billion for these cohorts while adding 75 million disability-adjusted life years (DALYs). Eliminating diabetes would add 90 million life-year equivalents at a cost of $2,761 per DALY. Reducing obesity back to levels seen in the 1980’s would have little effect on mortality, but yields great improvements in morbidity (especially heart disease and diabetes) with a cost savings of over $1 trillion. Smoking cessation will have the smallest impact, adding 32 million DALYs at a cost of $9.045 per DALY. While smoking cessation reduces lung disease and lung cancer, but these are relatively low prevalence compared to the other diseases. Its impact on heart disease is negligible. The effects on overall social welfare are unknown, since we do not estimate the costs of these interventions, the costs of any behavioral modification, or the welfare loss due to providers from lower medical spending.

Clearly, the example given in the CBO report refers to widespread use of preventative measure within a group that is at high risk for heart attacks and strokes, diabetics, people with hypertension and others with high risk factors for heart disease.

As the CBO report points out, the report you are quoting did not calculate the cost of preventing disease, which is what the discussion is about: is the cost of preventing disease more or less than the cost of treating the diseases if they had not been prevented.

One recent study that analyzed the interactions of different chronic conditions and
the costs of treating them—but did not address the costs of avoiding the
conditions—found that cutting obesity rates in half would reduce total medical
spending by the elderly Medicare population by roughly 10 percent in 2030.5

The CBO report states that about 20% of preventive measures actually do save money, so there is no contradiction in stating that Medicare already provides some of these.

You do realize, don't you, that Douglas Elmendorf, the director of CBO, was appointed by the Democratic Congress in January on this year, so there is no reason to suspect he would report anything that did not support the Democratic agenda unless he felt compelled to by the facts.

 

[cunclusion]

In fact, the example of treating high blood pressure and high cholesterol to prevent heart attacks and strokes is an example of early detection and maintenance. These measures are in widespread use only among the high risk population, not among the general population. If you wait any longer to begin treatment, you are treating the disease, itself, not trying to prevent it.

Again, I'd like to see the actual study. I think you are misunderstanding that it's saying; it's talking about the cost of widespread screening, rather than screening those at risk. It seems to be arguing against that specifically, which is pretty much the recommended norm anyway.

Obviously, the earlier the detection of risk factors the larger the at risk population will be because many of these will not go on to show other signs or symptoms of impending disease and the more expensive it will be to monitor these people and to try to control risk factors.

That is expensive and why guidelines exist as to who to screen for what and at what age.

The example given about monitoring blood pressure and cholesterol levels among diabetics and other with high risk of heart disease and of treating them to prevent heart attacks and strokes, is an example of preventive medicine being used in a high risk group, not of widespread screening. It studied the effect of widespread use of monitoring and preventive medication within this high risk group, not among a broader population, and it concluded that the cost of preventing heart attacks and strokes that were prevented by this monitoring and treatment among this high risk group was about ten times the cost of treating them if they had occurred. If you are interested in the effect of applying preventative medicine among high risk groups, this is an example of what that effect will be. The reason this is so is that the cost of treating the number of heart attacks and strokes that will be prevented among this high risk group of people is much less than the cost of monitoring and treating everyone in this high risk group.

Preventive medicine is good medicine and produces good health outcomes, but the myth that it also reduces health care costs has been thoroughly debunked and politicians who continue to make this claim are either ignorant of the facts or lying.

Ok that makes no sense, it costs way less to prevent a problem than to fix the problem when it happens. Its like your car if you do periodic maintenance on it, it lasts longer and you have fewer major issues with your vehicle. This is the same with the human body if a person takes control of their body (eg exercise, eat right, and get checkups) is way cheaper than trying to fix something.

 

[Emma]

Reducing Health Care Costs by Reducing the Need and Demand for Medical Services

 

[toomuchtime_]

And btw,

Reducing obesity back to levels seen in the 1980’s would have little effect on mortality, but yields great improvements in morbidity (especially heart disease and diabetes) with a cost savings of over $1 trillion.

That is just sad.

Actually, I made the same article about obesity and smoking just a few weeks ago, and some one responded by sending me to this study:

Obesity is a major cause of morbidity and mortality and is associated with high medical expenditures. It has been suggested that obesity prevention could result in cost savings. The objective of this study was to estimate the annual and lifetime medical costs attributable to obesity, to compare those to similar costs attributable to smoking, and to discuss the implications for prevention.

Although effective obesity prevention leads to a decrease in costs of obesity-related diseases, this decrease is offset by cost increases due to diseases unrelated to obesity in life-years gained. Obesity prevention may be an important and cost-effective way of improving public health, but it is not a cure for increasing health expenditures.

PLoS Medicine: Lifetime Medical Costs of Obesity: Prevention No Cure for Increasing Health Expenditure

I argued against this study as strenuously as you are arguing against the CBO report, and while I can find reasons to question it, the conclusion makes sense.

 

[Emma]

The example given about monitoring blood pressure and cholesterol levels among diabetics and other with high risk of heart disease and of treating them to prevent heart attacks and strokes, is an example of preventive medicine being used in a high risk group, not of widespread screening. It studied the effect of widespread use of monitoring and preventive medication within this high risk group, not among a broader population, and it concluded that the cost of preventing heart attacks and strokes that were prevented by this monitoring and treatment among this high risk group was about ten times the cost of treating them if they had occurred. If you are interested in the effect of applying preventative medicine among high risk groups, this is an example of what that effect will be. The reason this is so is that the cost of treating the number of heart attacks and strokes that will be prevented among this high risk group of people is much less than the cost of monitoring and treating everyone in this high risk group.

Preventive medicine is good medicine and produces good health outcomes, but the myth that it also reduces health care costs has been thoroughly debunked and politicians who continue to make this claim are either ignorant of the facts or lying.

I still believe it's talking about universal (therefore widespread) screening. I'll know for sure when I see the study it's referring to.

I am still not convinced it's a myth. That letter seems to contradict itself at times:



Also, a link provided in the letter:

Approximately 100 million elderly will enter Medicare over the next 25 years. We consider the potential benefits of interventions that would reduce or eliminate the most important risk factors for disease and spending. Effective control of hypertension could reduce health care spending $890 billion for these cohorts while adding 75 million disability-adjusted life years (DALYs). Eliminating diabetes would add 90 million life-year equivalents at a cost of $2,761 per DALY. Reducing obesity back to levels seen in the 1980’s would have little effect on mortality, but yields great improvements in morbidity (especially heart disease and diabetes) with a cost savings of over $1 trillion. Smoking cessation will have the smallest impact, adding 32 million DALYs at a cost of $9.045 per DALY. While smoking cessation reduces lung disease and lung cancer, but these are relatively low prevalence compared to the other diseases. Its impact on heart disease is negligible. The effects on overall social welfare are unknown, since we do not estimate the costs of these interventions, the costs of any behavioral modification, or the welfare loss due to providers from lower medical spending.

Clearly, the example given in the CBO report refers to widespread use of preventative measure within a group that is at high risk for heart attacks and strokes, diabetics, people with hypertension and others with high risk factors for heart disease.

As the CBO report points out, the report you are quoting did not calculate the cost of preventing disease, which is what the discussion is about: is the cost of preventing disease more or less than the cost of treating the diseases if they had not been prevented.

One recent study that analyzed the interactions of different chronic conditions and
the costs of treating them—but did not address the costs of avoiding the
conditions—found that cutting obesity rates in half would reduce total medical
spending by the elderly Medicare population by roughly 10 percent in 2030.5

The CBO report states that about 20% of preventive measures actually do save money, so there is no contradiction in stating that Medicare already provides some of these.

You do realize, don't you, that Douglas Elmendorf, the director of CBO, was appointed by the Democratic Congress in January on this year, so there is no reason to suspect he would report anything that did not support the Democratic agenda unless he felt compelled to by the facts.

I'm not saying I suspect him of anything untoward. The letter uses the term "widespread". I concede that widespread screening is costly.

I'm trying to dig around in the citations listed, and have found others. One thing I have noticed is there doesn't seem to be a consensus. I'm finding articles arguing both points.

I'm still looking for information regarding cost savings for early detection and routine maintenance care opposed to the cost of treating conditions that are advanced and/or have complications that could have been prevented, delayed or lessened if that care had been available early on. One article I found touched on it by saying that their study didn't take that into account. Many of these seem to only focus on the medical costs, and ignore indirect costs (as I describe above).

And something else I find very interesting... in the articles describing the cost of treatment (even with early detection) it's the price of medications that seem to be the primary factor driving up the cost. That I believe. The cost of medication in this country is obscene. I wonder what these cost studies would look like if they plugged in the cost of those same medications as they're priced in ... say ... Canada ... or any other country where the same damn pills cost a fraction of what they do here.

There's more to this than meets the eye, methinks.

 

[Emma]

And btw,

Reducing obesity back to levels seen in the 1980’s would have little effect on mortality, but yields great improvements in morbidity (especially heart disease and diabetes) with a cost savings of over $1 trillion.

That is just sad.

Actually, I made the same article about obesity and smoking just a few weeks ago, and some one responded by sending me to this study:

Obesity is a major cause of morbidity and mortality and is associated with high medical expenditures. It has been suggested that obesity prevention could result in cost savings. The objective of this study was to estimate the annual and lifetime medical costs attributable to obesity, to compare those to similar costs attributable to smoking, and to discuss the implications for prevention.

Although effective obesity prevention leads to a decrease in costs of obesity-related diseases, this decrease is offset by cost increases due to diseases unrelated to obesity in life-years gained. Obesity prevention may be an important and cost-effective way of improving public health, but it is not a cure for increasing health expenditures.

PLoS Medicine: Lifetime Medical Costs of Obesity: Prevention No Cure for Increasing Health Expenditure

I argued against this study as strenuously as you are arguing against the CBO report, and while I can find reasons to question it, the conclusion makes sense.

Well, they seem to be saying that those who are not obese tend to live longer, thus eating up more health care resources as they age. Then again, reducing obesity decreases the risk for disease conditions that are common as we get older.

And I keep coming back to that letter's own citation:

Approximately 100 million elderly will enter Medicare over the next 25 years. We consider the potential benefits of interventions that would reduce or eliminate the most important risk factors for disease and spending. Effective control of hypertension could reduce health care spending $890 billion for these cohorts while adding 75 million disability-adjusted life years (DALYs). Eliminating diabetes would add 90 million life-year equivalents at a cost of $2,761 per DALY. Reducing obesity back to levels seen in the 1980’s would have little effect on mortality, but yields great improvements in morbidity (especially heart disease and diabetes) with a cost savings of over $1 trillion.

Cost savings. I don't see how they can argue there is an increase net cost spending and at the same time produce evidence of HUGE cost savings.

I think it all boils down to targeted screening. The letter claims that is 'difficult'. I disagree.

 

[Emma]

Ok, my head is spinning again

I'll have to let this one go for tonight. Have a good one.

 

[toomuchtime_]

Again, I'd like to see the actual study. I think you are misunderstanding that it's saying; it's talking about the cost of widespread screening, rather than screening those at risk. It seems to be arguing against that specifically, which is pretty much the recommended norm anyway.


That is expensive and why guidelines exist as to who to screen for what and at what age.

The example given about monitoring blood pressure and cholesterol levels among diabetics and other with high risk of heart disease and of treating them to prevent heart attacks and strokes, is an example of preventive medicine being used in a high risk group, not of widespread screening. It studied the effect of widespread use of monitoring and preventive medication within this high risk group, not among a broader population, and it concluded that the cost of preventing heart attacks and strokes that were prevented by this monitoring and treatment among this high risk group was about ten times the cost of treating them if they had occurred. If you are interested in the effect of applying preventative medicine among high risk groups, this is an example of what that effect will be. The reason this is so is that the cost of treating the number of heart attacks and strokes that will be prevented among this high risk group of people is much less than the cost of monitoring and treating everyone in this high risk group.

Preventive medicine is good medicine and produces good health outcomes, but the myth that it also reduces health care costs has been thoroughly debunked and politicians who continue to make this claim are either ignorant of the facts or lying.

Ok that makes no sense, it costs way less to prevent a problem than to fix the problem when it happens. Its like your car if you do periodic maintenance on it, it lasts longer and you have fewer major issues with your vehicle. This is the same with the human body if a person takes control of their body (eg exercise, eat right, and get checkups) is way cheaper than trying to fix something.

I agree that the conclusion that prevention will cost more than treatment in 80% of cases seems counterintuitive, and so does Elmendorf, but he explains:

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. 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. Even when the unit cost of a particular preventive service is low, costs can accumulate
quickly when a large number of patients are treated preventively.

So while your reasoning is correct with regard to any one person, prevention costs less that treatment, since even in a high risk group such as the one cited in the CBO letter, doctors don't know which members of the group will have heart attacks or strokes even with the preventative care or which ones wouldn't have heart attacks or strokes without the preventative care, so the cost of preventing one heart attack has to include the cost of providing preventive care to many people who either had heart attacks or wouldn't have even without the treatment.

If doctors could pinpoint, or nearly pinpoint, those individuals who would benefit from preventative care, then it is likely prevention would generally be less expensive than treatment, but with regard to the major diseases such as heart disease and most cancers, doctors simply can't narrow the group of high risk patients to the extent where prevention is less expensive than treatment for the whole group. However, even if you could pinpoint an individual whose life would definitely be saved by preventive measures, wouldn't you have to add the cost health care during the years saved to the cost of prevention of that particular disease to determine if money had been saved or not?

 

[cunclusion]

Ok like when I had to go to the hospital for a achilles tear. Now when I was at the hospital they ran a Xray and a CAT Scan. But when I got to my specialist he wanted a MRI you cant see soft tissue real good with a Xray or a CAT Scan so basically I paid for two procedures that were worthless for the situation I was in. This is one of the things that need to be solved. Performing unnecessary procedures for any given situation its a waste of time and money, especially money.

 

[Meister]

Ok like when I had to go to the hospital for a achilles tear. Now when I was at the hospital they ran a Xray and a CAT Scan. But when I got to my specialist he wanted a MRI you cant see soft tissue real good with a Xray or a CAT Scan so basically I paid for two procedures that were worthless for the situation I was in. This is one of the things that need to be solved. Performing unnecessary procedures for any given situation its a waste of time and money, especially money.

Actually a CAT scan is an excellent proceedure for soft tissue. An XRAY was probably to cover any possible fracture of a bone. So You had some excellent service in this broken down healthcare system we have to endure.

CT scans of internal organs, bone, soft tissue and blood vessels provide greater clarity and reveal more details than regular x-ray exams.
CAT Scan (CT) - Body

 

[Emma]

Ok like when I had to go to the hospital for a achilles tear. Now when I was at the hospital they ran a Xray and a CAT Scan. But when I got to my specialist he wanted a MRI you cant see soft tissue real good with a Xray or a CAT Scan so basically I paid for two procedures that were worthless for the situation I was in. This is one of the things that need to be solved. Performing unnecessary procedures for any given situation its a waste of time and money, especially money.

Actually a CAT scan is an excellent proceedure for soft tissue. An XRAY was probably to cover any possible fracture of a bone. So You had some excellent service in this broken down healthcare system we have to endure.

CT scans of internal organs, bone, soft tissue and blood vessels provide greater clarity and reveal more details than regular x-ray exams.
CAT Scan (CT) - Body

MRI is preferred for tendon studies.


MRI of tendon injuries.

Imaging of orthopedic sports injuries - Google Books

MRI of the musculoskeletal system - Google Books

From your own link:

Detailed MR images allow physicians to better evaluate various parts of the body and certain diseases that may not be assessed adequately with other imaging methods such as x-ray, ultrasound or computed tomography (also called CT or CAT scanning).


What are some common uses of the procedure?

MR imaging is usually the best choice for examining the:

• body's major joints.
• spine for disk disease.
• soft tissues of the extremities (muscles and bones).

MR imaging is typically performed to diagnose or evaluate:

• degenerative joint disorders such as arthritis and meniscus tears (knee).
• fractures (in selected patients).
• joint abnormalities due to trauma (tendon tears for example).
• spinal disk abnormalities (herniated disk for example).
• the integrity of the spinal cord after trauma.
• sports-related injuries and work-related disorders caused by repeated strain, vibration or forceful impact.
• infections (osteomyelitis for example).
• tumors (primary tumors and metastases for example) involving bones and joints.
• pain, swelling or bleeding in the tissues in and around the joints and bones.

 

[cunclusion]

Ok like when I had to go to the hospital for a achilles tear. Now when I was at the hospital they ran a Xray and a CAT Scan. But when I got to my specialist he wanted a MRI you cant see soft tissue real good with a Xray or a CAT Scan so basically I paid for two procedures that were worthless for the situation I was in. This is one of the things that need to be solved. Performing unnecessary procedures for any given situation its a waste of time and money, especially money.

Actually a CAT scan is an excellent proceedure for soft tissue. An XRAY was probably to cover any possible fracture of a bone. So You had some excellent service in this broken down healthcare system we have to endure.

CT scans of internal organs, bone, soft tissue and blood vessels provide greater clarity and reveal more details than regular x-ray exams.
CAT Scan (CT) - Body

MRI is preferred for tendon studies.


MRI of tendon injuries.

Imaging of orthopedic sports injuries - Google Books

MRI of the musculoskeletal system - Google Books

From your own link:

Detailed MR images allow physicians to better evaluate various parts of the body and certain diseases that may not be assessed adequately with other imaging methods such as x-ray, ultrasound or computed tomography (also called CT or CAT scanning).


What are some common uses of the procedure?

MR imaging is usually the best choice for examining the:

• body's major joints.
• spine for disk disease.
• soft tissues of the extremities (muscles and bones).

MR imaging is typically performed to diagnose or evaluate:

• degenerative joint disorders such as arthritis and meniscus tears (knee).
• fractures (in selected patients).
• joint abnormalities due to trauma (tendon tears for example).
• spinal disk abnormalities (herniated disk for example).
• the integrity of the spinal cord after trauma.
• sports-related injuries and work-related disorders caused by repeated strain, vibration or forceful impact.
• infections (osteomyelitis for example).
• tumors (primary tumors and metastases for example) involving bones and joints.
• pain, swelling or bleeding in the tissues in and around the joints and bones.

So the fact is that all the hospital had to do was an MRI and skip the other two options all together because even the analysis they came up with was wrong stated my tear was alot worse than it really was. If they seen it in a MRI they would have seen a partial small tear. So basically a waste of money and an incorrect diagnosis...