The Politics of Prevention

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  • Posted By: mislam69 @ 08/25/2008 4:06:37 PM

    Are you joking Newweek? I can't be sure, but thanks for a misleading title that the Insurance industry is sure to love. Everyone knows that screening can't always prevent some diseases, and once the disease strikes, it can be more expensive than the cost of preventive visits. Was that your whole point, to arrive at which, you had to have a discussion with experts? You actually get paid to state the obvious? Can I get that gig?

    What about *overall* cost per year? If your experts mentioned this the discussion, you seem to have omitted that section. If everyone had access to regular medical checkups, as is the case in most other western nations, would it reduce overall healthcare cost to the tax payer? Would it reduce emergency-room visists, which are more expensive than a doctor's appointment? What it doctors are trained in and given incentives to reduce unhealthy behaviors in patients, as they do in England? Would that reduce the number of smokers? British doctors think so. Are they full of it? Now reading about those questions may be worthwhile. Please don't waste your time on drivel.

  • Posted By: Spence99 @ 08/25/2008 3:46:11 PM

    The United States is 23rd out of the 23 Industrialized nations in the world in infant mortality rates. The reason the lack of pre-natal care for those who can not afford the insurance with our for profit health care system. On average a premature baby costs a hospital $55,000.00. In some cases the cost can go as hig as $1.5 million. Newsweek does the nation a great dis-service when it publishes such publishes such crap without doing reasonable research.

  • Posted By: Spence99 @ 08/25/2008 3:37:59 PM

    The United States is 23rd out of the 23 industialized nations it in the world for infant mortality rate. The main reason, the lack of Pre natal care for those who are not insured in our for profit health care system. The average cost of a premature baby in a hoppital is $55,000.00. In some cases the cost can be 1.5 million. Newsweek should do a better job of investigative reporting before publishing a couple of hacks cherry picked arguments

  • Posted By: hithere2u @ 08/25/2008 3:21:38 PM

    What a heartless analysis: "If they work and people live longer, you prevent illness in the near term, but you extend life in the distant decades when people are older and their care is costly."???!! According to the authors, the best health plan would be for people to die young, so that society doesn't need to spend so much money taking care of old people. So rather than prevent disease, they'd propose just having us all drop dead.

  • Posted By: hithere2u @ 08/25/2008 3:19:43 PM

    What a heartless analysis: "If they work and people live longer, you prevent illness in the near term, but you extend life in the distant decades when people are older and their care is costly."!!!!???? So according to the study, the best healthcare plan would be to just have everyone die young, so that we don't need to spedn as much money taking care of old people? What kind of logic is that??!!

  • Posted By: C. MacLean @ 08/24/2008 10:57:19 AM

    The authors are confusing the difference between 'prevention' and 'screening.'

    Screening is using a diagnostic test to see if a person has early signs of a disease so the disease can be treated in its earliest stages. Things like getting your blood pressure checked, your pap smears and mammograms done, as well as prostate tests, colonoscopies, cholesterol checks, diabetes checks, etc. All of these are for the purpose of detecting disease that already exists.

    Prevention is performing some sort of intervention to make sure one never gets the disease in the first place. Vaccines, getting your teeth cleaned regularly and using dental sealants in children, good nutrition, prenatal vitamins, keeping weight off (i.e., never gaining it in the first place), helping kids not start smoking in the first place, getting the elderly to a podiatrist to make sure their shoes fit properly to prevent falls - all these are examples of making sure there is no disease to treat, not finding out IF there is disease to treat,

    Prevention will always be cheaper than treating a preventable disease, and always difficult to prove - how do you prove a negative; how do you quantify the numbers, how do you make the argument that $!00.00 worth of sealants prevented $1000.00 or $10,000.00 worth of cavities? How many cases of cholera and typhoid have we prevented by installing sewers? Prevention isn't sexy, because you can't really show the numbers.

    Screening may or may not be cheaper, depending on how many people you screen and what the screening method costs, but you can always say - "we spent $15,000.00 on pap smears for 1000 women and treated 50 cases of cervical dysplasia that WOULD have turned into cervical cancer if we hadn't done the pap smears, saving $500,000 on hysterectomies." (This an example, the actual math is not as cut and dried).

    Screening will always be sexier, because you can do the math and make people feel as if they did something positive. But prevention, true prevention, can't be measured in dollars - it can only be measured in less suffering - and a politician can't win an election on something as intangible as less suffering.

    • Posted By: backwhen @ 08/25/2008 3:14:19 PM

      I agree. When you are talking about prevention and someone indicates screening is a way to reach prevention, they are assuming that nothing is already being spent for treatment of existing diseases or conditions. And the truth is that under the current medical health insurance model 99% of what we pay is going toward the treatment of existing diseases and conditions and drug therapy is probably responsible for three quarters of that cost. If we weren't paying up front for the marketing and promotionally funded research of which the basic purpose is to popularize the drug rather than actually determine its effectiveness the total cost wouldn't be so flagrantly expensive. Prevention kind of puts a brake on potentially achievable profit which is a jaded viewpoint but it seems to be the truth when looking at spending for incurable diseases and conditions.

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