NCPA - National Center for Policy Analysis


September 2, 2009

Since June 2009, President Obama has been losing the health care debate when the central contradiction of Obamacare was fatally exposed: from his first address to Congress, Obama insisted on the dire need for restructuring the health-care system because out-of-control costs were bankrupting the Treasury and wrecking the U.S. economy -- yet the Democrats' plans would make the problem worse, says Charles Krauthammer, of the Washington Post.

Accordingly, Democrats have trotted out various tax proposals to close the gap, all centered on prevention.   Prevention, Mr. Obama claims, will save lives and money.  Because it seems so intuitive, it has become conventional wisdom.  But like most conventional wisdom, it is wrong.  Overall, preventive care increases medical costs, says Krauthammer.

This inconvenient truth comes, once again, from the Congressional Budget Office (CBO):

  • In an Aug. 7 letter to Rep. Nathan Deal (R-GA), CBO Director Doug Elmendorf writes: "researchers who have examined the effects of preventive care generally find that the added costs of widespread use of preventive services tend to exceed the savings from averted illness."
  • For the individual, catching something early generally reduces later spending for that condition; but, explains Elmendorf, we don't know in advance which patients are going to develop costly illnesses.
  • To avert one case, it's usually necessary to provide preventive care to many patients and this costs society money that would not have been spent otherwise.

However, this doesn't' mean we shouldn't be preventing illness.  But in medicine, as in life, there is no free lunch.  The idea that prevention is somehow intrinsically economically different from treatment is simply nonsense.

Prevention is not, as so widely advertised, healing on the cheap. It is not the magic bullet for health-care costs, concludes Krauthammer.

Source:  Charles Krauthammer, "Obama's Great 'Prevention' Savings Myth," Washington Poster/Human Events, August 14, 2009

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