CBO: Preventative Care for all NOT Cheaper

[RangerM]

An excerpt from a letter dated August 7, 2009 from the Congressional Budget Office:

.......Preventive medical care includes services such as cancer screening, cholesterol management, and vaccines. 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.

 

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. Judging the overall effect on medical spending requires analysts to calculate not just the savings from the relatively few individuals who would avoid more expensive treatment later, but also the costs for the many who would make greater use of preventive care. As a result, preventive care can have the largest benefits relative to costs when it is targeted at people who are most likely to suffer from a particular medical problem; however, such targeting can be difficult because preventive services are generally provided to patients who have the potential to contract a given disease but have not yet shown symptoms of having it.

 

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.....

 

Remember, this is your own government saying this, not a right-wing pundit.

 

I've attached the entire letter for you to read. (here is where you can find it on the web: http://www.cbo.gov/doc.cfm?index=10492&type=1)

08_07_Prevention.pdf

[suv_guy_19]

So you're arguing that people shouldn't have preventative care....interesting.

[fmccap]

So you're arguing that people shouldn't have preventative care....interesting.

I'd argue that they are lying to you because everybody else is saying it's going to cost more.

[suv_guy_19]

There is no way to know if it will really cost more (there is a good chance it will increase productivity), but that aside, should the issue of human health really be a purely economic issue?

[fmccap]

There is no way to know if it will really cost more (there is a good chance it will increase productivity), but that aside, should the issue of human health really be a purely economic issue?

Given our governments track record I would bet anything it will cost many times more then they say.

[RangerM]

So you're arguing that people shouldn't have preventative care....interesting.

Could you cite where I have said that, please?

 

One of the reasons for promoting "government healthcare" is that the additional coverages will provide preventative care, which will reduce overall costs to the system. This is part of the "More coverage, Less Cost, Improved Healthcare for All" argument.

 

The fact is, the Congressional Budget Office disagrees with that assessment.

[suv_guy_19]

Could you cite where I have said that, please?

 

 

If it's more expensive for government, then it must be more expensive for people personally and for insurance companies. It seems that no one should fund it....looking at it from a purely economic view. Of course, there are many benefits to everyone having access to preventative medicine, and talking about costs when we're really talkinga bout saving lives is simply cruel.

[RangerM]

If it's more expensive for government, then it must be more expensive for people personally and for insurance companies. It seems that no one should fund it....looking at it from a purely economic view. Of course, there are many benefits to everyone having access to preventative medicine, and talking about costs when we're really talkinga bout saving lives is simply cruel.

You didn't answer my question. Where did I say "that people shouldn't have preventative care"?

 

To address your point. If there are people willing to pay for insurance that covers preventative care, there will be companies willing to provide it.

 

It's the Administration who is promoting the "cost savings". If you have a problem with that, your issue is with them.

[suv_guy_19]

You stated that it costs more. You seem to be boiling health down to cost. If it costs more, and that's all we care about, then no one should do it.

[grbeck]

You stated that it costs more. You seem to be boiling health down to cost. If it costs more, and that's all we care about, then no one should do it.

 

Cost is important. The Administration is pitching its health care proposal on the basis that it will reduce costs in the long run. The supposed superiority of current national health care plans over what we have in the U.S. is that they provide the same results for less money (i.e., at lower cost).

 

Sorry, but you can't tout cost savings of what you advocate on the one hand, but when a proposed treatment or policy turns out to NOT save money, suddenly claim that costs aren't important, or that they shouldn't be "all that we care about."

Edited August 14, 2009 by grbeck

[RangerM]

You stated that it costs more. You seem to be boiling health down to cost. If it costs more, and that's all we care about, then no one should do it.

No, the Congressional Budget Office says is costs more. I have provided the information.

 

You didn't answer my question. Where did I say "that people shouldn't have preventative care"? You have put words in my mouth. Could you explain, please?

 

It's the Administration who is promoting the "cost savings". Given that there are no cost savings (per the CBO), are we allowed (in your opinion) to consider the Administration as being disingenuous?

[suv_guy_19]

What I'm getting at is that healthcare shouldn't simply be looked at in terms of cost. I don't really care what the administration is saying. I disagree with looking at this from a simply economic view. You're saying that it's not cheaper...and that seems to imply that you don't approve. Maybe, you do, I don't know, but if you do, then you are simply posting against the plan for the sake of doing it.

[RangerM]

What I'm getting at is that healthcare shouldn't simply be looked at in terms of cost. I don't really care what the administration is saying. I disagree with looking at this from a simply economic view. You're saying that it's not cheaper...and that seems to imply that you don't approve. Maybe, you do, I don't know, but if you do, then you are simply posting against the plan for the sake of doing it.

Health Insurance Reform or Healthcare Reform, however you want to say it is being touted on the basis of three things (call it a 3-legged stool)

 

1. More people insured

2. For less money spent (overall)

3. and better care for everyone.

 

 

The CBO has done this......

 

1. More people insured

2. For less money spent (overall)

3. and better care for everyone.

 

We are not looking at it from cost basis exclusively, but as part of the 3-legged stool, that now (per the CBO) has two legs, and it's getting wobbly.

 

My issue is that if you increase demand (which noone can reasonably deny) without at least an equivalent increase in the supply of doctors/facilities/etc, the case for reform now looks like this....

 

1. More people insured

2. For less money spent (overall)

3. and better care for everyone.

 

The stool is now a top, and when the spin stops, it will fall.

Edited August 14, 2009 by RangerM

[Edstock]

The stool is now a top, and when the spin stops, it will fall.

You're right.

 

There are way too many people out there with defective genes and bad lifestyles that will cost a fortune in preventive medicine, because with them, there's no "there" there, and they keep having children with the same problems.

 

Apparently the life-span for people in the bottom 25% is actually decreasing, as they get shorter and fatter, and become evermore prone to diabetes, cardio disease and cancer and other problems.

 

I don't think the problem is fixable in the US; in Canada, our privincial systems are having a tough time with the diabetes epidemic from the legions of cheezie-eaters, but there are signs of progress, like getting the pop machines out of the school cafeterias.

 

The point is, preventive medice can be made to work in Canada, but in the US it could be devastatingly expensive. For the long-term health of the US, as cold as this is, it might be best to let 'em die as quickly as possible, preferrably before they breed.

[Deanh]

"The stool is now a top, and when the spin stops, it will fall. "

 

there are drugs for stool problems....IF you are insured and can swing the deductible..........

[mikem12]

"The stool is now a top, and when the spin stops, it will fall. "

 

there are drugs for stool problems....IF you are insured and can swing the deductible..........

 

 

from the wall street journal

 

http://online.wsj.com/article/SB1000142405...3172846168.html

 

 

I think what many are saying is simply you can price yourself right out of house and home. The cost here in the US will be astronomical. There is no way the Gov can financially support this without wide spread tax increases across the board.

 

Well unless they are lying but God forbid me or anyone saying that Obama would lie. We will immediately be thrown under the nearest fast moving bus.

[Deanh]

from the wall street journal

 

http://online.wsj.com/article/SB1000142405...3172846168.html

 

 

I think what many are saying is simply you can price yourself right out of house and home. The cost here in the US will be astronomical. There is no way the Gov can financially support this without wide spread tax increases across the board.

 

Well unless they are lying but God forbid me or anyone saying that Obama would lie. We will immediately be thrown under the nearest fast moving bus.

sorry to change tracks...but how would it effect the whole ball game if Drug producing companies were brought in line with reality...if off shore drugs were brought in at half the price and the backpocket FDA was given a kick up the ass and put under more scruitiny....some prescriptions are simply inexcusable CRAZY money, and you know the profit pays for every second advertisement on the idiot box....but, if they were overseen, side effects could include....

[DUCKRACER]

sorry to change tracks...but how would it effect the whole ball game if Drug producing companies were brought in line with reality...if off shore drugs were brought in at half the price and the backpocket FDA was given a kick up the ass and put under more scruitiny....some prescriptions are simply inexcusable CRAZY money, and you know the profit pays for every second advertisement on the idiot box....but, if they were overseen, side effects could include....

 

You weren't kidding about the "only ewe" plate. LOL!

[Deanh]

You weren't kidding about the "only ewe" plate. LOL!

hardly anyone gets it...everynow and then i'll look in the mirror and see someone losing it...probably foreign....LOL! Hey, kiwi has to be proud of his heritage!

[mikem12]

sorry to change tracks...but how would it effect the whole ball game if Drug producing companies were brought in line with reality...if off shore drugs were brought in at half the price and the backpocket FDA was given a kick up the ass and put under more scruitiny....some prescriptions are simply inexcusable CRAZY money, and you know the profit pays for every second advertisement on the idiot box....but, if they were overseen, side effects could include....

 

 

Good question

 

I don't have much if any knowledge of what the Pharm companies do, but it was explained at least once that since the American companies spend literally billions of dollars a year in R&D, they then spend another 2 to 5 years getting something to pass through the FDA for approval. Europe dosen't have the many restriction we do. Those restricton add up in dollars over years. I guess thats why you don't see many drugs coming from overseas. They still have to go through the same process with the FDA.

[RangerM]

sorry to change tracks...but how would it effect the whole ball game if Drug producing companies were brought in line with reality...if off shore drugs were brought in at half the price and the backpocket FDA was given a kick up the ass and put under more scruitiny....some prescriptions are simply inexcusable CRAZY money, and you know the profit pays for every second advertisement on the idiot box....but, if they were overseen, side effects could include....

I'd have no problem with "mail order" (importation of) drugs myself. The deal Obama just made with the drug companies effectively prevents that from happening, however.

 

I know the drug companies have to be able to recoup their investment when they develop a new wonderdrug, and I certainly would not want to undermine the flow of life-saving medicines, or medicines that treat rare diseases (that often aren't profitable due to insufficient demand).

 

There are two ways I can think of to help both drug company and consumer. (Maybe others have ideas?)

 

One would be to provide drug companies a way to recoup their investment, while making the drugs less expensive, by allowing for extensions in patents. If drug companies know their patent won't run out as soon, allowing for competing generics, then they can extend the window for return on investment, allowing for lower prices.

 

OR possibly provide incentive to shorten the patent cycle. When a drug company competitor brings to market a similar drug for a given treatment, the original drug company's profits will drop. At that point, there may be an opening to incentivize the drug company to allow the patent to lapse prematurely. You can bet that Viagra's profits dropped when Levitra/Cialis were brought to market. Maybe an incentive to de-patent Viagra? The problem is that it might come back to bite Levitra/Cialis, so there would have to be some care taken.

 

(Deanh, just in case you're wondering, the reason I keep using these drugs as examples is that they're the ones I can name from the TV commercials. Not implying anything about you. :shades: )

Edited August 15, 2009 by RangerM

[Mark B. Morrow]

Good question

 

I don't have much if any knowledge of what the Pharm companies do, but it was explained at least once that since the American companies spend literally billions of dollars a year in R&D, they then spend another 2 to 5 years getting something to pass through the FDA for approval. Europe dosen't have the many restriction we do. Those restricton add up in dollars over years. I guess thats why you don't see many drugs coming from overseas. They still have to go through the same process with the FDA.

 

 

The issue in many cases is re-importation of drugs that were made in the USA and sold by US companies to Canada and other countries at a far lower price than we can buy them for here. Does anyone really believe that Pfizer sells Viagra at a loss in Canada? How about Nexium, or any other name brand drug? Of course not they still make a profit on the drugs they sell to Canada just not as much as they do here. If they didn't they would not sell them in other countries at all.

 

R&D costs are subsidized by means of generous tax breaks, they are also deductible from gross income in determining profit. The drud comapnies use the FDA approval as a seal of approval all over the world to market new drugs. Federally supported universities and labs do work on new drugs for which the drug companies reap the profits. Apparently only US citizens should have to pay full boat for our drugs. The Medicare Part D prohibited the government from using its superior buying power to get discounts in the prices. Hell, Wal-Mart demands volume discounts W just gave away the house.

 

I'm not particularly happy about the deal Obama made with Big Pharma to get support for HC Reform, but atleast he got an agreement for an $80 Billion discount over 10 years. Not much but not nothing. In addition Obama's deal is only to oppose further discounts and re-importation. If Congress puts these items in the bill he's not going to veto it.