Monday, August 10, 2009

Congressional Budget Office opines on prevention (at a 8th grade level)

An anonymous high school student, under the guise of the Congressional Budget Office, released a letter Friday to address how the CBO analyzed the budgetary effects of recent proposals to expand "government support for preventative care and wellness services" and to explain their findings.

The findings aim to establish a position that expanded preventative care and wellness services would actually ultimately INCREASE costs, as the expense of expanding the scope of these services would only offset a small percentage of the increased cost of performing them. As an example, they cite a study conducted by the American Diabetes Association, the American Heart Association, and the American Cancer Society which

"estimated the effects of achieving widespread use of several highly
recommended preventive measures aimed at cardiovascular disease
such as monitoring blood pressure levels for diabetics and
cholesterol levels for individuals at high risk of heart
disease and using medications to reduce those levels."

And while the study indicated that these measures would substantially reduce the probable cases of heart attacks and strokes, the savings would only offset about 10% of the increased provider costs.

It's frightening to me that this argument even exists. If preventative care costs exceed the savings that would be seen by avoiding serious conditions (and their associated procedures) shouldn't the take away be that preventative healthcare costs are too high? How expensive can it be to take a patient's blood pressure and give them medication? How are we having this argument at all without any mention of the benefits to quality of life?

The letter goes on to claim repeatedly that expanding government support for preventative care and wellness services would be redundant, as many insurers and employers are already providing those services at little or no cost to the employee/covered. Which is to say that insurance companies and employers have come to the conclusion that those services ARE beneficial (and cost effective) enough to provide. And have also managed to figure out the riddle to providing them, while staying economically viable.

Again, the logic escapes me. It's as if the CBO was tasked specifically with creating an argument against increased healthcare support, and this is the best they could come up with. Even ignoring their own previous findings, like the report they published 5 months ago that found that a bill (H.R. 1256) aimed at decreasing tobacco use (a wellness service) would result in a decrease of "11 percent among underage tobacco users and about 2 percent among adult users" over just a 10 year period. The overall savings involved in those reductions would have to be huge.

I'm convinced that someone assigned a word count to this letter, and said "create arguments and defend them until you've reach 3200 words".


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