I missed the opportunity last week to welcome Sarah Kliff to the dark side. No matter, belated is better than never. She writes
What if we’re all wrong? What if prevention doesn’t save money?
. . .
How can this be? The idea that prevention saves money feels intuitive. “When we think of prevention, we tend to think of the individual who benefited,” Russell writes. We conjure up an image of the woman who caught breast cancer early, averting expensive treatments, or the man who brought his weight down and lived a long, healthy life. That, however, discounts all the mammograms that didn’t detect cancer and didn’t prevent anything and all the individuals for whom weight management programs didn’t work. All those costs add up to the point that most preventive interventions cost more than they save.
Your sociopath membership card will be in the mail soon.
6 comments
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Monday ~ December 19th, 2011 at 6:18 pm
Curt Doolittle
Is there any evidence that weight loss persuasion, healthy diet persuasion, smoking persuasion, or exercise persuasion work? If there is I can’t find it.
Persuasion is not prevention.
The only health care modification that we need is that which protects the average person from catastrophic illness or injury.
Monday ~ December 19th, 2011 at 6:41 pm
Becky Hargrove
Wear your membership card proudly, I know I do!
Often I complain about one-to-the-many methods of knowledge dispersal as not quite being the right tools for the job. But in terms of healthcare prevention, such broadcast methods (books, media) sometimes work better than home healthcare nurses that obligingly come around to remind you of the same, all the while clucking that one’s Mom and other family members are misfits for not wanting to test her blood sugar. Note: nothing against the home healthcare person, I just know this is not the most efficient use of your time. Whereas, you would be a godsend when the patient is in desperate need and yet does not want to go to the hospital tonight.
Monday ~ December 19th, 2011 at 11:13 pm
q
not to mention all the disgusting ads in the new york subway which try to convince me to stop smoking (never smoked, i can do without the grossness) or drinking soft drinks (drink ~ 10 cans of sugary soda per year, effectively zero). i’m sensitive and they are strong drag on my mood.
on the other hand, i learned to cough into my elbow from one of these ads, rather than on my hand (and then touch the pole with my hand etc), perhaps that will keep someone or me from getting sick?
Monday ~ December 19th, 2011 at 11:17 pm
bdbd
Sociopaths don’t carry cards!
Tuesday ~ December 20th, 2011 at 5:19 pm
Phil Koop
Umm … just because an intervention *might* not work in theory doesn’t mean it doesn’t work in fact. There are people, e.g. the USPSTF (your tax dollars at work!) who actually try to, you know, *figure out* whether a particular intervention has net/net positive value. Rather than just adopting the time-saving method of assuming that interventions must be good or must be bad.
See e.g. http://blogs.bmj.com/ebm/2011/10/22/thousands-of-american-men-to-die-this-year-because-of-evidence-based-medicine-ebm/.
Wednesday ~ December 21st, 2011 at 12:07 am
DMITRI
Several comments in reply to her piece sum it up quite well. For one, the interventions described are really methods of early detection.
Prevention can be thought of as an investment, like higher ed in a sense; eating healthy costs more today relative to processed food, but it will likely save in the long run in more ways than one. Lifestyle change is not as easy to empirically quantify as she does with her examples.
In a way it’s mind-boggling to see people opposing a healthier society in the form of preventative measures.