The Preventative Care Myth

David Leonhardt has written an excellent piece in The New York Times regarding the lofty promises of preventative care:

…the current presidential candidates go one step further. They don’t merely argue that preventive care delivers good bang for the buck. They argue that it delivers good bang for no bucks whatsoever. And this is where the candidates are overreaching.

No one really knows whether preventive medicine will save money in the long run, let alone free up the billions of dollars a year needed to help pay for universal health insurance. In fact, studies have shown that preventive care — be it cancer screening, smoking cessation or plain old checkups — usually ends up costing money. It makes people healthier, but it’s not free.

“It’s a nice thing to think, and it seems like it should be true, but I don’t know of any evidence that preventive care actually saves money,” said Jonathan Gruber, an M.I.T. economist who helped design the universal-coverage plan in Massachusetts.

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“Fundamentally, if you’re going to control health care costs, it involves denying people care they want — or things they’ve been trained to think they want,” Mr. Gruber says. “There is no easy answer.”

There is no such thing as a free lunch. Nevertheless, politicians continue to propagate the idea that preventative care is the panacea to all problems related to the health care system. Gruber’s final comment is especially poignant. The only way to truly reduce costs is to reduce care. This can either be done by eliminating the employer-based incentives and encouraging individuals to make their own health care decisions and to buy less expansive coverage or by giving more power to the government and HMOs as gatekeepers to treatment. Personally, I prefer the former rather than the latter.