If conservatives don’t counter them, government-run health care will be here to stay.
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The Myth: Investing in preventive care will save money in the long run.
Why It Matters: President Obama has emphasized reducing costs in his push for expanding the role of government in health care, and he has cited preventive care as a key to cutting the nation’s medical expenses in the long term. The idea that by preventing illnesses we can avoid costly treatments down the road sounds intuitive. It’s a way of convincing the American people that there are certain commonsense measures we can take to save money and make people healthier at the same time, and thus justify the huge price tag of expanding health care coverage through government.
Obama spoke about the savings potential of preventive care during his campaign, and boasted that this year’s $787 billion economic stimulus package made “the largest investment ever in preventive care, because that is one of the best ways to keep our people healthy and our costs under control.”
The Reality: While the costs of treating an individual for a given illness may be exorbitant, the costs for testing, screening, and providing early treatment for millions of other people is often much higher.
As H. Gilbert Welch, a professor of medicine at the Dartmouth Institute for Health Policy and Clinical Practice, wrote in a New York Times op-ed last year, “Increasing the amount of testing for an ever-expanding list of problems always identifies many more people as having disease and still more as being ‘at risk.’ Screening for heart disease, problems in major blood vessels and a variety of cancers has led to millions of diagnoses of these diseases in people who would never have become sick.”
Overdiagnosis, Welch noted, in addition to incurring unnecessary costs, results in treatment such as surgery or prescription medication, both which have risks and potential side effects.
An article published in the New England Journal of Medicine last year took a more nuanced approach. Co-authors Joshua T. Cohen, Peter J. Neumann, and Milton C. Weinstein argued that preventive care can save money in certain instances, but it depends on the type of illness and who is being targeted.
Writing during last year’s election, the authors concluded that: “Our findings suggest that the broad generalizations made by many presidential candidates can be misleading. These statements convey the message that substantial resources can be saved through prevention. Although some preventive measures do save money, the vast majority reviewed in the health economics literature do not.”
Again, there are arguments to be made in favor of such measures, and no price can be put on a person’s peace of mind if they test negative for a devastating illness, but it is misleading to speak of preventive care as a magic bullet that will substantially reduce our nation’s health care costs.
The Myth: Other countries spend less than the U.S., but get better health care in return.
Why It Matters: If Americans are convinced that government-run health care systems do a superior job of delivering and financing health care, they’ll be more open to the idea of expanding the role of government in the U.S.
“At the rate we’re going, we are expected to spend one-fifth of our economy on health care within a decade,” Obama said in May. “And yet we’re getting less for our money. In fact, we’re spending more on health care than any other nation on earth, even though millions of Americans don’t have the affordable, quality care they deserve, and nearly 46 million Americans don’t have any health insurance at all.”
The Reality: Other systems frequently cited by advocates of government-run health care don’t have magic wands; they set budgets and ration care to the sick. Tests such as CT scans and MRIs that are routinely performed in the U.S. are done with much less frequency in other systems. But while other nations may be able to keep the costs of medical care lower, they have other drawbacks.
When actress Natasha Richardson suffered a head injury in Quebec’s Mont Tremblant ski resort in March, she was forced to take a two-and-a-halfhour drive to the nearest trauma center, in Montreal, because a helicopter was not available. After her death, Daniel LeFrançois, director of Quebec’s prehospital care, told the Montreal Gazette that helicopters were expensive, and they weren’t used because medical resources were allocated according to “the biggest gain for the biggest need.” Shortly after Richardson’s death, CNN reported that a sevenyear- old Ohio girl, Morgan McCracken, survived a similar brain injury. McCracken was rushed by helicopter to a Cleveland hospital from her local emergency room in six minutes even though it would have only been a 30-minute ambulance ride.