Great Britain's payment model for the National Health Service's Physicians, for just one example, actually pays them a HECK of a lot more money each year when they IMPROVE the health and healthy behaviors of their patients.
That's doesn't amount to evidence or argument for the idea that preventive care saves money. Its a possible mechanism for it to happen (or for the costs to go up since they are paying "a HECK of a lot more money each year"), but not that money is actually saved.
Weight loss, smoking secession, prenatal checkups and nutrition
Weight loss, and smoking secession are not preventive medicine, because they are not medicine (except metaphorically where you could call something that has nothing to do with health or medicine, "preventive medicine").
Doctors making the effort to encourage weight loss and smoking secession, may reasonably be considered preventive medicine, but that's not the same thing as the whole of weight loss and smoking secession.
Prenatal checkups may cost additional money. Sure the problem you catch and prevent can save a bundle, but you provide a lot of checkups for each major prevented problem. A lot depends on how expensive the checkups are. Ultrasound and other tests and devices can give you more information, but also adds to the cost. Treatment for the problems the checkup finds also costs money. In some cases the treatment is unnecessary for a health birth, in others its useless and doesn't prevent the health problems or the death of the child, in others its actually harmful. And you can also get children that survive and need a ton of expensive care. That's a good outcome (compared to them dying), but its an example of increased costs.
Nutrition efforts can often be misguided and therefore harmful, or at least of uncertain benefit. Also its not something you need doctors to do, and if you considering the costs of the doctors time it may raise costs even when its done right. Again done right it will produce better outcomes, but you can't count on it being done right. Also costs are complex here, better outcomes could mean someone lives longer and continues to consume health care. I want people to live, but a cost is a cost even if the benefit is great. Then you have to consider the limited impact of doctors attempts to get people to change their diets. Often people know they are eating in an unhealthy way and don't need their doctor to tell them that, they just don't want to, or feel unable to change.
And those are the examples you picked. Wide spread diagnostic screening, and other examples of preventive medicine are less likely to be cost effective.
Also see the final 90% of this post
Message 26116384
your earlier reply only considered the opening statement. |
