And I don't have time to spend 10 posts debating the meaning of preventative.
Sure you don't have to. No one is asking for 10 posts about it, and even if they where you would be free to reject the request. Talking about the idea of using terms clearly and consistently, doesn't vaguely resemble asking for 10 posts from you on a specific term.
Without having to define it in great detail its useful to have some idea of what is meant. It could be a one paragraph definition, but without some definition of terms, people could be arguing about totally different things without any hope of understanding each other. But of course providing such a definition is still not something you actually have to do.
Diagnostics... probably some are good and some are bad. I think the key is probably to weed out the bad ones.
I agree that some are good and some are bad, but the point wasn't "good vs. bad" but rather "adds to costs vs lowers costs". Some good diagnostic procedures (ones that increase expected overall health outcomes to a great enough extent to justify their costs), still impose a net cost in dollar terms.
I'm certainly not against diagnostic procedures (even if were talking about the field in general and not just cherry picking the very good ones), I just don't think they tend to save money overall (even if some of them do).
As for preventive medicine (using your definition to exclude all or most diagnostic procedures), I pretty much feel the same way. Some are good, some are bad. Some can reduce costs, others do not. I suppose you could reduce costs by focusing on the most cost effective, and dropping the effort (or at least the government side of the effort) for the least cost effective. But while that might leave you with the category as a whole saving money, I don't think its going to save a lot (largely since I don't think most of the efforts will be very successful).
Whether or not diagnostic procedures are included, I don't think the argument that "universal coverage" will save us money, because it will help enable preventive medicine, holds much water. Because -
1 - Coverage won't really be universal (unless your very lose about that term, in which case its arguably universal or near universal today)
2 - I'm skeptical about preventive care saving any money right now, and even if its better targeted in the future I'm skeptical about it being effective enough to be a major cost saver.
and perhaps most of all
3 - Preventative care (at least if the term excludes actual treatment and diagnostic efforts) is not something you need insurance coverage for. If treatment and diagnostics are not part of this category it would seem to mostly be educational campaigns. |
