nos-trum. pronunciation: \nos'-trum\. noun. Etymology: Latin, neuter of noster our, ours.
1. a medicine of secret composition recommended by its preparer but usually without scientific proof of its effectiveness.
2. a usually questionable remedy or scheme.
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Sunday, April 25, 2010

Does Prevention Lower Health Care Costs? Depends On Perspective

Facetious question:  if I die very young, haven't I "prevented" high lifetime health care costs?

The President, his health care advisors, and other experts often point to the cost-controlling value of preventive care.  To make sense of that claim consider some examples.

First example:  I am a 60-year old diabetic and hypertensive, controlling my blood pressure and blood sugar is good for me personally by keeping me healthy, and lowers the risk of being hospitalized for care.  Hospital care is very expensive, so keeping me at home and going strong lowers cost.  I go on relatively healthy for another 20 years before dying of complications.  The last year of life requires a lot more care as my health fails.  For a guy who made it to 80, I've kept lifetime costs as low as they could be through prevention.

Second example:  roll back the clock 10 years.  I'm now 50 but don't yet have high blood pressure or diabetes.  I have a heart attack and die.  While my dying event may be expensive--or not--it still is less expensive than living another 30 years being monitored and followed regularly for multiple chronic illnesses.  On top of that is the cost of my eventual decline in the last year of life, as in the first example.  But overall, my life, in terms of medical costs, has been much less of a financial burden.

So, the cost-containing influence of prevention depends on the diseases, the phase of the life cycle, the acute versus chronic nature of the health care, and a lot of other factors.

It seems to me that the underlying difference is one of perspective:  am I looking at cost in a short-term or single disease-focused way, or am I looking at what it costs for a complete life?

You can construct these mind experiments in a lot of different ways, making the cost come out one way or the other.  But all of them, like the two above, can be realistic.

In summary: prevention MAY lower cost, but not always.  Prevention ALWAYS is good medical care.

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