According to a quoted CDC study, the cost of chronic diseases that could be managed through preventative care services is about 75% of the U.S. healthcare spending, to the tune of about $260 billion dollars a year.
Can we then assume that by increasing our focus on prevention and management of those diseases, our efforts would ultimately lower healthcare expenditures?
Not necessarily.
Peter Neumann, a professor of medicine at Tufts University School of Medicine, summed up the issue, “Prevention itself costs money, and some preventive measures can be very expensive.”
A 2009 study by the Robert Wood Johnson Foundation showed that at that time only 13% of their measured preventative services were cost-effective, and physician spending has grown by an average of 3.6% per year between 2008 and 2018.
Yet, despite the evidence that preventative care would not reduce healthcare costs, the ACA, in 2010, required health insurance plans to cover 100% of certain types of preventive care. This would seem counter-intuitive if the goal was indeed to reduce the cost of healthcare for individuals.
So what are the arguments for preventative care to reduce the healthcare costs for those with chronic diseases?
Arguments for Preventative Care
One of the primary arguments for preventative care is that it reduces hospital visits. Since 2010, the same year the ACA mandated coverage, emergency room visits have decreased, suggesting a correlation between access to covered preventative care and fewer trips for “emergency” treatment.
Not only did emergency room visits decrease but we saw that when patients have regular access to affordable preventative care, their chronic conditions are more likely to be discovered and managed. This lowers the need for more expensive treatments for diseases that have progressed past regular management.
3 Types of Preventative Care
There are actually three types of prevention, a nuance that most policymakers and economists miss.
- Primary prevention is preventing a disease or problem in the first place, such as using spirometry data to predict the likelihood of an asthmatic episode.
- Secondary prevention prevents the progression or impact of an existing disease, such as educating asthma patients on how to avoid their asthma triggers and therefore, an asthma attack.
- Tertiary prevention helps people manage the long-term effects of a disease, such as the permanent structural changes in the airways, or airway remodeling from repeated asthma attacks.
Often, the assessment of preventative efforts for asthma patients measures the cost of primary prevention against the cost of treatment, which can include secondary and tertiary measures. However, with asthma, mainly a hereditary disease, management takes precedence over prevention.
Allergists and pulmonologists need to educate their patients on what prevention means and what works, and then help them to apply it to themselves. Even though preventative care does cost the patient money, it also improves the quality of a patient’s life, and that is very difficult to measure in monetary terms.
