Health care plan should cut costs first

Freedom New Mexico

Team Obama didn’t need this, but it’s important for the rest of us to know, especially as we listen to his address to Congress on health care, scheduled today.

President Obama’s plans to increase the national government’s responsibility and power over health care have had a rough time of it this summer. Among the reasons — the shouting at town halls has been a sideshow — have been a series of reports from the non-partisan (though Democratic-controlled) Congressional Budget Office questioning promises of huge cost savings from advocates of various approaches.

Most people figured it was unlikely the government would be able to provide health insurance for an additional 47 million people, even if only through partial subsidies, and save money in the process. Sure enough, said the CBO: Every plan passed out of a congressional committee to date would cost taxpayers an additional $900 billion to $1 trillion over the next 10 years.

Wait, said advocates. We want to mandate increased use of electronic record-keeping by doctors. That will save money and paperwork, and make it easier for complete patient records from one practitioner to another. That will save a bundle.

So the CBO studied that and concluded — without even commenting on possible privacy concerns with a centralized database in the hands of a government that has been known to lose huge quantities of data to thieves — that it might save a few million in time, but nothing dramatic.

Wait. We’re going to push for more preventive care. Surely early preventive care, which will help to prevent or delay the onset of serious diseases that are horrendously expensive to treat, especially toward the end of life when heroic (and expensive) measures are often used, will save money.

Sorry. A team has just completed a study, using data from long-standing clinical trials, for the journal Health Affairs. The researchers projected the cost of caring for people with Type 2 diabetes assuming early diagnosis, intervention and programs to prevent or delay serious complications. They assumed that a simple but aggressive program at early stages would cost about $1,024 per person per year.

Sure enough, they calculated it would pay for itself through lower spending on dialysis, kidney transplants, amputations and the like — but only after 25 years or so. Only patients diagnosed between ages 24 and 30 would realize a lifetime cost savings. For older patients the preventive care would add to overall costs, not reduce them.

That doesn’t mean preventive care isn’t a good idea. In most cases it is. Just don’t count on it to save significant sums.

With recent polls showing more Americans disapproving of Obama’s efforts on health care than approving — and the president’s approval rating in the Gallup daily tracking poll at just 50 percent, the fastest decline of any recent president — President Obama would do well to change strategies on health care.

He should reset with a program that actually has a chance of reducing health care costs first, before expanding taxpayer spending.