Tuesday, October 07, 2008

Campaign Myth: Prevention as Cure-All

In a presidential campaign that promises straight talk and no gimmicks, why do both candidates champion one of medical care’s most pervasive myths.

The myth is that like magic, preventive medicine will simultaneously reduce costs and improve health.

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The term “preventive medicine” no longer means what it used to: keeping people well by promoting healthy habits, like exercising, eating a balanced diet and not smoking. To their credit, both candidates ardently support that approach.

But the medical model for prevention has become less about health promotion and more about early diagnosis. Both candidates appear to have bought into it: Mr. Obama encourages annual checkups and screening, Mr. McCain early testing and screening.

It boils down to encouraging the well to have themselves tested to make sure they are not sick. And that approach doesn’t save money; it costs money.
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These interventions do prevent advanced illness in some patients, but relatively few. Any savings from preventing those cases is dwarfed by the cost of intervening early in millions of additional patients. No wonder pharmaceutical companies and medical centers see preventive medicine as a great way to turn people into patients — and paying customers.

If preventive medicine were effective in improving the nation’s health, it might warrant these added expenditures. But you can’t assume it is. Early diagnosis may help some, but it undoubtedly leads others to be treated for “diseases” that would never have bothered them. That’s called overdiagnosis.

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