Why Preventative Care Won’t Save Money

My practice consists of people who want to stay healthy and those recovering from some malady–often of the structural kind, but sometimes of the sub-clinical but bothersome kind. That means, people coming to my office hope to get back to doing what they want or make it so they’re always healthy.

These people are highly motivated. Since my practice is 90% cash, the patients seek out my services, value them so highly that they’ll pay money for them, and they will often be compliant. We have tough talks in my office. I have had this conversation many times:

Me: Here is what we need to do, but it will require a change of behavior on your part, a whole new lifestyle.

Patient: Okay…..

Me: If you are not interested in making these changes, you will not get the health benefits you desire. I do not want to waste your money and my time if you’re not ready for these changes.

Patient: Okay….

Me: How do you feel about (significant change in diet, new exercise regimen, changing sleep habits, changing exercise, at home rehab options, etc.)?

Patient: Well, I…..

And then, the patient thinks about it and decides. Even with paying for care and being self-selected to come into my office, only about 50% are willing to do the changes they need. Some don’t come back until they are ready. Some decide on symptomatic care and admit they don’t really want to change. I had one patient tell me, “I’d rather die than stop drinking Coke.” He was an alcoholic and diabetic. That’s good information to have–I can give him nutrition to supplement his horrendous lifestyle choices, but just the preventative care alone is not going to significantly help him if he won’t help himself. He will be in the hospital, eventually, and have a limb amputated or go into a diabetic coma. Those will be huge expenses.

So, while my practice centers on people taking control of their health and it’s profoundly satisfying because people are self-motivated, this is not the majority of American health care consumers. From the Washington Post:

Using data from long-standing clinical trials, researchers projected the cost of caring for people with Type 2 diabetes as they progress from diagnosis to various complications and death. Enrolling federally-insured patients in a simple but aggressive program to control the disease would cost the government $1,024 per person per year — money that largely would be recovered after 25 years through lower spending on dialysis, kidney transplants, amputations and other forms of treatment, the study found.

However, except for the youngest diabetics, the additional services would add to overall health spending, not decrease it, the study shows.

As an aside, I strongly question the $1,000 price tag for diabetes education and prevention. That seems awfully low. Since one doctor’s office visit alone is around $100, I wonder what else is being covered here. Are meds included? Counseling? What?

Most people, if given a choice, will go to the doctor and want to be “fixed”. That is, they’ll want a drug or surgery that enables them to continue on their path without having to change their behavior. Should socialized medicine come to America, that impulse will be reinforced. Health care costs will soar.

Preventative care only works when a patient is motivated, and even then, it’s challenging. Those under Government Run health care will have less incentive, not more, to take control of their health care.

Do I think that preventative care saves money for my patients? Absolutely. A healthy person over his lifetime, will likely need less health care intervention. Since nearly 90% of chronic disease is preventable, steps to prevent them make a huge difference. A person who never develops heart disease or diabetes or employs dietary ways to prevent cancers makes for a very nice health care cost risk long-term.

In my own life, the life insurance guy was shocked: I have low blood pressure, low cholesterol, I’m on no meds, I’ve had no surgeries. And, yes, I’m overweight, but that doesn’t mean, necessarily, unhealthy. My own grandma who is 92, has spent a lifetime of living preventatively. She is the picture of health–mentally and physically. Prevention does matter. But the individual must be motivated and must take the steps himself to be healthy.

No government can force an individual to have motivation. But they can force behavior…and that’s what they’ll try to do, eventually. In that case, the cure is worse than the disease.

Posted in America • Body • Corrupted Culture • Mind
Tags: Government • Health care