The Big Lie of Preventive Care

American Thinker ^ | Michael Applebaum, MD

[ventanax5]

The Patient Protection and Affordable Care Act (PPACA) will change the face of American medicine, based in no small part on a big lie about preventive care. A list of so-called "Preventive Services Covered under the Affordable Care Act" can be found here.

To apprehend the folly, it is necessary to understand what is meant by "preventive."

"Preventive":

Main Entry: 2preventive

Function: adjective

Date: circa 1626

: devoted to or concerned with prevention :precautionary : as a : designed or serving to prevent the occurrence of disease

It is clear that preventive care should "serv[e] to prevent the occurrence of disease."

There is no ambiguity.

Here are a couple of the "preventive services" that "beginning on or after September 23, 2010, ... must be covered without your having to pay a copayment or coinsurance or meet your deductible, when these services are delivered by a network provider."

HIV screening for all adults at higher risk

Syphilis screening for all adults at higher risk [bold in the original]

There is an inherent conflict: "The objective of medical screening is to identify disease[.]"

Unquestionably, for a disease to be "identified," it must be present, and therefore, its "occurrence" was not prevented.

[Tax-chick]

There seems to be a confusion between “prevention” and “diagnosis.” Diagnosis would, one assumes, lead to treatment, which is more expensive than not diagnosing and not treating illness.

[ArmstedFragg]

The areas you cited are examples in which the conflict between “public health” and individual patient choice are most evident. Those particular screenings are justified on the basis of reducing disease rates in the population as a whole, rather than preventing the individual from developing the disease. There's sort of a reverse divide in the example of many government health plans refusing to do routine PSA screenings because the net negative public health consequences clearly exceed the positive.

Patients come as individuals, though, and the more directly the payer of claims focuses solely on what's to the benefit of the populace as a whole, the less freedom the patient has. Somewhere there's a balance, but I'd suspect it involves pushing patient choice as far down the continuum toward the individual as possible. The incentives for government are in the opposite direction.

[basil]

I wonder how one “apprehends” a folly......

[neverdem]

BTTT!

[Conservativegreatgrandma]

We’re senior citizens at our house. We haven’t been to a doctor in years. We take no drugs. If Vit C, ACV, castor oil (to rub on, not drink), baking soda and peroxide can’t fix it, you’re in big trouble. We’re all gonna die someday.

[curiosity]

Indeed, though I suppose you could argue that this is prevenative in that knowledge of having an infections disease may reduce the chance of spreading it to others.

I'd also note that even true prevenative care tends to increase healthcare costs overall. Prevenative care results in longer lifespans and greater survivability of deseases, which in turn translates into a larger population of the old and sick. The cost-increasing effect of skewing the population to more old and sick people swamps the cost decreasing effects of preventing diseases or catching them early.

From a cost perspective, you don't want to prevent diseases that tend to quickly kill people before they get old.