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Pretty much the entirety of the article you're selectively quoting is praising preventative care.

The byline is "Contrary to conventional wisdom, it tends to cost money, but it improves quality of life at a very reasonable price."

and the article closes with this

But money doesn’t have to be saved to make something worthwhile. Prevention improves outcomes. It makes people healthier. It improves quality of life. It often does so for a very reasonable price.

There are many good arguments for increasing our focus on prevention. Almost all have to do with improving quality, though, not reducing spending. We would do well to admit that and move forward.

Sometimes good things cost money.




I’m not arguing over affect, I’m arguing over truth claims. The article leads with the facts and then argues that despite being a poor use of money we should still pay for preventive medicine for the warm fuzzy feelings it gives us. Pay attention to the facts, not the argument that we should ignore the facts for the warm fuzzy feelings.

If we’re going to spend huge amounts of money we should spend it better than on preventive care, on areas where the money can do more good. That money could be spent on foreign aid, on saving lives, not improving them, on earned income tax credit, to encourage people to get back into work or gain more work experience, on basic research or subsidy to get us to carbon neutral faster.

And the article completely fails to note the false positives, the unnecessary tests and the worry caused by preventive screening.

Money spent on preventive medicine isn’t wasted but it could certainly be better spent.

> In 2009, as part of the Robert Wood Johnson Foundation’s Synthesis Project, Sarah Goodell, Joshua Cohen and Peter Neumann exhaustively explored the evidence. They examined more than 500 peer-reviewed studies that looked at primary (stopping something from happening in the first place) or secondary (stopping something from getting worse) prevention. Of all the interventions they looked at, only two were truly cost-saving: childhood immunizations (a no-brainer) and the counseling of adults on the use of low-dose aspirin. An additional 15 preventive services were cost-effective, meaning that they cost less than $50,000 to $100,000 per quality adjusted life-year gained.


> I’m not arguing over affect, I’m arguing over truth claims. The article leads with the facts and then argues that despite being a poor use of money we should still pay for preventive medicine for the warm fuzzy feelings it gives us. Pay attention to the facts, not the argument that we should ignore the facts for the warm fuzzy feelings.

That's a very disingenuous summary born out of a "economics trump everything" mentality. If you believe that humans are more important than money it is wrong and the original articles byline is a better summary:

Contrary to conventional wisdom, it tends to cost money, but it improves quality of life at a very reasonable price.


Humans are more important than money; that’s why we should spend the money on saving human lives in the developing world, not making the lives of already healthy, wealthy first world inhabitants slightly more comfortable, why we should spend it on investments in the future not hideously wasteful consumption in the present. If we’re going to spend the money that inefficiently give people a tax cut instead. There are many better ways to spend the money than a tax cut but preventive health care isn’t it.

If we want to improve health outcomes we could do many things more effective than increasing preventive care. Nurse practitioners cost half as much as doctors and are just as effective at primary care. That’s a genuine huge bang for the buck intervention that could be done and isn’t. Never mind preventive medicine. Do something that actually works instead.

Primary Care Outcomes in Patients Treated by Nurse Practitioners or Physicians: A Randomized Trial. JAMA : the journal of the American Medical Association. 283. 59-68. 10.1097/00132586-200012000-00026.




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