What’s Behind It?
Many people, especially the uninsured, do not receive recommended preventive care, such as screenings for cancer, cholesterol checks, or vaccines. As a result, some develop serious illnesses, such as cancer and heart disease. It is sometimes suggested that investing in preventive care (broadly defined as clinical services that reduce patients’ risk of developing a chronic or life-threatening illness) saves money because it can decrease the incidence of these significant and costly diseases later on.
The Broader Picture
The benefits of prevention are primarily improved health for consumers, rather than reduced health spending. For example, early detection of cancer can often save lives, greatly improving patients’ longevity and quality of life. However, screening a large population for cancers is expensive. In the aggregate, screening for cancer rarely saves health care dollars, because spending is reduced only for the small percent of patients whose cancers are detected but new costs are incurred for every individual screened. Furthermore, earlier detection may yield more expensive interventions, such as follow-up diagnostic testing, short-term and longer term treatments. Screenings such as these are valuable because they can give people longer, healthier lives, but they do not generally save money.
Not all preventive services are created equally. There is variation not only in cost savings but also in the overall health impacts of various types of preventive services. The National Commission on Prevention Priorities ranked the cost effectiveness and health impact of 25 preventive services and found variation across both measures. Five preventive services, such as childhood immunizations, proved to save money and provide benefits. Yet while some preventive services do save money, most don’t; and while some preventive services that don’t save money still have clear health benefits, others do not.
The most effective and potentially cost-saving preventive care is usually a specific intervention targeted at a defined high-risk group. For example, studies have shown that reducing high cholesterol in patients without heart disease is expensive and not always effective. But reducing high cholesterol among heart attack survivors can prolong their lives and may even save money by preventing later heart attacks. Likewise, pneumococcal vaccines provide savings only when targeted at the elderly, who are more susceptible to pneumonia and more likely to develop serious and costly complications. When investing in prevention, it is important to carefully target the intervention to realize maximum effectiveness and cost savings.
The Bottom Line
In pure economic terms, investing in prevention usually does not save money. However, many investments in prevention lengthen lives, improve quality of life, and enhance productivity, yielding significant benefits for both individuals and society as a whole.
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