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Thursday, July 5, 2012

Can someone explain this?

In the hurricane of hot air that is blowing now about Obamacare, one of the more curious claims is that Obamacare will reduce medical costs by making healthy visits to the doctor like an annual physical and other preventive medicine free. In other words, there will be no copay for a patient who makes a well visit to the doctor. This seem wrong to me. Let me explain:

Let's start with a few incontrovertible facts.
1) There a roughly 311 million Americans.
2) Each of these 311 million Americans is going to die someday.
3) The overwhelming bulk of the cost of the American healthcare system is expended for care of people who are within 6 months of death.

Let's now add in the logic.
1) For each of the 311 million Americans, there is going to be a period right before death. This will be when they incur the bulk of their healthcare costs.
2) Well care visits and screening tests are not free even if Obamacare says that there will be no copay. The costs for these medical procedures will just have to come out of the insurance premiums rather than in part coming from copays.
3) Well care visits and screening tests may or may not catch illnesses that lead to death. If these visits and tests do discover the illnesses, then the heavy medical costs that preceed death may be delayed, but they will not be avoided.
4) As people get older, they are more likely to need regular medical care above and beyond that which they receive in the last six months of life. Old eyes need to be examines and get cataracts removed. Old joints need treatment for arthritis. Folks who discover that they are diabetic need ongoing treatment. You get the picture. As a result, as more people reach advanced age, the total medical costs of the country will rise not fall.
5) More preventive medicine means higher costs due to greater use of preventive medicine as well as due to longer life with higher costs for the aged.

Now let me be clear. I am not advocating that people should have healthcare withheld from them in order to cut costs. Quite the contrary, I strongly believe that folks who can benefit from medical care ought to receive such care. I take issue, however, with the empty headed crowd that announce how the country will SAVE money due to the use of preventive medicine. It is just not true.

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