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View Diary: Analysis of the Pelosi Health Care Reform Bill (78 comments)

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  •  Free is the key word. (0+ / 0-)

    It's not like you're paying for the full cost of the colonoscopy.  You're still paying far, far less than its cost with a $50 co-pay.  Those 20-sumpin's are still paying for a good deal of the costs of your colonoscopy -- just not everything.  Free preventative care is going to jack up the prices of insurance like 10-20 percent.  I don't think that's going to be popular.

    Operator, operator -- what's the number for 9-1-1? - Homer Simpson

    by jim bow on Tue Nov 03, 2009 at 07:47:20 AM PST

    [ Parent ]

    •  It's be popular for the recipients (0+ / 0-)

      It will be a big draw for the people seeking preventative care and that preventative care is going to be much cheaper than the expensive care other policy holders will have to pay for, in the case of people that didn't get that preventative care to begin with.

      The no-copay preventative care seems to be part of a move to stop the emergency room from being some people's first stop for what could have been treated months ago in a doctor's office.

      I seems to remember a study that found that any co-pay detered some people from seeking preventative care.

      I know I am quite annoyed at Kaiser for having a 'no annual checkup' policy.

      •  Except then ... (0+ / 0-)

        ... you either have to (a) pay a higher premium, or (b) cut back on coverage of more essential benefits, i.e., hospitalization.  For a family with a diabetic child, it's important that the family have good coverage of essential items in order to prevent medical bankruptcy.

        There are tradeoffs with everything.  I just think I'd rather have more protection against medical bankruptcy for essential services than spend more money on preventative care.  I feel the family with a child with heart problems needs our help more than a 51-year-old needs to pay nothing for a colonoscopy.  $100 for a colonoscopy isn't much.

        Operator, operator -- what's the number for 9-1-1? - Homer Simpson

        by jim bow on Tue Nov 03, 2009 at 10:18:53 AM PST

        [ Parent ]

        •  preventative is cheaper than results (0+ / 0-)

          you either have to (a) pay a higher premium, or (b) cut back on coverage of more essential benefits, i.e., hospitalization.

          My understanding was that the logic goes that if you pay for the preventative care, you will be paying less for hospitalization as a whole, because the preventative care catches stuff before the hospitalization is needed.

          So you can afford to give the kid with heart problems care, because the colonoscopy test revealed something that could be treated sooner and more easily, so you're not spending cash on colon problems that could be spend on heart problems.

          Now I will say that there is an issue to be made of , how many negative colonoscopies equal one surgery/hospitalization. How wide a net of people do you screen for X before you're spending money screening people for something they very likely don't have or for which there is no cheaper early intervention.

          •  Investing in prevention doesn't save money. (0+ / 0-)

            The math says so.  Say a colonoscopy costs $1,000 per operation, one in every 750 colonoscopies catches cancer, and treating cancer costs $500,000.  By the math, that means investing in colonscopies costs $1,000 - $500,000/750, or $333.33, for every person.  That doesn't mean we shouldn't invest in prevention; it just means investing in prevention costs -- not saves -- money.

            Operator, operator -- what's the number for 9-1-1? - Homer Simpson

            by jim bow on Tue Nov 03, 2009 at 12:27:03 PM PST

            [ Parent ]

            •  single example or more (0+ / 0-)

              Hmm, That's counter to what I had thought previously.
              Is colonoscopy simply a well chosen example or are there a preponderance of them?
              Clearly vaccination is cheaper than fighting the actual disease.
              Controlling high blood pressure and high cholesterol though detection by regular checkups and diet and/or medication are cheaper than treating a stroke or heart attack.
              Treating a disease with antibiotics early on (keeping in mind problems with overuse etc.)is cheaper than having someone with a massive fever in an ER.
              Or are there studies that say otherwise?

              Those are the things that come to mind when I think of preventative medicine.

            •  Good job on diary (1+ / 0-)
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              jim bow

              I want to say that you did a great job on the diary and I appreciate the input of someone with an actuarial background.

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