Preventive Care is Good, Even Though It's Not Saving Money

[@pyayaXC]

"Sometimes good things cost money..." transition to the Patreon pitch for Heathcare Triage. I see what you did there.

[@loomhigh]

lol

[@B15HOP]

And sometimes the best things in life, are free...

[@alexanderreusens7633]

I assume these studies did not factor in the indirect benefits of prevention? Increased productivity is good for the economy...

[@rickytorres9089]

Exactly! You may ACTUALLY be saving money if you work a half decent job regularly! Let's not even forget about other indirect money pits too. Babysitters, pet sitters, and so on are routinely sought after if one is sick...

[@coleweede1953]

People on disability are a burden to the economy (which is ok they are helpless in that situation) so getting them out of that situation and get them back into the workforce is a big win.

[@kimberlydrennon4982]

A thing to keep in mind is that while money isn't saved in the example of the smokers, the people living longer means they can contribute to society more, so productivity is increased and costs are basically the same... if you're into min/maxxing human lives, that is... which politicians definitely are.

[@qb4428]

Actually, people living longer does not increase productivity since the elderly are objectively a massive drain on taxpayers.

[@DrowFighterMage]

Assuming they were elderly or retired at least. Plus people who have health problems from smoking are going to need more treatment in the mean time. But what about other things that strike people who are younger? Or that can be alleviated if caught in time? This sounds very cherry picked.

[@brentc6095]

Prevention also might provide economic benefits. It is generally easier for a business to weather the planned absence of an employee for a preventative visit than it is to handle the unplanned absence from getting sick. That is going to be much harder to measure in an evidence based way though.

[@DrowFighterMage]

You didn't mention lost productivity from people who get sicker because they didn't have preventive care. Maybe if they fined people for using the ER when it isn't an emergency (where coverage is universal) that would help some. Also, consider that some people live in areas where not a lot of doctors accept Medicaid or that people get injured or sick when the only thing open is the ER.

[@spartycool]

Your first sentence is addressed at 3:31

[@qb4428]

No evidence that lost productivity outweighs the costs. Just accept the facts.

[@cbl6520]

The Medicaid part couldn't be more true, the percentage of doctors accepting new medicaid patients continues to drop each year due to low reimbursement.

[@adnanilyas6368]

Who gets to tell what is an emergency and what isn’t? Without diagnostic tests, a lot of things that aren’t life threatening can certainly seem like they are.

[@DrowFighterMage]

@ Spartacus, no it wasn't. He only mentioned that they had to spend more on people who otherwise would have died & if they quit smoking they would have not been paying the tax. There was no mention lost productivity from losing a worker or caregiver.

[@jehold2010ify]

Good point it's not just about savings but quality of life. I have many clients who have had back surgery and regret it. They are not significantly better and found alternative therapies like massage helped them manage and cope better than surgery did.

[@TommyTrink]

Wonderfully said. Especially with something as tricky as back problems, it’s amazing how well treatments other than surgery can work. Yes, sometimes it works great (my stepfather had spinal surgery 10 years ago, and has had very few issues since), but I feel as though many immediately write off the benefits of massage therapy and chiropractic care just because they aren’t as “permanent” (and surgery IS typically just a one-time expense)

[@paxundpeace9970]

Back surgery is also the topic of the video from Healthcare Triage below. kzbin.info/www/bejne/iqq1dqyDq9ODeqs Regional Difference in Procedure and prices by Healthcare Triage

[@myztik5716]

How do they know it's not both

[@RibbitingScience]

Question in regards to the 'cost savings' argument: Has there been research on potential cost savings beyond direct expenditures, looking into the potential economic savings form preventive care from reduced lost work hours draining national economic output? I'm curious if the the macroeconomic benefits tilt the scale towards the 'savings' side of the argument.

[@downsidebrian]

The problem is, the very people who have the authority to change this care more about the money than the outcomes. What if we talk about it like this: To get the same outcome without improved prevention would cost vastly more money, if possible at all. That would make it clear that it's cost-effective, without making it seem like we'd be spending less.

[@gwendlehasagecko969]

My only question is that you didn’t address people’s continued/increased earning potential when they avoid illness - the arguments I’ve heard most often have been for positive affect on the economy overall rather than reduced healthcare costs specifically.

[@rickytorres9089]

What about expenditure to SUPPORT the household and so on? If my mom was sick for even a day she loses quite a bit for her cleaning business. If your on the clock like she like you can probably relate to what I am talking about. So with that, the costs of supporting the sick person (baby sitter, pet sitter, lawn services etc etc etc) I bet you would save something too!

[@zomakaja]

why is he yelling at me?

[@rugbyguy59]

Fedorai Zomakaja BECAUSE YOU’RE NOT LISTENING!!!!

[@karlhenke91]

AAAAAAAAAaaaaaa...!

[@symbolxchannel]

Preventive care isn't about money... It's about quality of life.

[@tiffsaver]

I have both Social Security Medicare, AND a separate co-pay insurance supplement that I pay out of my own pocket. But when I went to go in for a routine physical prior to my upcoming surgery, THEY REFUSED TO PAY FOR EVEN ONE PENNY OF IT. Wait a minute... they'll pay $50,000. for a surgical procedure, but not the $200. it costs for a goddamned ANNUAL PHYSICAL?? I once thought that preventative care was a good idea, just like going in for an annual dental checkup. When I missed mine a few years a while back, I got a abscessed tooth, the dentist had to pull my largest molar, and it will cost me SIX THOUSAND DOLLARS TO GET ONE DENTAL IMPLANT TO REPLACE IT. Try coming up with that kind of cash when you're 71 and retired!!! In the entire world of health care and medical insurance, WHY ISN'T THERE AFFORDABLE INSURANCE FOR DECENT DENTAL CARE??? I suppose that Uncle Sam just doesn't believe that having healthy teeth is good idea.

[@Disthron]

Isn't preventative care only really expensive because the healthcare industry is price-gouging in America? Didn't you say in the very last episode that other countries have similar health outcomes for MUCH less cost?

[@Janaaa36]

You break my heart, Aaron!! But fine. Now the question is, how do we sell prevention to policymakers without having the benefit of cost saving on our side?

[@stevenastley2570]

I would have brought all of your available books but I only download to kindle for reading

[@camcat26]

Maybe we should discuss obstacles interfering with primary care, like how hard it is to get into a practice as a new patient after moving to a new area?

[@darlantro]

So cost savings from preventative care are generally offset by later spending because individuals live to be older? Was that the crux? Or was it that most prevention is not designed with cost in mind? Either way it's like saying keeping a car well maintained isn't cost saving because you put more resources into maintaining than if you junked it much earlier. Sure there is a balance, you don't need to be washing and waxing your car very day, but that analogy is apropos as a way of outlining how other factors have to be taken into consideration, not just cost.

[@JustPorcupines]

Agreed. When a cancer diagnosis is given early enough, in many cases it can be surgically removed. If preventative care is deemed unimportant, the same cancer patient would later need chemo/radiation treatments, which could go on for years. If the patient goes into remission, the odds of another cancer diagnosis are generally high. Assuming the cancer returns 2-4 times, before finally taking the person's life, the cost of delayed treatments is far higher, when compared to preventative care. The same could be said for high cholesterol. If caught early, a small dietary change is often the only treatment needed, vs more dangerous levels, requiring medication.

[@Hooplahoma]

If only more people cared about preventative care for their health in the first place!

[@Goni983]

Got the audible of the bad food Bible. Great book

[@skywise001]

Keep working on that pronunciation of Oregon. Also owch. You popped that balloon pretty hard. I liked that myth. :/

[@familywilliams4058]

I've heard you refer to Oregon several times during the course of Healthcare Triage, and I feel I should point out that you are pronouncing it incorrectly. I know that it looks like it SHOULD be pronounced similarly to polygon, hexagon, ect. but it's actually pronounced Oregun. You've got the first part right, kudos to you, but the second half is gun, not gone. It is extremely common for people who do not live here to mispronounce it, so don't feel bad. (psst, you should hear some people try to say Willamette....it's waaaay worse.)

[@christianlibertarian5488]

I'm sure glad someone else has said that besides me. Preventive care is good medicine, but it won't save any money.

[@Leftistattheparty]

Wonder if this would apply in countries with single-payer that are able to negotiate prices down.

[@TacComControl]

I wonder, how much would be saved if we put a stop to chargemaster pricing?

[@zoesaverage]

I'm wondering if the outcomes on cost vs. cost benefit would be different depending on the healthcare system. If it costs a lot to do an intervention in the US, maybe the same intervention in a low-income country would be cheaper and have a greater cost benefit? So many factors to consider! I will definitely keep this in mind for my furture work.

[@cbl6520]

Only one problem with this, other countries control costs largely through artificially low reimbursement and pricing. In other words, it doesn’t reflect the true cost of those interventions and as such, you end up with less access, due to the lack financial incentive. Not what I would call an effective means of saving.

[@karlhenke91]

So I quit smoking recently (finally), and...yeah, the quality of life increase is pretty fantastic. I genuinely didn't realize I wasn't supposed to be coughing that much.

[@lalayatem3758]

Wolfie Magnet praise The Lord, God Bless you truly

[@stringX90]

If preventative care doesn't actually save me money, why are my insurance options forced to have it in their plans?

[@bm8350]

Since you mentioned it, could you maybe do a video on low dose aspirin?

[@pikminlord343]

An excellent video

[@skyleonidas9270]

o shit of course this people will live forever and drain the social security

[@SaucerJess]

💚

[@Chamelionroses]

In other words people are mostly clueless in predicted economy per culture and place while humans being clueless in majority about healthcare besides data.

[@Chiyenworkout]

So basically ... ending sugar subsidy don't change healthcare cost outcome?

[@doublebrass]

great video but i'm afraid it's pronounced "Oh-Ruh-Gun"

[@ExPwner]

Wait, so you're saying that the very premise of the ACA is complete bunk? Well, props for being honest about it when the research didn't fit the narrative. I too would still be for the benefits of prevention, but it's funny that even the selling point was a lie.

[@kimberlydrennon4982]

I wouldn't call it complete bunk. I've benefited from being on my parents' health insurance while I look for a job to support my husband and I. Prior to ACA, we'd be sunk once we got married. That would have led to a huge conflict in conscious because we thought it was the morally right thing to do to get married, but it would have been financially foolish. I have another friend whose income has been so low while she was in college that she also has benefited from ACA. Also Hank Green has talked about how the ACA has made it possible for him to get insurance at all. Previously, since he has a chronic disease, he would have been unable to get insurance as an individual and would essentially not have been able to make Complexly - and therefore Healthcare Triage, the thing it is today. So, no, he's not saying the very premise of ACA is complete bunk. There are a lot of good things *and* a lot of bad things about that law. It's as if you should view things... complexly.

[@owbu]

the main objective of the ACA was to increase the amount of insured people. Which it achieved. The ACA is far from perfect (its a for profit system made up by republicans instead of an actual health care system afterall) but what it tried to do it managed to do.

[@cbl6520]

Considering nearly every republican in congress voted against it, I can assume you don't know what you speak of. Secondly, of course it insured more people, but the bulk of those were young people who didn't want health insurance, who were forced to buy it against their will at gun point (which is wrong). Not to mention the 105% increase in premiums since it was passed. Its cons far outweighed its pros, the goal should have been to improve access to care, access to insurance and access to care are not the same thing. www.politifact.com/texas/statements/2017/oct/04/john-cornyn/john-cornyn-says-obamacare-premiums-more-doubled-f/ www.forbes.com/sites/physiciansfoundation/2014/03/26/a-look-back-at-how-the-president-was-able-to-sign-obamacare-into-law-four-years-ago/#22a63969526b www.forbes.com/sites/scottgottlieb/2015/05/14/how-many-people-has-obamacare-really-insured/#5ae7e629788a

[@qb4428]

Hanno, why do you assume that for profit is bad? The vast majority of medical innovation comes from for-profit companies.

[@KagerowRS]

Actually, Hanno does know what he is speaking about. It was proposed by Heritage Foundation, and first implemented by Mitt Romney. Also, check premium increase since 1998, not since ACA. Selling point is indeed a lie, if the point of ACA was to save money. After all, what could be cheaper than to let them die earlier? Less treatment, more money saved. Also, while I won't judge if profit is good or bad, credit for majority of medical innovation should actually go to the people who innovated them. Not the manufacturers and the licensers. I'm always interested by the fact that discussion like this is quite common in US. I wonder if there is any other country that does this.

[@owbu]

I would like to personally thank smokers for dying early. You guys are really helping making America great again!

[@JamesLacher]

Self care to prevent disease is what is needed. People need to take responsibility of their own health.

[@Fireclaws10]

James Lacher most diseases aren't preventable though.

[@ExPwner]

Uh-oh! You better watch out with mention of personal responsibility. Many of those who comment here abhor even the mention of people being responsible for their own lives.

[@JamesLacher]

Most diseases ARE preventable. BTW, I'm a LIBERAL and I still believe in personal responsibility.

[@juliahanderson6126]

Some of the most cost debilitating diseases are genetic and can't really be prevented. You know, like Crohn's, lupus, cerebral palsy, cystic fibrosis, multiple sclerosis, epilepsy, etc.

[@EduardoEscarez]

Some diseases are preventable, but they depend often in other variables rather than just personal responsibility. For example, obesity. Here in Chile the government had to implement a lot of regulations ( www.nytimes.com/2018/02/07/health/obesity-chile-sugar-regulations.html ) because sometimes you can't ask someone to eat healthy if there isn't a lot of options to have. I have the fortune to live near several supermarkets and a market with fresh produce;and time, knowledge and energy to cook. But someone that lives far away from the market, doesn't know how to cook, has to work a lot for minimum wage is going to choose other options. So, even if implementing restrictions in sugar is a good idea, it should be within other things, like free cooking courses, improving access to fresh produces, etc. We don't exist apart of our environment.

[@NotShowingOff]

Population control....