Sign up for The Media Today, CJRâs daily newsletter.
Preventative care saves money? Câest impossible, Madame Speaker! For weeks, we on Campaign Desk have been pointing out this fallacy, but members of Congress seem reluctant to embrace the evidence. Thatâs a rather strange stance for elected representatives, whoâve been busy telling their constituents that health care costs can best be reduced by evaluating the evidence and paying only for what works. Apparently, evidence is sometimes a good thing and sometimes a bad thing, depending on which point works for your argument. In this case, the evidence is this: Preventative care does notâdoes notâsave money. In fact, it actually costs money.
On the News Hour with Jim Lehrer last night Judy Woodruff interviewed Pelosi at length, mostly about health careâunsurprising, since health reform is currently Topic A. What was surprising was what Pelosi told Woodruff:
One of the challenges we have is, we know that there are tremendous savings in going forward with the preventive piece, hundreds of billions of dollars. The Congressional Budget Office, the accounting office here, doesnât give you any credit for prevention. But we are so sure about that that I donât know that weâll ever even need the pay-fors because the prevention will provide so much saving.
Wow! Thatâs quite a statement. The Speaker of the House is so sure that preventative care is going to save billions of dollars in medical expenditures that Congress wonât even have to look for other money to cover the costs for subsidies to help people buy insurance. (Remember, the pay-for rules require that every time Congress passes a new program, it must find offsetting revenue from another pot.) Now hereâs the problem: What happens when these savings donât materialize, as the evidence suggests they wonât? Will they magically appear, like the rabbit pulled from the magicianâs hat or the ghosts in Harry Potter land? If the billions donât appear, what trick will Congress use to cover the shortfall–cut benefits for the millions who canât afford the coverage they will be required to buy?
In June, one of our Excluded Voices interviews featured Rutgers professor Louise Russell, one of the countryâs leading experts on preventative care. âIt certainly is not the solution to anything in terms of medical costs,â she told us. Russell also said: âItâs so easy for people to misunderstand the issue. I hesitate to think that people who say preventive care saves money are deliberately misleading. I think most of them donât understand it.â
In a subsequent post, Russell said she agreed with the CBOâs decision not to score or evaluate preventative care savings. âOne way to look at the review of studies on prevention,â she explained, is that âfor every one preventative intervention that reduces medical spending, there are four that increase it.â
Asked to offer advice to reporters, Russell said that the press should challenge the idea that preventative care saves money. But, last night, Woodruff allowed Pelosi to foster that illusion. By not pushing back on the point in a follow-up question, Woodruff left the impression with her viewers that Pelosi had indeed pulled a rabbit out of the hat. No doubt reporters trailing Congressmembers during the August recess will hear lots about how prevention saves money. When they do, itâs important to remember what Louise Russell said.
Has America ever needed a media defender more than now? Help us by joining CJR today.