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Preventive Medical Care [i] (August 7, 2009)

handle is hein.congrec/cbo1052 and id is 1 raw text is: O CONGRESSIONAL BUDGET OFFICE Douglas W. Elmendorf, Director U.S. Congress Washington, DC 20515 August 7, 2009 Honorable Nathan Deal Ranking Member Subcommittee on Health Committee on Energy and Commerce U.S. House of Representatives Washington, DC 20515 Dear Congressman: This letter responds to the question you asked at a July 16, 2009, committee markup concerning the Congressional Budget Office's (CBO's) analysis of the budgetary effects of proposals to expand governmental support for preventive medical care and wellness services. Specifically, you asked whether the agency's scoring methods reflect potential reductions in federal costs from improvements in health that might result from expanded support for those activities.1 Preventive Medical Care Preventive medical care includes services such as cancer screening, cholesterol management, and vaccines. In making its estimates of the budgetary effects of expanded governmental support for preventive care, CBO takes into account any estimated savings that would result from greater use of such care as well as the estimated costs of that additional care. Although different types of preventive care have different effects on spending, the evidence suggests that for most preventive services, expanded utilization leads to higher, not lower, medical spending overall. That result may seem counterintuitive. For example, many observers point to cases in which a simple medical test, if given early enough, can reveal a condition that is treatable at a fraction of the cost of treating that same illness after it has progressed. In such cases, an ounce of prevention improves health and reduces spending-for that individual. But when analyzing the effects of preventive care on total spending for health care, it is important to recognize that doctors do not know beforehand which patients are going to develop costly illnesses. To avert one case of acute illness, it is usually necessary to provide preventive care to many patients, most of whom would not have suffered that illness anyway. Even I For additional information on both topics, see Congressional Budget Office, Key Issues in Analyzing Major Health Insurance Proposals (December 2008), pp. 132 139. www.cbo.gov

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