A Wall Street Journal article (WSJ Article) summarized some research results regarding the potential cost savings of prevention and wellness efforts, particularly for persons with chronic diseases. The article, which to some extent confuses disease management programs with what more typically would be considered wellness and prevention, also reports several interviews with academic and industry sources. The overall conclusion is that not much money is likely to be saved by these programs, primarily because the cost when applied to a large population tends to outweigh the health care savings which eventually accrue. The article points out that it is also often difficult to get patients, sometimes those patients most in need, to comply with wellness and prevention efforts.
The article, however, appropriately concludes by suggesting that perhaps savings isn’t the right way to measure these programs. If we think there is a value to having a healthy population that adopts appropriate wellness behaviors, these programs should be utilized even if they don’t result in near-term or even longer-term savings. Many of these efforts have also been looked at over relatively short time-frames. It may be that it would take ten years or more to really show some significant lowering of health care needs and costs for a population that adhered to good wellness practices.
The immediate political consequence, however, and the apparent reason for writing the article, is that these findings undermine one of the supposed sources of savings which would help pay for health care reform. The Congressional Budget Office had pointed out in a December 2008 report that it was unlikely that prevention programs would save more than modest sums and they may cause price increases. So just as with greater use of health information technology, no significant savings from this source are likely to be available to fund expanded coverage. It is increasingly apparent that fears over greater than anticipated costs and difficulty in finding the money to pay even the projected costs may be the most formidable hurdle for reform.