A few medical interventions actually save money in the long run. The older childhood vaccines save money. The newer ones don’t. Prenatal care has been estimated to save about $3 for every $1 spent. A lot of office visits and tests are covered by the savings of one less prolonged admission by a baby to the neonatal intensive care unit.

Unfortunately, little else in medicine saves money. This isn’t to say that eating right, staying active, and wearing your seat belt won’t pay off for you down the road. Eating less will save money for many Americans now and produce healthy dividends decades later. However, many common interventions such as mammograms, Pap smears, cholesterol checks, and diabetes and high blood pressure treatment spend more money on the front end than they save later on. If this sounds crazy, I don’t blame you for reacting this way. I’m convinced 95% of American doctors don’t understand these basic realities.

A classic discussion of this reality is contained in an article by David Eddy, MD PhD from 1992 called Cost-effectiveness analysis: a conversation with my father (JAMA 1992;267(12):1669-1675). In it, he discusses some of the difficult trade-offs posed when one considers the cost of some common medical decisions. Another important resource is the Cost-Effectiveness Analysis Registry sponsored by Center for the Evaluation of Value and Risk in Health by Tufts Medical Center(https://research.tufts-nemc.org/cear/default.aspx).

Pretty much all members of GIMeC love to say, “An ounce of prevention is worth a pound of cure.” This is rarely true. When healthcare dollars are spent to try to delay injury or death, the truth is, “An ounce of prevention costs a ton of money.”*

*I didn’t coin this phrase. I read it years ago. If someone knows who said this first I want to give him or her appropriate credit.