Let Them Get Sick?

The idea that preventing disease is cheaper than waiting for the illness to appear and then treating it is almost axiomatic in the healthcare arena. As it turns out, however, this is one of those axioms that isn’t true.

“Health is not valued till sickness comes.”—Thomas Fuller

The idea that preventing disease is cheaper than waiting for the illness to appear and then treating it is almost axiomatic in the healthcare arena. As it turns out, however, this is one of those axioms that isn’t true.

This isn’t to say that prevention isn’t worth the money spent on it, since it does help lower the incidence of disease. It does mean that the cost of preventive measures, from prescription drugs to blood pressure screenings, to mammograms, to air bags in automobiles, is very often more than the cost of treating the disease or injury they are designed to prevent.

One reason for the seeming anomaly is that prevention targets far more people than will ever get the disease that’s being prevented. Despite the media attention that killer diseases like cancer and heart disease get, most people, even those with risk factors connected to these illnesses, tend to stay healthy for most of their lives. Some studies have shown, for example, that a 50-year-old male smoker with a total cholesterol level of 240 stands only a one in four chance of having a heart attack in the next 10 years. For women with the same profile, the risk is just over one in ten. Those odds can be reduced dramatically by statin drugs, but at a cost of $160,000 a year for each year of a man’s life saved. For women, the price tag is even higher—$240,000 a year.

Several preventive measures, on the other hand, cost a lot less than treating the disease being prevented. Among these are childhood vaccinations, colonoscopies for older people, and smoking cessation programs—all are worth far more in the long run than the dollars spent on them.

$286 billion—Total sales for prescription drugs in the US in 2007.(IMS Health, 2008)