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1 Gus  Tue, Feb 14, 2012 1:59:05pm

I call bullshit on this conclusion.

2 Political Atheist  Tue, Feb 14, 2012 2:00:42pm

re: #1 Gus

Did you look at the studies? If not your just guessing wrong.
One of the explanations is that you have to apply the preventative care to many who would never have had the illness.

Do you have any links to studies that show otherwise? Love to see that if available.

3 Political Atheist  Tue, Feb 14, 2012 2:02:28pm

From the article-In fact, a government policy to encourage prevention could end up paying for services that people are already receiving, including breast and colon cancer screenings and vaccines, Elmendorf said.

Other studies backed up the CBO's analysis, including a Feb. 14, 2008, article in the New England Journal of Medicine that was written in response to campaign promises for more preventive care.

"Sweeping statements about the cost-saving potential of prevention ... are overreaching," according to the paper. "Studies have concluded that preventing illness can in some cases save money but in other cases can add to health care costs." They write that "the vast majority" of preventive health measures that were "reviewed in the health economics literature do not" save money.

"Some preventive measures save money, while others do not, although they may still be worthwhile because they confer substantial health benefits relative to their cost," the authors write. "In contrast, some preventive measures are expensive given the health benefits they confer. In general, whether a particular preventive measure represents good value or poor value depends on factors such as the population targeted, with measures targeting higher-risk populations typically being the most efficient."

Meanwhile, a separate study conducted by researchers from the American Diabetes Association, American Heart Association and the American Cancer Society concluded that, while interventions to prevent cardiovascular disease would prevent many strokes and deaths, "as they are currently delivered, most of the prevention activities will substantially increase costs."

To make sure that the data hadn’t changed dramatically since we last looked at this issue, we contacted Peter J. Neumann, director of the Center for the Evaluation of Value and Risk in Health at the Institute for Clinical Research and Health Policy Studies at Tufts Medical Center. He was one of the three co-authors of the New England Journal of Medicine article.

He said the patterns his group found in 2008 have not shifted dramatically since then.

4 Curt  Tue, Feb 14, 2012 2:05:07pm

re: #1 Gus

I call bullshit on this conclusion.

Calling PolitiFact on this? Wow...brutal.....

5 Gus  Tue, Feb 14, 2012 2:06:02pm

re: #2 Daniel Ballard

Did you look at the studies? If not your just guessing wrong.
One of the explanations is that you have to apply the preventative care to many who would never have had the illness.

I'm looking at one of these pseudo studies now:

Of course, our review reflects a selected sample of studies in the peer-reviewed literature and does not cover all possible opportunities to spend resources to improve health. In addition, there may be inconsistency among the studies in terms of the methods used. Still, our analysis is based on a large and diverse set of studies that used recommended metrics for cost-effectiveness analysis, and we believe that it offers important lessons.

So they admit that their review contains a selected sample and come up with a weak defense of "Still, our analysis is based on a large and diverse set of studies"? They don't conclude that it doesn't save money but by and large may or may not save money depending on the preventive measures. But at the same times they admit to not have studied all potential preventive measure but instead used a "diverse" sampling. Still, they don't say it's a completely false assumption.

6 Political Atheist  Tue, Feb 14, 2012 2:06:49pm

re: #4 Curt

Every time Politifact or Factcheck has something hard on Obama someone (sometimes many) auto object. Which is a shame, the sitting President should beheld to account for his statements. We sure wanted that the last President. Now, Not So Much.

the real tragedy here is he made a false claim on a fiscal basis. Well health& medicine is about lives. And preventive care saves many lives. But that was not good enough. So, IMO shame on Obama for losing the proper priority, and using facts rather loosely. Wrong not just once but twice.

7 researchok  Tue, Feb 14, 2012 2:09:15pm

Dollars and cents have a certain value. Saving a life or staying healthy has an entirely different value.

Healthcare costs dollars and cents. Life and health are measured in entirely different ways.

I don't see why the issues have to be conflated.

8 Gus  Tue, Feb 14, 2012 2:11:42pm

You're going to tell me that the cost of vaccinating people doesn't save money?

9 blueraven  Tue, Feb 14, 2012 2:13:35pm

I think it depends on which preventative care services. Certainly having access to routine check ups will save money.

Other procedures may not, but that is because many of these procedures are overpriced in the first place. The big challenge is to reduce, or at least stabilize the cost of some of these procedures.

10 Political Atheist  Tue, Feb 14, 2012 2:15:34pm

re: #8 Gus

You're going to tell me that the cost of vaccinating people doesn't save money?

That's not really what Obama said, and therefore not what Politifact evaluated. Nor what I Paged.
Is saving lives not good enough to go for it? It has to save money too? WTF?

11 darthstar  Tue, Feb 14, 2012 2:17:19pm

I agree with Gus...it's bullshit. Saving lives is saving money, because preventive care prevents people from having to go to the ER.

And Politifact can suck my little Irish dick.

12 Four More Tears  Tue, Feb 14, 2012 2:19:34pm

re: #11 darthstar

I agree with Gus...it's bullshit. Saving lives is saving money, because preventive care prevents people from having to go to the ER.

And Politifact can suck my little Irish dick.

This man is 100% correct: he does have a little dick.

13 Gus  Tue, Feb 14, 2012 2:21:11pm

re: #10 Daniel Ballard

That's not really what Obama said, and therefore not what Politifact evaluated. Nor what I Paged.
Is saving lives not good enough to go for it? It has to save money too? WTF?

Well these assholes at Politifact are characterizing it as a complete falsehood when in fact the so called studies all say "it depends." Which means it's not a completely false statement. And this is all based in an "as designed" healthcare system prior to health care reform. It's based on an existing system. Which means that it can provide cost saving all across the board at some future date. There is room for change and improvements instead of making one generalized and sweeping statement that "preventive care does not save money" for all of eternity. But then again since conservatives are resistant to change I can see why they would see things this way.

This Politifact story remains as such, bullshit.

14 Political Atheist  Tue, Feb 14, 2012 2:21:42pm

re: #11 darthstar

I agree with Gus...it's bullshit. Saving lives is saving money, because preventive care prevents people from having to go to the ER.

And Politifact can suck my little Irish dick.

Wow it looks like fact checking is only welcome when it supports Obama. That is unexpected around here, I guess the truth falls to partisanship AGAIN.
Shit.

How about the New England Journal Of Medicine? That suit u=you better or is this just auto object for fear Obama may lose if these kinds of things are aired out?

""Sweeping statements about the cost-saving potential of prevention, however, are overreaching. Studies have concluded that preventing illness can in some cases save money but in other cases can add to health care costs.3 For example, screening costs will exceed the savings from avoided treatment in cases in which only a very small fraction of the population would have become ill in the absence of preventive measures. Preventive measures that do not save money may or may not represent cost-effective care (i.e., good value for the resources expended). Whether any preventive measure saves money or is a reasonable investment despite adding to costs depends entirely on the particular intervention and the specific population in question. For example, drugs used to treat high cholesterol yield much greater value for the money if the targeted population is at high risk for coronary heart disease, and the efficiency of cancer screening can depend heavily on both the frequency of the screening and the level of cancer risk in the screened population."

15 blueraven  Tue, Feb 14, 2012 2:22:42pm

re: #10 Daniel Ballard

That's not really what Obama said, and therefore not what Politifact evaluated. Nor what I Paged.
Is saving lives not good enough to go for it? It has to save money too? WTF?

Do you know the cost of one night in a hospital? It is outrageous. If a Dr visit and a prescription can prevent that hospital stay, that is real savings.

So vaccinations aside, preventative care, regular exams will save money.

Most of the real money spent is on a small percentage of the population, particularly the elderly. That's just a fact.

16 Gus  Tue, Feb 14, 2012 2:24:42pm

I see this load of crap is making the GOP happy already:

17 Political Atheist  Tue, Feb 14, 2012 2:26:26pm

re: #16 Gus

I see this load of crap is making the GOP happy already:

I don't care. That has no relevance to the money or the studies. Or shall we give Obama a pass to say whatever he wants without question because it's an election year?

18 Gus  Tue, Feb 14, 2012 2:27:14pm

False my ass. At best it's straight down the middle. Health care reform can bring this to a complete truth. If you think we're going to be stuck in pre-HCR America with regards to healthcare you're dead wrong. We're not going back to that shit ever again. So the GOP can have their orgasms about this Politifact story saying that preventive care doesn't save money but it's going to play a major role in the future of the healthcare system. Their only goal is to save money for their fat cat corporate supporters who are rich enough to not care about any of this.

19 Political Atheist  Tue, Feb 14, 2012 2:33:30pm

re: #18 Gus
If it were as false as you seem to say, they have the pants on fire rating, a big step worse.

Look at this letter, no news edit just the document linked.
[Link: www.cbo.gov...]

20 blueraven  Tue, Feb 14, 2012 2:36:38pm

Does contraception save money?
How about breast exams, mammograms?
Colon cancer screening?
Vaccinations?
High Blood pressure screening?

We need to do a better job of not doing tests when they are not needed and giving the patient more options, as well as disclosing the cost of options available.
Obviously there has to be some discretion over testing.

21 Political Atheist  Tue, Feb 14, 2012 2:37:12pm

Would you call this a split? I do not..
From the PDF link
""Researchers who have examined the effects of preventive care generally find that the added costs of widespread use of preventive services tend to exceed the savings from averted illness. An article published last year in the New England Journal of Medicine provides a good summary of the available evidence on how preventive care affects costs.3 After reviewing hundreds of previous studies of preventive care, the authors report that slightly fewer than 20 percent of the services that were examined save money, while the rest add to costs.""

It's just a damn shame he did not emphasize the real truth, that care saves lives. Priority backwards.

22 Political Atheist  Tue, Feb 14, 2012 2:39:10pm

re: #16 Gus

I see this load of crap is making the GOP happy already:

[Video]

-1 for sheer irrelevance. Partisans don't get to change facts. They have to live with them.

23 kirkspencer  Tue, Feb 14, 2012 2:39:40pm

The Elmensdorf letter and the NEJM article both note that some preventive services save money.

That means politifact's "totally false" is wrong on its face.

24 Political Atheist  Tue, Feb 14, 2012 2:40:45pm

One more from the PDF

Providing a specific example of the benefits and costs of preventive care, another recent study conducted by researchers from the American Diabetes Association, the American Heart Association, and the American Cancer Society estimated the effects of achieving widespread use of several highly recommended preventive measures aimed at cardiovascular disease—such as monitoring blood pressure levels for diabetics and cholesterol levels for individuals at high risk of heart disease and using medications to reduce those levels.4 The researchers found that those steps would substantially reduce the projected number of heart attacks and strokes that occurred but would also increase total spending on medical care because the ultimate savings would offset only about 10 percent of the costs of the preventive services, on average. Of particular note, that study sought to capture both the costs and benefits of providing preventive care over a 30-year period.

25 Political Atheist  Tue, Feb 14, 2012 2:42:13pm

re: #23 kirkspencer

If you can't prove it saves money, and your statement flies in the face of the studies as shown above you are wrong to assert this alleged truth. I'm not calling him a liar, just wrong on this point.

26 Lord Baron Viscount Duke Earl Count Planckton  Tue, Feb 14, 2012 2:42:21pm

Here's a bit I don't get about NEJM study:

Although some preventive measures do save money, the vast majority reviewed in the health economics literature do not.

IIUC, they mean specific types of preventive measures, not instances of preventive measures. But then the above statement doesn't show by itself that preventive measures, as an aggregate, cannot save money. It only shows that the majority of types of measures supposedly do not save money. But what types are more frequent, etc.? What I would like to know is what happens in the real world, i.e. whether the sum of instances of preventive measures saved money or is projected to save money.

(Sorry if I misunderstood the article.)

27 Prideful, Arrogant Marriage Equality Advocate  Tue, Feb 14, 2012 2:46:15pm

re: #11 darthstar

Let me just say for the record, this is not a common feature of most men of Irish extraction i have known.
All you Irish guys out there...*Call me. Wink*

28 blueraven  Tue, Feb 14, 2012 2:50:35pm

re: #24 Daniel Ballard

One more from the PDF

Providing a specific example of the benefits and costs of preventive care, another recent study conducted by researchers from the American Diabetes Association, the American Heart Association, and the American Cancer Society estimated the effects of achieving widespread use of several highly recommended preventive measures aimed at cardiovascular disease—such as monitoring blood pressure levels for diabetics and cholesterol levels for individuals at high risk of heart disease and using medications to reduce those levels.4 The researchers found that those steps would substantially reduce the projected number of heart attacks and strokes that occurred but would also increase total spending on medical care because the ultimate savings would offset only about 10 percent of the costs of the preventive services, on average. Of particular note, that study sought to capture both the costs and benefits of providing preventive care over a 30-year period.

And this

In sum, expanded governmental support for preventive medical care would
probably improve people’s health but would not generally reduce total spending
on health care. However, government funding for some specific types of
preventive care might lower total spending. In its estimates, CBO seeks to capture
the likely future effects on the budget on a case-by-case basis
.

29 Lord Baron Viscount Duke Earl Count Planckton  Tue, Feb 14, 2012 2:51:17pm

re: #19 Daniel Ballard

If it were as false as you seem to say, they have the pants on fire rating, a big step worse.

Look at this letter, no news edit just the document linked.
[Link: www.cbo.gov...]

Aha, this seems to answer some questions, thanks. Reading now.

30 Prideful, Arrogant Marriage Equality Advocate  Tue, Feb 14, 2012 2:54:35pm

Has anyone looked at studies from other places in the world who have had preventative measures in place for a while and see if there is any savings and what areas those savings are, if any?

31 jaunte  Tue, Feb 14, 2012 2:58:08pm

Politifact needs an "It Depends" rating.

32 blueraven  Tue, Feb 14, 2012 2:58:18pm

Reading the PDF from the CBO; it does not really support a position either way.

What it tends to say is some preventative services save money and others do not.

It has to be looked at on a case by case basis (as to the effectiveness of a particular procedure)

33 Political Atheist  Tue, Feb 14, 2012 2:59:36pm

re: #32 blueraven

So Obamas declarative claim is unsupported, at best.

34 Lord Baron Viscount Duke Earl Count Planckton  Tue, Feb 14, 2012 2:59:41pm

re: #28 blueraven

And this

IIUC, this means that either you fund general preventative measures, and then you don't decrease spending, but do improve health. Or you focus on specific types of measures, and then you do save money, but only at the cost of limiting the preventative measures, and thus presumably the improvement of health is rather limited.

35 Lord Baron Viscount Duke Earl Count Planckton  Tue, Feb 14, 2012 3:00:58pm

re: #32 blueraven

Reading the PDF from the CBO; it does not really support a position either way.

What it tends to say is some preventative services save money and others do not.

It has to be looked at on a case by case basis (as to the effectiveness of a particular procedure)

They do say that in total, the preventative measures do not reduce spending. I.e. when you consider all the applied measures.

When you do select only the specific effective measures, then, of course, you reduce spending, but at the cost of improving health.

36 Lord Baron Viscount Duke Earl Count Planckton  Tue, Feb 14, 2012 3:04:55pm

re: #35 Tofu Romney (Mitt's Evil Twin)

And obviously, focusing only on cost-saving preventative measures is inhumane and is not what should be done. Which in effect would mean that the humane, i.e. wide-ranging application of preventative measures regardless of cost-effectiveness will not, indeed, reduce spending, if CBO is correct.

37 Political Atheist  Tue, Feb 14, 2012 3:05:15pm

What's killing me is anyone suggesting this is about money. It's about saving lives. As we fall into the money first trap, we stray into the immoral money first health second territory. Of course we should fund good responsible preventative care.

38 Prideful, Arrogant Marriage Equality Advocate  Tue, Feb 14, 2012 3:07:37pm

So basically, preventative measures improve health but don't really save money. So it comes down to what your priorities are. Do you want to save money or do you want to improve health?
So what Obama said was not really correct because there is no proof that it will save money?
Am i on the right track here?

39 Lord Baron Viscount Duke Earl Count Planckton  Tue, Feb 14, 2012 3:11:51pm

re: #38 No Woman No Cry

So basically, preventative measures improve health but don't really save money. So it comes down to what your priorities are. Do you want to save money or do you want to improve health?
So what Obama said was not really correct because there is no proof that it will save money?
Am i on the right track here?

It would seem so, if we assume CBO did an objective analysis.

40 Lord Baron Viscount Duke Earl Count Planckton  Tue, Feb 14, 2012 3:12:50pm

However, I would wait a day or two and see what other specialists say on this.

41 blueraven  Tue, Feb 14, 2012 3:17:01pm

re: #39 Tofu Romney (Mitt's Evil Twin)

It would seem so, if we assume CBO did an objective analysis.

I think they do an objective analysis but with limits.

Scorekeeping Rules and Procedures

Beyond the substantive factors that can limit the effect of expanded governmental
support for preventive medical care and wellness services on future government
spending on health care, budget “scorekeeping” rules specify that only certain
types of spending effects can be considered for purposes of Congressional budget
enforcement. Scorekeeping rules were set forth by the Congress in the conference
report for the Balanced Budget Act of 1997 and are updated occasionally upon
agreement by the full group of “scorekeepers,” a group that consists of the House
and Senate Committees on the Budget, the Congressional Budget Office, and the
Office of Management and Budget. The purpose of those rules is to ensure
consistent budgetary treatment across programs and over time.
Two particular scorekeeping rules could affect provisions that provide funding for
preventive care or wellness services. They prohibit counting any changes in
mandatory spending as a result of changes in the amount of mandatory funding
for administration or program management or in the amount of discretionary
appropriations for any activity. (A mandatory spending program is one that does
not require annual appropriations—for example, Medicare and Medicaid;
discretionary programs are funded each year in an appropriation bill—including,
for example, the research programs of the National Institutes of Health.) The rules
were adopted in part to avoid situations in which hoped-for, but quite uncertain,
savings are used to offset near-term, certain spending increases or revenue
decreases in the same legislation...
As a result, even when new prevention and wellness activities funded from
discretionary appropriations would, in CBO’s judgment, generate eventual
savings in Medicare or Medicaid, those savings would not be credited to the
appropriation action as part of the budget scorekeeping process. Some legislation
would authorize such appropriations, but not provide them, leaving that action for
future appropriation bills. Because such legislation would not actually provide
funding for prevention or wellness activities, it too could not be credited with...

42 Political Atheist  Tue, Feb 14, 2012 3:30:21pm

I just have to wonder how the critics of this page would have reacted if Rick Santorum had said the same thing and gotten the same rating. I just can't help but suspect the anti GOP factor has prevailed in peoples minds over more objective approaches. Would we have sen bullshit called on it? Maybe, but I have my doubts.

43 wrenchwench  Tue, Feb 14, 2012 3:33:32pm

re: #31 jaunte

Politifact needs an "It Depends" rating.

How about a 'Pants In The Tree' rating?

nothing substantial to add here...

44 sagehen  Tue, Feb 14, 2012 3:43:43pm

re: #24 Daniel Ballard

One more from the PDF
The researchers found that those steps would substantially reduce the projected number of heart attacks and strokes that occurred but would also increase total spending on medical care because the ultimate savings would offset only about 10 percent of the costs of the preventive services, on average. Of particular note, that study sought to capture both the costs and benefits of providing preventive care over a 30-year period.

Every one of those non-strokes or non-heart attacks is somebody who either doesn't end up on disability, or doesn't die and their kids goes into state custody, or stays at their job and keeps paying taxes...

Obviously, we could save a lot on medical care by nobody ever having any, and just let genetics decide who lives past 40. I don't see how that saves money for society overall, even if we were to totally disregard the cost in human misery.

45 Romantic Heretic  Tue, Feb 14, 2012 3:45:34pm

Shrugs. I live in Canada where we spend less on health care in the States with better results. Although I haven't a scientific study to prove it I believe it is because there is easy, quick access to health care before any health issue becomes severe.

Saying preventative health care doesn't save money is like saying fireproofing your home, being careful with sources of flame and not stacking inflammables in your living room doesn't save money. Not doing all that will indeed save you money, and make it more likely that your home will burn to the ground.

So go ahead. Save money.

Anyway, at the core this isn't about money. It's about the good thing to do.

46 blueraven  Tue, Feb 14, 2012 3:48:27pm

re: #42 Daniel Ballard

I just have to wonder how the critics of this page would have reacted if Rick Santorum had said the same thing and gotten the same rating. I just can't help but suspect the anti GOP factor has prevailed in peoples minds over more objective approaches. Would we have sen bullshit called on it? Maybe, but I have my doubts.

With all due respect, its hard to imagine Rick Santorum making such a statement.
Besides, even if the President went overboard with a general statement including govt. There is no doubt in my mind that a healthy lifestyle and preventative care saves money for the family.
CBO is limited as to how it can score anticipated savings in the health care act.

47 researchok  Tue, Feb 14, 2012 3:49:12pm

re: #37 Daniel Ballard

What's killing me is anyone suggesting this is about money. It's about saving lives. As we fall into the money first trap, we stray into the immoral money first health second territory. Of course we should fund good responsible preventative care.

This is no small matter.

One of man's distinguishing characteristics is empathy. That is why we have hospitals, schools, social services, etc. We deem these things not as a luxury but as necessities to developed and civilized human cultures and societies.

We don't leave our injured, maimed or ill to die. We expend huge and heroic efforts to save lives and to improve the quality of life. We also love, comfort and care for each other- healing characteristics which have no price tag.

That said, we do need to be mindful of how our health care dollars are spent. We encourage appropriate long term care and end of life care because our finances are not unlimited. As we live longer we will have to reassess some of what those implications are. Whether we care to admit or not, the distribution of health care funds will be a reality in the very near future. Huge health care expenses come at the beginning or end of life- times when we are least likely to see a 'return' on our investment.

That matters little because we are human and that caring and empathy is a part of our DNA. We can recognize the investment will return little in financial terms while at the same time we recognize our obligation as human beings to each other. One truth does not invalidate the other truth.

Grandpa may not be productive in the fiscal sense, but he may contribute mightily to the foundations and stability of the family. Surely that has profound worth.

Retired teachers can be invaluable to students,even if they have to be paid and have adequate transportation provided for them. The same can be said for anyone willing to pass on decades of learning, wisdom and insight. Are any of these things income producing? No. Are they an expense? Yes. However, their contributions are priceless.

Healthcare is not an income producing proposition- it never was and never will be. It may influence productivity, etc., but in the end it remains an expense- one which we go to great lengths to incur because that is who we are.

48 CuriousLurker  Tue, Feb 14, 2012 3:51:44pm

re: #42 Daniel Ballard

I just have to wonder how the critics of this page would have reacted if Rick Santorum had said the same thing and gotten the same rating. I just can't help but suspect the anti GOP factor has prevailed in peoples minds over more objective approaches. Would we have sen bullshit called on it? Maybe, but I have my doubts.

First, I can't imagine the circumstances under which Santorum would say the same thing. Bad example.

Second, making it personal by questioning people's sincerity WRT to concern about preventive health care by characterizing it as possible knee-jerk partisanship doesn't strengthen your argument.

Third, I haven't seen anyone question your motives for posting this story or assigning any sort of personal partisan reason for it.

Are you sure you're being objective, or are you just getting pissed and lashing out? I'm just sayin'. You're usually better than this.

Going back to my coding now...

49 WINDUPBIRD DISEASE [S.K.U.M.M.]  Tue, Feb 14, 2012 4:58:13pm

Politifact is dogshit

50 Prononymous, rogue demon hunter  Tue, Feb 14, 2012 5:28:23pm

Frankly, I think Obama tried to sell a point that isn't isn't widely supported by the research. I used to think that, intuitively, preventative care reduces spending on the subsequent health issues. And indeed it may, but the research isn't there to support it. The effect of preventative care on fiscal issues is incredibly complex and difficult to study.

First, obviously, there is the issue of prevented disease. Surely some preventative measures save a significant amount over treating the outcome. However, there is also the case of overdiagnosis. Not every cancer is malignant, not every disease would have required treatment, and not every positive diagnosis is correct. This reminds me about a recent Komen article that had some slightly related points. And lastly, as Sagehen points out, what is the overall effect on the economy by keeping people healthier?...

It is a complex issue and I don't think Obama was right in saying what he did. But personally, the saddest point about all this is that Obama felt he had to cast preventative care as a fiscal issue rather than a public health issue. Unfortunately some people don't really care much about the quality of life for our fellow humans. He could have said something like "preventative care is more fiscally efficient" (lives saved/better health for not much change in cost), but I fear that is already too nuanced for the target audience.

51 BishopX  Tue, Feb 14, 2012 5:48:11pm

I think that the other issue is that there are differing definitions of preventative care. The medical literature mostly seems to be talking about specific treatments related to certain risk conditions. If you widen the definition of preventative care to include regular doctor visits, I would think that the numbers would change for the better. The fact is that hospital stays and emergency room visits are incredibly inefficient in terms of cost. Any non-prescription based preventative care approach which minimizes hospital stays is going to be a net positive.

The flip side of this is that the medical journals are also not considering the economic costs due to illness in their analysis. From a macro perspective, the costs of illness in terms of lost wages and lost productivity due to stress and worry over loved ones being ill has a huge impact. If you've ever lived or worked with someone undergoing chemotherapy you know that their not running at anywhere near 100%.

52 docproto48  Tue, Feb 14, 2012 5:55:30pm

re: #1 Behold Politifact's Latest Distortion

I call bullshit on this conclusion.

I say invoke the greatest cost saving mechanism......................
Let people die

53 Dark_Falcon  Tue, Feb 14, 2012 6:52:26pm

re: #14 Daniel Ballard

Wow it looks like fact checking is only welcome when it supports Obama. That is unexpected around here, I guess the truth falls to partisanship AGAIN.
Shit.

How about the New England Journal Of Medicine? That suit u=you better or is this just auto object for fear Obama may lose if these kinds of things are aired out?

""Sweeping statements about the cost-saving potential of prevention, however, are overreaching. Studies have concluded that preventing illness can in some cases save money but in other cases can add to health care costs.3 For example, screening costs will exceed the savings from avoided treatment in cases in which only a very small fraction of the population would have become ill in the absence of preventive measures. Preventive measures that do not save money may or may not represent cost-effective care (i.e., good value for the resources expended). Whether any preventive measure saves money or is a reasonable investment despite adding to costs depends entirely on the particular intervention and the specific population in question. For example, drugs used to treat high cholesterol yield much greater value for the money if the targeted population is at high risk for coronary heart disease, and the efficiency of cancer screening can depend heavily on both the frequency of the screening and the level of cancer risk in the screened population."

What did you expect? Nobody likes having their side called out as wrong. And when its a big claim your side made its worse, because you can't admit error without handing your opponents a club with which to publicly beat you. In such situations, the normal human response is to "shoot the messenger".

54 Political Atheist  Tue, Feb 14, 2012 7:04:26pm

re: #53 Dark_Falcon

What did you expect? Nobody likes having their side called out as wrong. And when its a big claim your side made its worse, because you can't admit error without handing your opponents a club with which to publicly beat you. In such situations, the normal human response is to "shoot the messenger".

Well said Dark. Thanks.

55 CuriousLurker  Tue, Feb 14, 2012 7:16:27pm

re: #53 Dark_Falcon

What did you expect? Nobody likes having their side called out as wrong. And when its a big claim your side made its worse, because you can't admit error without handing your opponents a club with which to publicly beat you. In such situations, the normal human response is to "shoot the messenger".

re: #54 Daniel Ballard

Well said Dark. Thanks.

So that's it? No one was actually being sincere, all the disagreements were just partisan, knee-jerk, shoot-the-messenger type responses designed to evade admitting one's "side" could be wrong? Nice. Great to know what you guys' opinion of the liberals here is.

That keen ability to see directly into people's hearts & minds and read their motivations must really come in handy. //

56 blueraven  Tue, Feb 14, 2012 7:17:18pm

So just to get off what the President said for a minute and look at Politifact

What about the Mostly True rating they gave Marco Rubio for his claim that: A majority of Americans are conservatives.

There is no evidence to back up that statement. In fact politifact pretty solidly debunks it.

[Link: www.politifact.com...]

We have two nits to pick with Rubio’s statement, though.

First, he said a majority of Americans are conservatives. In Gallup’s poll, the number has never crossed the 50 percent threshold. Technically, he would be more accurate if he said a plurality of Americans are conservative.

Second, we should note that while more Americans identify as conservative, that has not redounded to the good fortune of the Republican Party.

More Americans than ever identify as political independents, at 40 percent. Republicans don’t even come in at second -- that would be the Democratic Party, claiming the allegiance of 31 percent of Americans. Republicans get third place, with 27 percent claiming the GOP label.

And here’s another wrinkle: When you ask people which party they lean toward, the independents split up so that the country is almost evenly divided. For the year of 2011, Gallup reported that 45 percent of Americans identified as Republicans or leaned that way, while 45 percent identified as Democrats or leaned that way.

Rubio said that the majority of Americans are conservative. A respected ongoing poll from Gallup shows that conservatives are the largest ideological group, but they don’t cross the 50 percent threshold. So we rate his statement Mostly True.

Huh?

Politifact needs to find some consistency in their ratings.

57 Gus  Tue, Feb 14, 2012 7:20:14pm

re: #56 blueraven

So just to get off what the President said for a minute and look at Politifact

What about the Mostly True rating they gave Marco Rubio for his claim that: A majority of Americans are conservatives.

There is no evidence to back up that statement. In fact politifact pretty solidly debunks it.

[Link: www.politifact.com...]

Huh?

Politifact needs to find some consistency in their ratings.

Oh don't worry. Politifact even "fact" checked Glee:

"The U.S. Census believes that by 2030 the majority of Americans will use Spanish as their first language."

#Fail

How lame is that.

58 Dark_Falcon  Tue, Feb 14, 2012 7:28:05pm

re: #57 Gus

Oh don't worry. Politifact even "fact" checked Glee:

"The U.S. Census believes that by 2030 the majority of Americans will use Spanish as their first language."

#Fail

How lame is that.

Then do you propose simply discarding Politifact as a reliable watchdog? Because that's what it sounds like.

59 blueraven  Tue, Feb 14, 2012 7:35:00pm

re: #58 Dark_Falcon

Then do you propose simply discarding Politifact as a reliable watchdog? Because that's what it sounds like.

Well they do not seem to be very serious at times. I think they should be taken with a big grain of salt.

60 Dark_Falcon  Tue, Feb 14, 2012 7:41:45pm

re: #59 blueraven

Well they do not seem to be very serious at times. I think they should be taken with a big grain of salt.

OK, but I am going to favorite your post and remember you said that. It's no problem and you've got a good point, but just so you know.

61 Gus  Tue, Feb 14, 2012 7:46:04pm

re: #58 Dark_Falcon

Then do you propose simply discarding Politifact as a reliable watchdog? Because that's what it sounds like.

Yes and no. None of these studies prove much of anything. Most of it is based on established big-ticket care within the Medicaid and Medicare system and doesn't include simpler preventive care like dentistry, vaccinations, check-ups, exams, etc.

It increase costs in spending how? Well I'll tell you one of the reasoning used in these studies and that is it decrease morbidity rates meaning extended periods of people being on Medicaid or Medicares. IOW, preventive care keeps people from dying younger which means they remain in these programs for longer periods. But it still reduces costs in specific areas which must be contained. It also doesn't take into account preventive medicine which is specific to health care reform legislation.

It doesn't take into account the cost savings to society as a whole. It might increase health care spending at specific points but it fails to take into account the net gain of good health brought about through preventive care on society as a whole. The CBO study did not do this and merely focused on the impact to existing entitlement program procedures and programs. It's a lop-sided view and make no cross benefit analysis at all. Including the NEJM study. This was all done in the vacuum of the medical establishment alone.

So yes. It's bullshit.

62 Political Atheist  Tue, Feb 14, 2012 7:49:24pm

re: #61 Gus

You still have not put up a link or study that shows the opposite view. Make all you want of the limits of the studies. Fine, all good. But what do you have that refutes the broad declarative statement Obama made?

63 Dark_Falcon  Tue, Feb 14, 2012 7:55:39pm

re: #62 Daniel Ballard

You still have not put up a link or study that shows the opposite view. Make all you want of the limits of the studies. Fine, all good. But what do you have that refutes the broad declarative statement Obama made?

I think you meant to say 'supports' right there. The Politifact article is the piece trying to refute the president's statement.

64 Gus  Tue, Feb 14, 2012 7:56:25pm

re: #62 Daniel Ballard

You still have not put up a link or study that shows the opposite view. Make all you want of the limits of the studies. Fine, all good. But what do you have that refutes the broad declarative statement Obama made?

I haven't found one but that doesn't mean it doesn't exist or can't be formulated. Where in the world was down time, sick leave, or loss of productivity taken into account. These studies are basically leading to the conclusion that preventive care -- and I'm including medicine -- leads to lower costs to society. And I'm also saying that that conclusion is absurd since the only possible conclusion is that an unhealthy population spends as much as a healthy population. Was depression taken into account in these studies? No. Was mental health taken into account? No. There are dozens of societal aspects not included in these studies and was only done on existing procedures within the entitlement system.

65 Gus  Tue, Feb 14, 2012 7:57:52pm

re: #62 Daniel Ballard

You still have not put up a link or study that shows the opposite view. Make all you want of the limits of the studies. Fine, all good. But what do you have that refutes the broad declarative statement Obama made?

Long story short. Obama's right.

66 blueraven  Tue, Feb 14, 2012 8:20:55pm

re: #60 Dark_Falcon

OK, but I am going to favorite your post and remember you said that. It's no problem and you've got a good point, but just so you know.

That's fine, I dont have a problem with what I post being called out. I think politifact has become progressively sloppy.
What do you think of the Rubio claim and the politifact rating?

67 philosophus invidius  Tue, Feb 14, 2012 8:33:03pm

Reminds of this story:

The premature deaths of smokers has economic benefits, according to a controversial report commissioned by a leading US cigarette manufacturer.

[Link: news.bbc.co.uk...]

On the face of it, it seems disingenuous to interpret Obama as saying that all preventative services will save money. The policy obviously needs to be implemented smartly based on evidence of what preventative treatments are cost-effective.

In light of that, an interesting article recently noted:

CareMore, through its unique approach to caring for the elderly, is routinely achieving patient outcomes that other providers can only dream about: a hospitalization rate 24 percent below average; hospital stays 38 percent shorter; an amputation rate among diabetics 60 percent lower than average. Perhaps most remarkable of all, these improved outcomes have come without increased total cost. Though they may seem expensive, CareMore’s “upstream” interventions—the wireless scales, the free rides to medical appointments, etc.—save money in the long run by preventing vastly more costly “downstream” outcomes such as hospitalizations and surgeries. As a result, CareMore’s overall member costs are actually 18 percent below the industry average.

[Link: www.theatlantic.com...]

Anecdotal of course, but ...

68 Prononymous, rogue demon hunter  Tue, Feb 14, 2012 8:35:43pm

Personally, we should do preventative care for the health benefits to the American population. If it saves money that's just icing on the cake. If it costs a little, big deal.

69 jamesfirecat  Tue, Feb 14, 2012 8:42:54pm

re: #58 Dark_Falcon

Then do you propose simply discarding Politifact as a reliable watchdog? Because that's what it sounds like.

I think that became the obvious smart move ever since they decided to make their "lie of the year" a statement that was actually true.

70 Political Atheist  Tue, Feb 14, 2012 8:50:42pm

re: #69 jamesfirecat

I think that became the obvious smart move ever since they decided to make their "lie of the year" a statement that was actually true.

Except Factcheck agreed too...

71 Timmeh  Tue, Feb 14, 2012 9:35:03pm

Saving lives is in fact saving money though, because you can put a monetary value on life.

The Value of a Human Life: $129,000 (per year).

ergo saving lives = saving money

Just like "time is money." A human life span is a finite quantity of time, and time is money.

72 Political Atheist  Tue, Feb 14, 2012 9:44:07pm

re: #65 Gus

Long story short. Obama's right.

Okay we disagree on this one. Well run through.

73 goddamnedfrank  Tue, Feb 14, 2012 9:46:06pm

re: #71 Timmeh

Saving lives is in fact saving money though, because you can put a monetary value on life.

The Value of a Human Life: $129,000 (per year).

ergo saving lives = saving money

Just like "time is money." A human life span is a finite quantity of time, and time is money.

Not only that but as Gus pointed out the study doesn't put a price on depression, counseling, sick time, other attendant lost productivity and the ripple effects these have on family members, friends and business associates. It's an extremely narrow and disingenuous presentation that anybody who has actually experienced the consequences of a missed diagnosis and lost opportunity for preventative care should be able to see through with ease.

74 goddamnedfrank  Tue, Feb 14, 2012 10:04:08pm

Another cost that the NEJM study completely skips over and does not address, funeral expenses. So when they say preventative care saves lives, not money, they stop counting the monetary cost at the moment of death. They don't factor in the cost of the medical examiner to society, or the funeral home, cremation or burial expenses to the family, all of which are absolutely devastating in the modern era. It's like they think untimely death is free, and doesn't carry it's own health care and continuing financial consequences for the survivors.

75 Political Atheist  Wed, Feb 15, 2012 6:02:50am

re: #74 goddamnedfrank

They should not count funeral costs. Everyone dies, so there are no preventative measures for that. Only delays.

76 Political Atheist  Wed, Feb 15, 2012 6:04:45am

I get it.

Despite good data Obama Must Not Be Wrong. It Might Help The GOP.

We'll see how this attitude plays out after the election, and the electoral distortions pass.

77 Lord Baron Viscount Duke Earl Count Planckton  Wed, Feb 15, 2012 6:07:55am

re: #76 Daniel Ballard

I get it.

Despite good data Obama Must Not Be Wrong. It Might Help The GOP.

We'll see how this attitude plays out after the election, and the electoral distortions pass.

Don't jump to conclusions.
E.g. 2-3 weeks ago on Twitter Gus blasted Obama's first ad for inaccuracies, and linked to factcheck on that. Would a blind Obama partisan do that?

78 Lord Baron Viscount Duke Earl Count Planckton  Wed, Feb 15, 2012 6:13:16am

re: #74 goddamnedfrank

Another cost that the NEJM study completely skips over and does not address, funeral expenses. So when they say preventative care saves lives, not money, they stop counting the monetary cost at the moment of death. They don't factor in the cost of the medical examiner to society, or the funeral home, cremation or burial expenses to the family, all of which are absolutely devastating in the modern era. It's like they think untimely death is free, and doesn't carry it's own health care and continuing financial consequences for the survivors.

If we're going that far, then it could also be argued that by stopping living people do actually spare the govt from further spending on them (after the funeral services). They no longer fall ill, go to prisons, etc.
The reverse is that they no longer work and/or buy things, so they don't pay taxes.
Basically, there need to be some limits on what is taken into account. Because due to the "butterfly effect" one simply can't make such a complex calculation.
The question is where is the cut-off line.

79 Political Atheist  Wed, Feb 15, 2012 8:49:49am

re: #77 Tofu Romney (Mitt's Evil Twin)

Don't jump to conclusions.
E.g. 2-3 weeks ago on Twitter Gus blasted Obama's first ad for inaccuracies, and linked to factcheck on that. Would a blind Obama partisan do that?

This comment was not aimed at Gus specifically. It's intended to give partisans pause.

And, some ads will be so far out there even the partisans will eye roll. Mostly on the right of course but we will see some whoppers akin to the Dems fear mongering to current S/S-Medicare beneficiaries about the changes that will not effect them. The Lie Of The Year at Politifact and a "whopper" at Factcheck, for which I took similar heat after Paging.

80 Political Atheist  Wed, Feb 15, 2012 10:32:49am

Note to Obama
Specifics are your friends.

Our ruling

As a general notion, the idea that "preventive care … saves money, for families, for businesses, for government, for everybody" is no more true today than it was in 2009. Yes, preventive measures often save lives and keep patients healthier. Certain preventive measures may save money as well. But the findings of CBO and physicians who have studied the medical literature indicate that Obama’s sweeping generalization that preventive services save money is not accurate. We rate the statement False.

81 blueraven  Wed, Feb 15, 2012 11:00:08am

re: #80 Daniel Ballard

Note to Obama
Specifics are your friends.

Our ruling

As a general notion, the idea that "preventive care … saves money, for families, for businesses, for government, for everybody" is no more true today than it was in 2009. Yes, preventive measures often save lives and keep patients healthier. Certain preventive measures may save money as well. But the findings of CBO and physicians who have studied the medical literature indicate that Obama’s sweeping generalization that preventive services save money is not accurate. We rate the statement False.

OK fair enough...but why did they give Marco Rubio a Mostly True for his sweeping generalization that a majority of Americans are conservatives, after they completely tore apart that claim?

Do you not see the inconsistency here? Maybe a half true for both would have been better, since certain preventative measures do save money and a plurality (not a majority) of Americans do say they are conservatives.

[Link: www.politifact.com...]


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