Thursday 6 November 2008

Obama's America - is prevention really better than cure?

During campaigning, President-elect Barak Obama hinted at a UK-style health service, with access to healthcare for all.
It does make a lot of sense - healthcare in USA is bringing the economy to its knees, as it simply costs too much for the economy to bear. UK-style healthcare not only costs a great deal less, but provides an excellent standard of care universally from before the cradle (maternity care) to beyond the grave (grief counselling). It's so good that many European countries are emulating it.
But is prevention (the UK model) better than cure?
That depends. Taking age-related conditions such as CVD (cardio-vascular disease), diabetes and cancer; prevention in the form of medication to control the symptoms certainly improves quality of life and probably allows an individual to contribute to society for many years. But it appears to cost much more. An early diagnosis leads to early treatment, which may continue for 40 years. At say $10,000 per year, this is a lot of money. Whereas a late diagnosis may cost $100,000 over a 6 month stay in hospital, after which the patient dies and the costs stop.
In practice, those PCTs (the NHS bodies responsible for purchasing care in each district or county) who have a higher average length of life are in deficit (spend more than they receive) although the average across the country evens out. This reinforces the above assertion - keeping your population alive costs more! As a society, we determinedly add life to years and years to life. For the USA, you need to make a clear decision that you are prepared to foot the bill.

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