| BUSINESSWEEK ONLINE : FEBRUARY 22, 1999 ISSUE | ||||||||
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| READERS REPORT
Prevention Usually Costs More Than Cure Although Richard L. Huber, chief executive of Aetna Inc., is right that government-run health care would be a fiasco of undreamed-of proportions, he is not quite accurate in making the argument that managed care keeps people healthy rather than waiting until they become sick (''Managed care gets a bum rap,'' Readers Report, Jan. 25). If this were true, there would be few unhappy patients and equally few complaints. Since that is obviously not the case, there must be more to the equation. Unfortunately, prevention is cheaper than cure only within very limited parameters. And, unlike doctors, who are trained to fight disease no matter how much it costs, managed care is interested in prevention only when it saves money, which is less often than most people realize. A simple example: mammograms. If detected early, breast cancer is curable approximately 90% of the time without mastectomy. And the overall five-year survival rate for such cancers is an astounding 97%. So why has it taken federal and state legislation to force managed-care companies to cover yearly mammograms for women over the age of 50? And why is there still much resistance to covering them for women between the ages of 40 and 50, even though breast cancer kills more women aged 35 to 45 than any other disease? The answer is, unfortunately, that even though the treatment of early breast cancer costs a lot less than caring for those with more advanced disease, performing mammograms every year on every woman over the age of 40 to detect those few who will develop a cancer in any one year costs a great deal more than doing the mammograms less often and missing a few early cancers. In other words, that much prevention is not cost-effective. And, therefore, it's not good for bottom-line profits or stockholders. And those are the real concerns of for-profit managed-care companies, including Aetna. David H. Fields, M.D. Vice-President Association of Independent Physicians New York _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ BACK TO TOP |
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