• Health care that pays for itself

    I would not suggest that cost saving should be the criterion by which we judge the virtue of health care treatments. However, for the subset of treatments that are cost saving, it’s hard to justify not providing them.* I discuss one of them in a new post on the AcademyHealth blog. Take a look!

    * It’s not impossible to justify not providing them. One way would be to show that some other use of funds yields a greater return (appropriately monetizing all effects, including those on health, well-being, and all externalities). In practice, this is a challenging exercise. Well, anyway, go read the post.


    • Excellent article, Dr. Frakt. As to why we don’t to this – as a society, we seem to prefer to blame substance abusers for their problems – e.g., they are weak, have no self-control, bring this upon themselves – rather than handle these issues as the medical problems that they are, and treat them appropriately.

      Sadly, there are many people in this country who would say that _they_ shouldn’t benefit from my tax money because _they_ are “bad people”.

    • With our fractured insurance system, it’s not clear that the benefits of treatment will accrue to those who bore the cost. If an addict gets cleaned up and gets a job with health insurance, Medicaid will have born the cost of his treatment, but he’ll go off their lists. Too many of these success stories and their average cost per patient will go up as they spend money treating people whose savings accrue to a different insurer. Further, once the patient is off Medicaid’s rolls, tracking their costs will be harder.

      This is, to me, the problem with the structure of our insurance industry. A huge cost savings for society or a patient can be a loser for an insurer.

    • You say

      “Yet, SUD treatment has been shown to be both effective for patients and cost saving for payers and wider society. ”

      I wouldn’t need any research tell me about the obvious cost savings but where is the research saying it is “effective for patients.” The conventional wisdom is that the drop out and recidivism rates are very high. Is that not the case?