Myths We Love

Megan Scudellari’s, “Myths that will not die,” (Nature, Dec. 17, 2015 Vol. 528 pages 322-325) http://www.nature.com/news/the-science-myths-that-will-not-die-1.19022 focused on five myths: (1) screening saves lives for all types of cancer; (2) antioxidants are good and free radicals are bad; (3) humans have exceptionally large brains; (4) individuals learn best when taught in their preferred learning style; and, (5) the human population is growing exponentially.

Each statement had some initial evidence to support it but over time more research challenged the initial outcomes. What was compelling as I read the article was realizing that there were factors that seem to perpetuate if not strengthen a myth. These factors include a vocal community of supporters; the development of products, industries, and research lines to address or remedy the situation; and, attempts to discredit new research. As a result, myths like lies that are repeated, become accepted as truth. In the end the damage is done to all of us because rather than moving forward with science we are in a chokehold because of what others want us to believe.

As I look forward to 2016 and beyond, my hope is that as our knowledge grows we will use information wisely and change what we know and espouse. "Trust, but verify," should apply to much of what we do in health so that we can achieve the healthier and longer lives we all want.

Early Death Means Health Care Savings

While there is much agreement about the need for health care savings we also need to agree on how we define good health services and outcomes.  CBO Director Elmendorf’s comment below needs our careful consideration:

"Even if successful, measures to reduce smoking and obesity—two factors linked to the development of chronic and acute health problems—might not have a substantial impact on health care spending for some time.  In the long term, spending on diseases caused by poor health habits could decline substantially, but the impact on federal costs would also have to account for people living longer and receiving more in Medicare benefits (for the treatment of other diseases and age-related ailments) as well as other government benefits that are not directly related to health care (including Social Security benefits)."

--Douglas W. Elmendorf; Director, Congressional Budget Office 

   Testimony before the Senate Finance Committee

   February 25, 2009

Prevention Is Not About Saving Money; It’s About Saving Lives

There are so many discussions going on about health that it is hard to keep track of which policy would make the most impact. Too often it is a case of holding on to the old models that defined the business of health care. Just as business has learned that fundamental aspects of their models were flawed the best health policies change some of the fundamentals of the current health debate. A good place to start is to rethink the purpose of prevention.

Prevention may save money and it may not. Last month Health Affairs reported that “... hundreds of studies have shown that prevention usually adds to medical costs instead of reducing them.” As The Washington Post pointed out, when prevention works it extends life and there are the costs of using health care over those additional years of life. Also prevention requires reaching large population groups and that requires resources.

The additional costs of prevention is a matter of what we value. The benefits of breathing with ease from not smoking, not dying young from cancer through early detection, or not having a heart attack from starting to exercise are well worth the costs.

The cost savings through prevention is not what should make it worth doing but rather how it contributes to the vibrancy and productivity of our society. Prevention is important simply because it is the right thing to do.