Posted by
Catmman on Monday, August 10, 2009 6:03:53 PM
I've posted three times in the past three months about the problems with so-called 'preventative health' or what is more euphamistically referred to as '
Wellness' or '
Wellness Programs'.
Here,
here and
here.
The Fallacy of Preventative Health
Today,
the CBO confirms my previous point about such programs costing
more money,
not saving it. The basic gist of this revelation is that expanded utilization of a service will increase cost for it - the more people who partake of PH (preventative health) initiatives drives the need for more program resources, costing more money. Bolstering a point I brought up in one of my earlier posts, this analysis also points out that PH does work - for some individuals. Not everyone develops diseases which early screening might detect. Making everyone take a test to check cholesterol is ridiculous since not everyone has to worry about it. Unless you have a family history or some other predisposition, doing these types of tests for most people is a waste of money. Yet that is exactly the point of PH - give everyone an annual ""preventative health assessment", whether they need one or not.
I've sited my personal experience in the military with this very system. Everyone, regardless of history of current health is
REQUIRED to perform a PHA (preventative health assessment). It is even tracked for mobility purposes. Not having completed just the
assessment is cause for counseling and/or administrative action. You might think that this sounds like a good idea. Getting a checkup from a doctor every year would be a good thing, right? That's what I thought when they first started as well. What could be the harm?
"Preventative Health Assessment - a Tool of The Debil"
At first PHA's were pretty useful, at least they seemed to be. You had to see a doctor (or PA), had a health questionaire filled out, were asked some general "how are you feeling" questions, etc. If there was a need, some blood was drawn to check for cholesterol (you had to have an HIV test anyway) or other stuff. General vitals were taken and annotated. On average it took anywhere from 30-60 minutes. No big deal.
That was about 15 years ago or so. The process had to be changed. Why? Not enough doctors (or PA's) to do PHA's all the time. Basically the system got overloaded and became expensive. Entire sections of military clinics and hospitals were dedicated just to doing PHA's, not to mention the loss in man-hours for the troops who had to take off work for the appointment. It was a big expenditure of time and money. Anyway, the process had to be changed, streamlined. Jump forward to now.
PHA's are conducted utilizing computer based surveys, online. You still spend the same amount of time (depending on how you answer the questions) conducting the survey, but now you don't go to the doctor. You answer CBT questions. Unless you answer any of the questions improperly, that's it. You'll get some feedback (again, from a computer, based on your answers) about cutting back on smoking or needing to exercise a bit more, and that's it. If you are requiring immunizations or boosters, you'll get a reminder for that as well. If you answer questions relating you feel your health is poor, or otherwise feel bad, then you'll be prompted that you need to go see a doctor. You will also get a follow-up e-mail telling you to get an appointment (maybe they'll schedule one for you) to get checked out. If you have to go see a real doctor, then you'll go through more or less the same process you would have went through to begin with had you not had to bother with a computer survey.
The subjectiveness of the system makes is useless as well as pointless. You base your answers to the CBT questions on how you are feeling right then. If you feel fine, your answers will be correspondingly positive and vice-versa.
This process is somehow more efficient and cost effective (not withstanding all the money spent on the computer software and program maintenance, all done by civilian contractors btw.) than the way it used to be. Of course now the person in question may have to waste more time (time doing the CBT
and going to the doctor if necessary) but someone, somewhere feels like this is the way to go and by doing this somehow keeps the force "healthier". This process just illustrate the Air Force system. I have no real clue about the other service branches, but there is probably something similar in place.
Keep in mind, the Air Force couldn't make "preventative health" cost effective for a few hundred thousand active duty service members. How does the government expect to make PH cost effective or save money for 300,000,000+ American citizens?
The Trojan Horse
PH will also be the trojan horse for the government to control every aspect of your life. If you smoke, the government will know it. Not exercising enough? The government will know it. Not eating right? The government will know it. The government will set the standards of what constitutes "healthy living", not you.
If you are a smoker and develop lung cancer at some point in your life, sorry, you smoke - no chemotherapy for you. If you stopped smoking 30 years ago, and still develop lung cancer, what do you think the answer will be from a government suit when you try to get it treated? "Yes, you did
stop smoking, but since you
did smoke, and you smoked knowing the risks, sorry, no chemotherapy for you."
PH will be a way for the government to deny you any type of care it warrants, based on whatever standard of living it comes up with - all justified using a PH rubric. Once the government standard is in place, if you deviate from it, your done. Get the picture? By the government having the power to dictate what healthy living is, based on PH information (you will have access to in some form or fashion), you let the government effectively control every aspect of your life. In most respects, the trojan horse aspect of this is more sinister than the cost of PH being touted as savings.
When it comes to government health care, '
Wellness' is code for control.