Preventative Treatment Not Always a Wise Investment

I often hear proponents of increasing health care spending arguing for more preventative care. "More diabetes tests, mammograms, PSA tests, gene testing, blood work ups" they demand. More power to them. Mammograms save lives. PSA tests can find prostate cancers early when survival rates are north of 90%. I like preventative treatments. However, those calling for them often parrot the same refrain: prevention saves the health care system money. This statement seems logical, it seems reasonable. It is also, unfortunately, not true. In many cases, preventative care ends up costing the health care system more than the illnesses they prevent would have cost. I dug up an old Charles Krauthammer article that I read a while back, and he explained it well: "Think of it this way. Assume that a screening test for disease X costs $500 and finding it early averts $10,000 of costly treatment at a later stage. Are you saving money? Well, if one in 10 of those who are screened tests positive, society is saving $5,000. But if only one in 100 would get that disease, society is shelling out $40,000 more than it would without the preventive care." Since you have to provide preventative care to everyone, even those who may have never gotten the disease in the end anyways, the preventative care will often drain more out of tight health care budgets than it saves. Why am I writing about this now? Last week, the Cancer Advocacy Coalition of Canada released a report calling for many health care innovations, including cutting-edge genetic testing for cancer. These gene tests, or 21-gene assays, can determine whether particular breast cancers will benefit from radiation treatment. Apparently, roughly 25% of breast cancers will not respond positively to radiation treatment, meaning it is essentially useless. Interesting stuff. The group goes on to argue, and the media reports, that Canada should have more access to these $4000 tests. By telling us which 1 out of every 4 breast cancers won't benefit from the $15,000 radiation treatment, these tests will save the health care system money. Got that? If we test all breast cancers at $4000 a pop, we will find out which 1 out of every 4can forgo the expensive $15,000 radiation treatment, thus savings our health care system a bundle. Let's run that math down one more time:
$4000 tests x 4 = $16,000
1 x $15,000 radiation treatment avoided for every 4 tests = $15,000
In the end, doesn't this particular preventative procedure actually cost the health care system $1000 more for every 4 breast cancers?
Now, albeit, this is a rather cold method of determining appropriate care. You could argue, and I would strongly agree, that the $1000 is money well spent for sparing women the agony of radiation treatment that's not going to do any good. Any innovation that can help in the fight against cancer is a welcome one, even if it costs more. However, I'd just rather here our leaders simply say that, instead of masquerading behind disingenuous arguments about "savings."