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Tuesday, April 15, 2008

David Brown's story "In the Balance" [April 8], exploring how the cost of preventive care, contrary to public perception, often exceeds that of treating disease, prompted lots of reader response. Here is a sampling:

The story and the studies it cites seem to ignore some important considerations:

1. Death isn't the only endpoint. Morbidity comes earlier to patients who receive less preventive care. Sick patients cost a lot of money. Preventive care can delay illness even when it doesn't delay death. The costs related to early morbidity are enormous.

2. Real prevention begins with lifestyle change and early education. Any costs of lifestyle change are incurred by individual patients and not the government. Likewise, early education can be incorporated into existing curricula and will not cost the federal government much, if anything.

Charles diPierro, MD

Charlottesville

You use only one side of the economist's balance pan: Yes, to live longer, you cost society more. But you contribute more in exchange, by being with grandchildren, volunteering, spending down a pension into the economy, growing a garden, etc.

By the extension of your logic, you're saying, "First thing, let's kill all the retirees."

Norbert Hirschhorn, MD


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