Intended for healthcare professionals

Rapid response to:


Prevention of diabetes

BMJ 2006; 333 doi: (Published 12 October 2006) Cite this as: BMJ 2006;333:764

Rapid Response:

Cost of risk reduction

In addition to the clinical effectiveness of lifestyle interventions
vs drugs to prevent diabetes, Americans face another challenge--the ever-
present "cost to the public."

A recent analysis of the results of counseling vs drug use in the New
York Times, Oct 17, included the helpful observation by the medical
director of a healthcare consulting company that "if a large health plan
decided to offer [individualized counseling] for its members at risk for
diabetes, the plan's price for every member would rise by 1%."

Thus, the public is once again being made a pocketbook voter in the
choice of medical care. "Those people"--in this case, those at risk for
diabetes--will cost YOU money if they're counseled rather than simply take
their pill.

The question is not whether reducing health risks is a good idea--who
could disagree with that?--but rather, the use of financially driven
public pressure to make healthcare decisions.

Competing interests:
None declared

Competing interests: No competing interests

19 October 2006
Joan McClusky
medical writer
New York, NY 10003