Extract A: The economics of preventative health screenings

Why do we fund preventative cardiovascular health screenings? For early detection of undiagnosed heart conditions and therefore reducing sudden cardiac deaths? Or is there insufficient evidence that they yield such substantial positive externalities?

The cost of administering a comprehensive cardiovascular screening is estimated to be around £150 per person, alongside the administrative expenses of managing patient records and follow-up consultations.

Advocates of preventative screenings argue that any reduction in premature mortality easily justifies these costs. Furthermore, they assert that screenings save lives of individuals who may otherwise be unaware of underlying health issues. Viewed in this light, many health economists believe that a preventative health screening is a merit good.

The National Heart Health Alliance (NHHA) claims that early intervention following screening reduces the incidence of critical cardiac events by 22%. The external cost generated by sudden cardiac events is vast, reaching upwards of £310 000 for each emergency hospitalisation and subsequent long-term intensive care. This total accounts for emergency ambulance services, surgical interventions, lost economic productivity, and ongoing social care.

However, some medical organisations dispute the net benefits. They argue that widespread screenings can lead to high rates of false positives, causing unnecessary anxiety and leading patients to undergo invasive diagnostic procedures they do not need. They argue that public funding for these screenings represents a government failure, redirecting scarce resources away from general acute care. Under a purely market-based system, however, these services would be severely underprovided.