But prevention of what?
1. Prostate cancer by PSA screening. (Whoops, early detection doesn't decrease mortality.)
2. Breast cancer by self-exam. (Whoops, ditto. Mammograms work, though.)
3. Colon cancer by colonoscopy. (Right-sided cancer might not be caught by colonoscopy.)
4. Pneumonia by vaccination. (Whoops, maybe not - except in high-risk groups.)
5. Heart disease in women by estrogen replacement therapy. (We know how that turned out.)
6. Cancer by vitamin ingestion. (Whoops again.)
So not only is prevention very unlikely to save significant healthcare money, but we have to make sure we're actually preventing what we set out to prevent.
These are not the best examples. Influenza vaccine prevents about 20,000 deaths per year, obesity intervention prevents millions of new incidence of diabetes, HTN, heart disease. Environmental pollution regulation prevents the development and exacerbation of many diseases like asthma, lung cancer, stroke, heart attacks. In the US the Clean Air Act is a case in point. It all depends on how narrow you construct your definition of prevention.
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