My annual checkup uncovered that I was a raging type II diabetic with an A1c of 8.7 (higher is worse, 4-6 is normal). I changed my diet. Cost to my insurer over the last eleven years? ~$600.
My friend Leroy Nova didn't find out he had diabetes (no annual checkup) until he passed out on a BART (Bay Area Rapid Transport) platform. He spent a month in the hospital in a coma. At $10k/night (typical), it cost $300k.
Let's say an insurance company has 1M members, so if you screen everyone for diabetes each year, it 1M * $100 = $100M.
Or you don't screen everyone, but just pay the costs when they get so sick they are admitted. So it's 1M * 0.01% (diabetes that results in 30 days of hospitalization) * $300K = $30M
You just saved $70M by not screening everyone.
And it's not just private insurance companies that do this, government paid healthcare systems do too. It's just basic health economics. Of course, the goal is to include all costs, lost work, etc.
It's an entire field of study.
The thing is - when you look at how best to allocate healthcare dollars, what's great at a population level can suck at the individual level because you're just one patient out of millions.
My friend Leroy Nova didn't find out he had diabetes (no annual checkup) until he passed out on a BART (Bay Area Rapid Transport) platform. He spent a month in the hospital in a coma. At $10k/night (typical), it cost $300k.