Prevention is no panacea. If the country expects to keep people well by catching and treating disease early, better health won’t come cheap.

Stanford med school prof Abraham Verghese explains in a critique of Obama’s health plan in The Wall Street Journal. The gist: health reform won’t pay for itself.

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“Counting on the ‘savings’ that will come as a result of investing in preventive care and investing in the electronic medical record among other things,” he writes, is “a dangerous and probably an incorrect projection.”

Sure, losing weight and exercising more don’t cost much. But Verghese says screening, testing and treating patients early is expensive. “Prevention is a good thing to do,” he says, “but why equate it with saving money when it won’t?”

The bottom line, Verghese writes, is that fundamental reform and an expansion of coverage can’t happen without cutting costs. That means drug prices, doctors’ fees and hospital charges are all in line to get whacked.

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In the Columbia Journalism Review, Trudy Lieberman, president of AHCJ’s board of directors, interviewed Rutgers researcher Louise Russell about the potential for preventive care to curb health care costs. Russell (bio page) said that, in many cases, preventive care may actually add to overall health care costs because, for such care to be effective, it needs to be employed on a large scale.

Russell says studies that claim savings based on prevention are not only calculating medical expense, but also figuring in potential future earnings of those whose lives are saved by prevention. She also encourages a stronger focus on more cost-effective preventive measures, like flu shots, over more expensive options like annual pap smears.

In the final third of the interview, Russell specifically addresses reporting on preventive care and provides guidance and recommendations.