President Obama touts ‘free’ checkups -- but who is paying the bill?

President Obama has shifted back into the offensive on the Affordable Care Act, with 40 of his 73 posts this month on Twitter focusing on healthcare. And on Tuesday, he touted another aspect of government healthcare, telling his 40 million followers:

Of course, no healthcare services are actually “free” even if they do not require a direct co-payment from the patient. A recent study from the University of Pittsburgh School of Medicine estimated that healthy Americans spend about $8 billion on annual checkups. And once the ACA if fully implemented, an estimated 30 million previously uninsured Americans will now be eligible for annual checkups. The University of Pittsburgh study estimated that 44.4 million people voluntarily go in for annual checkups. So, technically, costs could nearly double in coming years.

Even in conservative estimates, that means billions in costs will now be shifted to insurance providers who are all but certain to pass along those costs right back to consumers in the form of higher premiums.

Plus, there are some experts who claim that routine doctor visits will be far from “free” depending on the annual deductible included in one’s plan. And then there are routine co-payments and laboratory blood work fees that vary depending on someone’s individual plan.

Still, the counterpoint to all of this is that routine annual checkups are cost-effective because preventive medicine helps cut down on future health costs. But most doctors say that not everyone needs a physical every year. And a recent New York Times report finds that “arguments against the annual physical for all adults have been fueled by a growing number of studies that failed to find a medical benefit.”

The Times points to a recent Danish study which found no discernable benefit over time for those who received annual checkups versus those who did not.

The Washington Post ran a similar story earlier this year, in which two Colorado doctors said that annual checkups are “pretty much useless.”

"General health checks do not improve important outcomes and are unlikely to ever do so based on the pooled results of this meta-analysis spanning decades of experience," authors Allan Prochazka and Tanner Caverly wrote in their study. "There remains a belief in the value of general health checks despite the accumulating evidence. This belief is buoyed by screening advocacy groups and insurance coverage, and they have ramifications for patient welfare and health care costs."

So, who should get annual physical exams? Most doctors agree people over 50 and anyone who has experienced prolonged pain or similar symptoms. But for everyone else, an over reliance on doctor visits may not amount to much more than needlessly handing over money to insurance companies.

And regardless of whether or not you need that annual checkup, someone is picking up the bill.