More adventures in tweeting from Senator John McCain (R-AZ) who tells us: “It’s not the quality of health care it’s the cost – wellness and fitness!” Like Ezra Klein I don’t really understand what that means.
One possible reconstruction is that McCain is saying that our problem is that health care costs are too high because of insufficient attention to wellness and fitness. This is, I think, a bit of a misunderstanding. It’s true that investments in wellness and fitness would be highly cost effective ways of improving public health. But it’s in the nature of the human species that even very healthy people eventually get sick and die. Consequently, it’s often far from clear whether or not healthier behavior reduces health care costs in the long run. Dying of lung cancer at 57 could be cheaper than developing Alzheimer’s and living to 97. Which isn’t to downplay the importance of “wellness and fitness”—these can do a lot to improve quality of life. But they’re more-or-less separable from the issues of who gets health insurance, what does it cover, what does it cost, and how efficiently are health care services directed.