Does Healthiness Reduce Health Care Costs

I agree with the main thrust of what Pema Levy’s saying about Jan Brewer’s draconian Medicaid cuts, but I think people need to be cautious about this kind of subsidiary claim: “The more you invest in education, exercise, and affordable food programs, the less Medicaid – and health care in general – costs in the long-term.”

It’s pretty hard to say how true that is. Developing diabetes and needing treatment for decades is, indeed, much more expensive than alternatives that involve healthier lifestyles. But on the other hand, dying of a heart attack at age 67 is probably going to be cheaper over the long term than scenarios that involve living to 98. Everyone dies, and almost everyone gets sick before they die. The reliable way to reduce health expenditures is to die suddenly, without obtaining any medical treatment, like by getting shot.

I think the right point to make is that “health care costs” aren’t a bad thing, living with poor health is a bad thing. The problem with our current system is that it rather arbitrarily settles on heavy subsidies for health-promotion activities that qualify as “health care” and no subsidies for other health-promoting activities that don’t qualify as health care. But we know that health care—medical treatments provided by doctors—isn’t a particularly cost effective means of promoting good health.