Breaking a commonly-held myth:
Preventing obesity and smoking can save lives, but it doesn’t save money, researchers reported yesterday.It costs more to care for healthy people who live years longer, according to a Dutch study that counters the common perception that preventing obesity would save governments millions of dollars.
“It was a small surprise,” said Pieter van Baal, an economist at the Netherlands’ National Institute for Public Health and the Environment, who led the study. “But it also makes sense. If you live longer, then you cost the health system more.”
More effective would be limiting fruitless end-of-life care, but of course, this is less politically feasible.
Related posts:
- How the government is banking on prevention to save money
- My take: Heath Ledger, contracts, disease prevention
- CBO: Prevention does not save money
- Prevention doesn’t save money
- Discussing end-of-life care in the ICU and saving Medicare money
- My take: Sharing prescriptions, saving money, adherence programs
- Stop relying on "prevention" to save money
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Well, it’s not clear from the model but suspect they’re looking at healthcare costs only. Looking at the full social cost of obesity vs health would probably tell a very different story.
Alexa I disagree. I think there is no conceivable way that prevention could decrease health spending.
The reductio ad absurdum for this is to imagine the cheapest possible health system.
That would be “live until you die.”
There may indeed be an optimal level of spending such that morbidity and mortality are decreased to a theoretical minimum. But my guess is that optimal level is destined to remain only theory. In practice, any intervention will be costly but an intervention that prolongs life will inevitably be more costly as it increases the area under the “life with morbidity” curve.
Yes, but again, I’m distinguishing between “health spending” and “all spending.” When you “live until you die,” you may take up zero health dollars; you will also produce less dollars at your job because (1) it takes you longer to recover from illness, and then (2) you’re dead.
Your assumptions may be correct in a tight labor market, but they seem to fall apart if there is any significant unemployment.
The cheapest health system that I know of is the Russian system–takes the lowest percentage of GDP and that a pitiful GDP–with ever declining life expectancy.
Provide no care at all beyond vaccines and the lost productivity is a pittance compared to what is saved by shortened periods of disability and dependence and shorted retirements–a period of negative productivity.
The data is all there for anyone to look at if they care to. The problem is that the opposite has been proclaimed, with no basis in evidence, for so long that most people just take it for fact and are too lazy to think for themselves. We spend tremendous resources and structure whole areas of policy on false beliefs and are then surprised at the consistent failure to get the expected results.
Those who survived childhood in 1900 lived to an average age of about 70–past the retirement age, so really we are not doing much on the whole to keep people productive.
It is the sort of thing that is obvious when you actually look at the data but which no one has looked at the data.
Docs rant all the time about what smokers cost “the system”. I have known too many smokers to graciously die of CA shortly before collecting social security to buy that argument. We always talk about “lives saved” by this or that as if somehow, the final mortality rate had been reduced to something less than 100%.
It reminds me of the cost savings argument that the governor of Texas gave for mandating Giardiasil vaccine–when in fact it turned out that the cost of vaccinating every girl in Texas would cost ten times as much as is spent on treating cercival cancer there. It may save lives–or may not–but it will not save money. But the belief is so strongly rooted in our mindset that he didn’t even look at or ask for the numbers.
It isn’t the guy snarfing moon pies with nicotine stained fingers while he misses his doctor’s appointments to squeeze in another (heavily taxed) shift dragging down the system. It is the work out queens and health nuts who run to the doctor for everything, want to live forever, keep all their appointments and followups, and get every single recommended test and procedure.
The civic hero is the 100 pound overweight chain smoking businessman who croaks just before or after retirement giving the state a nice pile to loot in estate taxes. Grasshoppers live longer than ants.
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